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Background: Granular Cell Tumors (GCTs), also known as Abrikossoff tumors, are rare neoplasms that typically originate from Schwann cells. These tumors most commonly occur in the head and neck region, particularly the tongue. While GCTs are generally benign, less than 2% of cases exhibit aggressive biological features such as rapid growth, high recurrence rates, and metastasis. In this report, we present a rare case of a Malignant Granular Cell Tumor (MGCT) of the chest wall, which posed significant challenges in both characterization and management. Case Presentation: A fifty-year-old man underwent an ultrasound examination for a nodular mass on his right chest wall. The ultrasound revealed a firm, hard mass measuring 2 cm x 2 cm with an uncertain diagnosis. A fine-needle aspiration biopsy (FNAB) guided by ultrasound was performed, resulting in a diagnosis of Abrikossoff tumor. The patient subsequently underwent radical excision of the mass, which confirmed the initial diagnosis. Nine months after surgery, a newmass with similar characteristics was detected during a physical examination. The patient underwent a second surgery, but this time the histopathological examination was negative for neoplastic cells. However, another mass appeared at the same site as the previous surgical excision. A CT scan and MRI of the right chest wall confirmed the presence of a 2 cmx 2 cmnodular mass. The patient then underwent a deeper excision. Histomorphological and immunohistochemical assessments confirmed the recurrence of MGCT. Conclusion: This case highlights the malignant potential of GCTs. The numerous local recurrences necessitated three surgeries and additional procedures. The aggressive nature of this pathology underscores the complexity of managing these tumors, which are poorly understood and lack proven post-operative strategies for controlling local and distant disease. [ABSTRACT FROM AUTHOR]

This study addresses the critical challenge of accurately identifying skin disorders as benign, malignant, or non-tumors, essential for timely and successful treatment. Early identification can greatly minimize tumor development and cut fatality rates. Given the high costs involved with standard medical detection approaches, this research addresses using sophisticated Convolutional Neural Networks (CNNs) with transfer learning to categorize skin malignancies efficiently. Specifically, the study assesses the performance of MobileNetV2, VGG16, and VGG19 architectures. The primary objective is to find which model has the maximum accuracy in classifying skin cancers. Our findings reveal that while a standard CNN reached an accuracy of 62.2%, the transfer learning models greatly outperformed it, with MobileNetV2 achieving the highest accuracy at 93.9%, followed by VGG19 at 90.0% and VGG16 at 88.9%. These results imply that MobileNetV2 is the most successful solution for this task since it consistently obtained a prediction accuracy of 90% for both in-dataset and out-of-dataset images. [ABSTRACT FROM AUTHOR]

Background: Basal Cell Carcinoma (BCC) is the most common type of skin carcinoma and is considered an epidemic disease due to its increasing frequency in many countries. The most important problem of BCC is local invasion It grows in a "silent" way into immediately adjacent tissue. It rarely metastasizes. The early tumors are commonly small, translucent or pearly, raised and rounded areas located on a few dilated, superficial vessels. There are six subtypes of BCC that include nodular, pigmented, superficial, morphea form, cystic. The most important risk factor for basal cell carcinoma is exposure to UV-radiation. Outdoor workers with a long history of workrelated UV-exposure are at increased risk of developing BCC. Other risk factors include family history of skin carcinoma, light skin phototypes, advanced age. Objective: The current study investigated pathological and histological changes in tissue sections to identify the factors contributing to the infection frequency. Patients and Methods: Thirty-three BCC patients' samples have been collected from the main care center at al-Baquba Teaching Hospital of Diyala Province, Iraq. All patient groups were clinically diagnosed as BCC by dermatologists. Results: The study showed macroscopic and microscopic histological changes. An ulcerated macroscopic appearance of the lesion was shown. The tumor lesions are located on the face. It was noted that the percentage of patients was higher in men than women and higher in light skin than dark skin. The study also showed that the age group 66-74 years had a higher infection percentage, while the lower percentage was of the age group > 83 years. Conclusion: These findings pave the way for future research endeavors aimed at prevention, early detection, and targeted treatment strategies for this prevalent skin carcinoma. [ABSTRACT FROM AUTHOR]

