Exclude seborrhoeic keratosis

While lesions may ‘break the pattern’, there are clues to distinguish the benign from the suspicious.

A 75-year-old woman presented to her general practitioner for a skin examination. Two lesions were noticed on her back (Figure 2).

Both lesions ‘broke the pattern’. The one on the left had a rough surface while the one on the right looked and felt smooth.

Lesion 1

Close examination of the lesion on the left revealed a scaly surface and palpable surface keratin filled invaginations (crypts) with dermatoscopy revealing multiple white and orange clods and a sharply demarcated border over the