Abstract
BackgroundEruptive seborrheic keratoses (ESK) is a benign skin condition that has been associated with malignant and nonmalignant diseases. We conducted a systematic review of reported cases of ESK to identify and summarize associated comorbidities.MethodsMEDLINE and Embase were searched from database inception (1946) to July 31, 2020 for original articles describing ESK with or without a co-occurring condition. Subject demographics, as well as details of ESK and associated diagnoses were extracted from 76 articles (70 case reports, 3 case series, 3 case control studies) representing 92 patients.ResultsIn total, 76.1% (n = 70/92) of patients with ESK had a co-occurring malignancy, 4.3% (n = 4/92) presented with a nonmalignant condition, 9.8% (n = 9/92) experienced ESK as an adverse drug reaction, and 9.8% (n = 9/92) did not report any underlying medical condition. ESK preceded a cancer diagnosis in 76.1% (n = 70/92) of patients with a mean latency period of 4.0 months (range: 0.25-9 months). The most common malignancies associated with ESK were cutaneous T-cell lymphoma (n = 10/70, 14.3%) and gastrointestinal adenocarcinoma (n = 9/70, 12.9%). ESK preceded nonmalignant conditions or no disease in 14.1% (n = 13/92) of patients with a mean latency period of 3.1 months (range: 0.75-6 months). Drug-induced ESK occurred in 9.8% (n = 9/92) of patients with a mean latency period of 7.1 weeks after changing medication.ConclusionAlthough the role of ESK as a paraneoplastic cutaneous marker is debated, healthcare providers should consider screening for underlying malignancy in patients presenting with ESK. Larger studies are needed to confirm its role as a marker for disease.
Highlights
Eruptive seborrheic keratoses (ESK) is a rare dermatological disorder characterized by the rapid appearance of several benign pigmented skin lesions
Our data found that 76.1% (n = 70/92) of reported cases occurred in patients that were subsequently diagnosed with a malignancy
In accordance with previous literature, we found that ESK was most commonly associated with cutaneous T-cell lymphoma and gastric adenocarcinoma.[8]
Summary
Eruptive seborrheic keratoses (ESK) is a rare dermatological disorder characterized by the rapid appearance of several benign pigmented skin lesions. ESK presents as well- demarcated round or oval lesions with a verrucous surface It is diagnosed clinically in rare cases, a biopsy can be used to differentiate ESK from other benign and malignant lesions.[1,2] Histopathologic examination shows proliferation of keratinocytes with keratin-filled cysts.[3] Treatment is not required but can be considered if the lesions are symptomatic or for cosmetic reasons. Eruptive seborrheic keratoses (ESK) is a benign skin condition that has been associated with malignant and nonmalignant diseases. ESK preceded a cancer diagnosis in 76.1% (n = 70/92) of patients with a mean latency period of 4.0 months (range: 0.25-9 months). ESK preceded nonmalignant conditions or no disease in 14.1% (n = 13/92) of patients with a mean latency period of 3.1 months (range: 0.75-6 months). Larger studies are needed to confirm its role as a marker for disease
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