Simple Summary: Outgrowth of skin tumors in cancer patients who receive therapies with BRAF inhibitors is frequently observed as an undesired side effect. Infection with certain human papillomaviruses may play a role in BRAF-inhibitor-associated skin tumor development. In this study, the impact of BRAF inhibitors and Ultraviolet B (UVB) light on tumor growth was investigated in laboratory mice after infection of their skin with a murine papillomavirus. We could show that the combination of BRAF inhibitor treatment and UVB exposure resulted in higher numbers of virus-induced tumors compared with virus-infected mice that had received only BRAF inhibitors, only UVB irradiation or no additional treatment. This shows that BRAF inhibitors, particularly when combined with UVB light, support skin tumor growth in mice and may represent a novel way by which BRAF inhibitors contribute to skin cancer development. The development of keratinocytic skin tumors, presumably attributable to paradoxical activation of the MAPK pathway, represents a relevant side effect of targeted therapies with BRAF inhibitors (BRAFis). The role of cutaneous papillomavirus infection in BRAFi-associated skin carcinogenesis, however, is still inconclusive. Employing the Mus musculus papillomavirus 1 (MmuPV1) skin infection model, the impact of BRAFis and UVB exposure on papillomavirus induced skin tumorigenesis was investigated in immunocompetent FVB/NCrl mice. Systemic BRAF inhibition in combination with UVB light induced skin tumors in 62% of the MmuPV1-infected animals. In contrast, significantly fewer tumors were observed in the absence of either BRAF inhibition, UVB irradiation or virus infection, as demonstrated by lesional outgrowth in 20%, 5% and 0% of the mice, respectively. Combinatory exposure to BRAFis and UVB favored productive viral infection, which was shown by high numbers of MmuPV1 genome copies and E1^E4 spliced transcripts and an abundance of E6/E7 oncogene mRNA and viral capsid proteins. BRAF inhibition, but not viral infection or UVB light, activated ERK1/2, whereas γH2AX expression, inducible by UVB light, remained unaltered by BRAFis. These results provide experimental evidence that BRAF inhibition and UVB irradiation synergistically promote MmuPV1-induced skin tumor development in vivo. This indicates an alternative pathway by which papillomavirus skin infection may contribute to BRAFi-associated skin tumorigenesis. [ABSTRACT FROM AUTHOR]

GCA, also known as Buschke-Lowenstein tumor, is a rare sexually transmitted disease associated with HPV types 6 and 111. These warts are considered histologically benign, but there is a risk of localized invasion and development of malignancy. This malignant transformation occurs most often in the perianal and vulvar areas, and involvement of other sites is relatively rare2. In this case, we report a rare case of a giant wart originating from breast skin infected with HPV and progressing to cutaneous squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Perivascular epithelioid cell tumors (PEComas) are mesenchymal tumors that exhibit characteristic epithelioid or spindle cell morphology and typically grow around blood vessels. These tumors are characterized by the expression of melanocytic and smooth muscle markers, such as HMB-45, Melan-A, and smooth muscle actin, indicating a dual differentiation phenotype. PEComas are extremely rare diseases, and patients typically have a very poor prognosis. Here, we report a case of malignant cutaneous PEComa with pulmonary metastasis in a Chinese female and review relevant literature. The patient underwent surgical resection of a soft tissue tumor in the left upper arm under general anesthesia, and the subsequent pathological findings suggested a tumor with perivascular epithelioid cell differentiation (PEComa). The patient received adjuvant chemotherapy and radiotherapy after surgical resection, along with monitoring through computed tomography (CT) scans. Three months later, pulmonary metastasis was detected, but both the cutaneous PEComa in the left upper limb and the pulmonary metastatic lesions were stably controlled under active management and treatment. This is a rare case worth reporting and studying, and therefore, we conducted a long-term follow-up, and we hope to provide help for the clinical treatment of PEComa. [ABSTRACT FROM AUTHOR]

