Chapter

Benign tumors and cysts of the epidermis

Irritated seborrheic keratosis is characterized by

the formation of squamous eddies within the
epidermis and the presence of spindled keratinocytes. Some areas of the tumor typically still produce a loose lamellar shredded-wheat pattern
of keratin, and horn cysts composed of loose
lamellar keratin are often present. In areas, the
keratin becomes compact, eosinophilic, and parakeratotic. A zone of loose lamellar keratin may
be seen above the dense eosinophilic keratin. This
was produced before the lesion became irritated.
It has since been pushed upward.
a

b
a

Figure 2-18 Irritated seborrheic keratosis with prominent

spindling of keratinocytes

Inflamed seborrheic keratosis

Key features
Lymphocytes and spongiosis
In areas, the stratum corneum becomes

compact, eosinophilic, and parakeratotic

Loose lamellar keratin is commonly retained in

other areas

Horn cysts are common

Lichenoid interface dermatitis may be present
An overlying crust may be present
b

c
Figure 2-17 Irritated seborrheic keratosis with prominent
squamous eddies

Figure 2-19 Inflamed seborrheic keratosis with

lymphocytes and spongiosis

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