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Dermatopathology: Practical & Conceptual January - March 2010
7. New Quandary: Superficial epithelioma with sebaceous differentiation?
Muna Shuweiter, M.D.
Almut Böer, M.D.
Superficial epithelioma with sebaceous differentiation is a diagnosis made rarely and it is controversial whether it actually represents a distinctive neoplasm. Especially unclear is the relationship to reticulated acanthoma with sebaceous differentiation and to seborrheic keratosis with sebaceous differentiation.
Articles available on the subject are reviewed and findings pictured in photomicrographs are compared.
More than one type of lesion has been designated with the term "superficial epithelioma with sebaceous differentiation." In most of the lesions published under the designations "superficial epithelioma with sebaceous differentiation" and "reticulated acanthoma with sebaceous differentiation," a diagnosis of seborrheic keratosis with sebaceous differentiation cannot be excluded based on all criteria given in the literature. Moreover, many of the lesions are shave specimens and the connective tissue below the lesion cannot be seen. Some examples of sebaceous induction above dermatofibromas have a reticulated and plate-like arrangement of epithelial structures with sebaceous differentiation and show similarities to reticulated acanthoma with sebaceous differentiation.
The evidence that either superficial epithelioma with sebaceous differentiation or reticulated acanthoma with sebaceous differentiation refer to a distinctive neoplasm is not compelling. Many of the lesions fulfill criteria for seborrheic keratosis with sebaceous differentiation and some may represent an induction phenomenon.
Dr. Shuweiter is a dermatologist at Salmanya Medical Center in Bahrain. She worked on this project during her dermatopathology fellowship at the Dermatologikum Hamburg, Germany, where Dr. Böer is dermatopathologist. This article was reviewed by Masoud Asgari, M.D., and Francois Milette, M.D.Contact corresponding author via email:
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