Background: Skin neoplasms, particularly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are prevalent forms of skin malignancies. To enhance accurate diagnosis, non‐invasive techniques including high‐frequency ultrasound (HFUS) are crucial. HFUS offers deeper penetration compared to reflectance confocal microscopy (RCM), and optical coherence tomography (OCT), making it valuable for examining skin structures. The aim of this study was to investigate and diagnose localized manifestation of BCC and SCC with HFUS and compare it with pathology results in patients referred to Razi Hospital, Tehran, Iran. Method and materials: This study included patients diagnosed with BCC and SCC, with clinical and pathological confirmation, attending the oncology clinic of Razi Hospital, Tehran, Iran, from 2022 to 2023. Exclusion criteria comprised metastatic and recurrent cases, patients who underwent treatment or surgery, and tumors located in anatomically challenging areas. HFUS with a 20 MHz probe and Doppler ultrasound were employed to examine the skin. Tumors were subsequently excised, fixed in formalin, and sent for pathological assessment. Ultrasound findings were compared with pathology results. Results: The study assessed 40 patients, with half diagnosed with SCC and the other half with BCC. The majority of SCC patients were male (80%), while BCC patients were relatively evenly divided between males (65%) and females (35%). The mean age was 59.15 ± 11.9 years for SCC and 63.4 ± 8.9 years for BCC. Cheeks (20%) and lips (35%) were the most common sampling sites for BCC and SCC, respectively. The correlation coefficients for tumor size and depth between ultrasound and pathology were 0.981 and 0.912, respectively, indicating a high level of agreement between the two methods. Conclusion: In BCC patients, there was complete agreement between sonographic loco‐regional extension and pathology findings. However, some discordance (30%) was observed in SCC cases. The study demonstrated a strong correlation between ultrasound and pathology in accurately detecting the depth and extent of the tumor. However, due to the inclusion of only patients with positive pathology, it is not appropriate to evaluate the diagnostic test values and compare them with pathology results. Therefore, it is highly recommended to carry out additional studies with larger sample sizes to further validate these findings. [ABSTRACT FROM AUTHOR]

Background: Basal Cell Carcinoma (BCC) is the most common type of skin carcinoma and is considered an epidemic disease due to its increasing frequency in many countries. The most important problem of BCC is local invasion It grows in a “silent” way into immediately adjacent tissue. It rarely metastasizes. The early tumors are commonly small, translucent or pearly, raised and rounded areas located on a few dilated, superficial vessels. There are six subtypes of BCC that include nodular, pigmented, superficial, morphea form, cystic. The most important risk factor for basal cell carcinoma is exposure to UV-radiation. Outdoor workers with a long history of work-related UV-exposure are at increased risk of developing BCC. Other risk factors include family history of skin carcinoma, light skin phototypes, advanced age. Objective: The current study investigated pathological and histological changes in tissue sections to identify the factors contributing to the infection frequency. Patients and Methods: Thirty-three BCC patients' samples have been collected from the main care center at al-Baquba Teaching Hospital of Diyala Province, Iraq. All patient groups were clinically diagnosed as BCC by dermatologists. Results: The study showed macroscopic and microscopic histological changes. An ulcerated macroscopic appearance of the lesion was shown. The tumor lesions are located on the face. It was noted that the percentage of patients was higher in men than women and higher in light skin than dark skin. The study also showed that the age group 66-74 years had a higher infection percentage, while the lower percentage was of the age group > 83 years. Conclusion: These findings pave the way for future research endeavors aimed at prevention, early detection, and targeted treatment strategies for this prevalent skin carcinoma.

