title: Squamous cell carcinomas in situ arising in seborrheic keratoses: an association with concomitant immunosuppression?
abstract: BACKGROUND
  Seborrheic keratoses (SK) are the most common cutaneous neoplasm in humans. Given their numbers, a squamous cell carcinoma in situ (SCCIS) arising from an SK would not be unexpected, although this occurrence has not been widely reported.
  
  
  OBJECTIVE
  This study compares the immune status of patients with a SCCIS arising contiguously from SK (SK/SCCIS) and the number of daily medications taken by these patients. The biopsy tissue was evaluated for the presence of human papillomavirus DNA.
  
  
  METHODS
  Over a 5-year period at our institution, 13 cases of SK/SCCIS were diagnosed. For each case, age- and sex-matched control patients with a histologically diagnosed unremarkable SK were randomly selected. The number of patients taking immunosuppressing medications was determined from each group and compared statistically. In addition, polymerase chain reaction analysis of the 13 SK/SCCIS biopsies was performed.
  
  
  RESULTS
  Five of the 13 study patients took immunosuppressive medications compared to none of the 39 control patients (P = 0.0005). None of the biopsies demonstrated the presence of human papillomavirus DNA by polymerase chain reaction.
  
  
  CONCLUSIONS
  Immunocompromised patients with SKs appear to carry a greater risk of these otherwise innocuous lesions developing an SCCIS, although given the small number of patients evaluated, further research into this possible association is warranted.
authors.affiliation: Department of Medicine (Dermatology), Vanderbilt University, Nashville, TN, USA; Department of Pathology, Vanderbilt University, Nashville, TN, USA.
authors.forename: Alan S
authors.initials: AS
authors.lastname: Boyd
authors.forename: Pei F
authors.initials: PF
authors.lastname: Su
authors.forename: Yu
authors.initials: Y
authors.lastname: Shyr
authors.forename: Yi W
authors.initials: YW
authors.lastname: Tang
mesh_terms: D000368:Aged; D002278:Carcinoma in Situ / Q000150:complications / Q000276:immunology* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000276:immunology* / Q000473:pathology; D016022:Case-Control Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D017492:Keratosis, Seborrheic / Q000150:complications / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D012878:Skin Neoplasms / Q000150:complications / Q000276:immunology* / Q000473:pathology
chemical_list: D004279:DNA, Viral; D007166:Immunosuppressive Agents