BACKGROUND: Basal cell carcinoma is a skin tumor that arises from neoplastic transformation of the basal cells of the epidermis. Its prevalence varies according to the anatomical site and is frequently distributed in photoexposed areas, while those arising in non-sun-exposed areas are very rare. Basal cell carcinomas of the vulvar area are extremely rare, they account for about 0.05% of all skin basal cell carcinomas. Its etiology is not completely known. The clinical appearance may be that of a nodule, polyp, ulcer or hyper- or hypopigmented area. In most cases it presents asymptomatically, which delays diagnosis and timely treatment. CLINICAL CASE: A 58-year-old female patient, with high blood pressure in control, who presented a nodular neoformation, located in the genital region, in the right labia majora, asymptomatic, 1 cm in diameter, blackish color, defined edges, ulcerated surface and no underlying lymphadenopathy. The excisional biopsy reported findings compatible with solid pigmented basal cell carcinoma. CONCLUSIONS: Basal cell carcinoma has a varied and imprecise clinical presentation, which hinders an early diagnosis and approach due to the multiple differential diagnoses that it has, thus, the histopathological analysis of the lesion is the cornerstone for its diagnosis and surgical excision with clean margins of the tissue is the treatment of choice. In general, it has a good prognosis. [ABSTRACT FROM AUTHOR]

Squamous cell carcinoma is the second most common skin cancer case. The incident increase 2-4% every year. Squamous cell carcinoma has a predilection on sun-exposed areas with red scaly plaque appearance. Dermatofibroma is a benign tumor that can appear in all parts of the body especially on extremities. The etiology of dermatofibromas still unknown, but suspected due to punctures or trauma. A male patient, 71 years old with sole mass on left thigh suspected of dermatofibroma with a differential diagnosis of SCC. Preoperative laboratory examinations by FNAB found dermatofibroma results and postoperative histopathological examination result found SCC. Small sampling and inaccurate areas, especially in SCC with poorly differentiated histology, can confound histopathological results. Excision biopsy preferred because the wide sample is needed. All skin tumors with large sizes, either in exposed UV areas or not, FNAB examination is not prefered, excision biopsy advisable to avoid misdiagnosis. [ABSTRACT FROM AUTHOR]

Primary cutaneous SMARCA4‐deficient undifferentiated malignant neoplasm (SD‐UMN) is a rare and recently described entity characterized by the loss of expression of the SMARCA4 (BRG1) protein, which is involved in chromatin remodeling. SD‐UMN presents a diagnostic challenge due to its rarity and unique histopathological and immunohistochemical features. In this report, we present a case of primary cutaneous SD‐UMN in a 67‐year‐old man who presented with a rapidly growing, ulcerated, and bleeding nodule on his right cheek. Histopathological examination revealed a highly cellular dermal tumor consisting of pleomorphic epithelioid cells with prominent mitotic figures and necrosis, lacking any morphological evidence of differentiation. Immunohistochemical analysis showed a complete loss of SMARCA4 and SMARCA2 expression, while INI‐1 expression remained intact. p53 was diffusely expressed, and p16 was completely absent. In addition, a range of markers, including high‐molecular‐weight cytokeratin, p63, SOX10, INSM1, MCPyV, NKX2.2, CD99, CDX2, CD56, ERG, NUT, desmin, androgen receptor, chromogranin, CD34, and CD43 were all negative. To date, only two cases of primary cutaneous SMARCA4‐deficient undifferentiated tumors have been reported in the literature. Therefore, this case report adds to the limited body of knowledge on the clinical and histopathological features of this novel entity. The report highlights the importance of considering SD‐UMN in the differential diagnosis of undifferentiated cutaneous tumors. [ABSTRACT FROM AUTHOR]

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BackgroundGranular Cell Tumors (GCTs), also known as Abrikossoff tumors, are rare neoplasms that typically originate from Schwann cells. These tumors most commonly occur in the head and neck region, particularly the tongue. While GCTs are generally benign, less than 2% of cases exhibit aggressive biological features such as rapid growth, high recurrence rates, and metastasis. In this report, we present a rare case of a Malignant Granular Cell Tumor (MGCT) of the chest wall, which posed significant challenges in both characterization and management.Case PresentationA fifty-year-old man underwent an ultrasound examination for a nodular mass on his right chest wall. The ultrasound revealed a firm, hard mass measuring 2 cm x 2 cm with an uncertain diagnosis. A fine-needle aspiration biopsy (FNAB) guided by ultrasound was performed, resulting in a diagnosis of Abrikossoff tumor. The patient subsequently underwent radical excision of the mass, which confirmed the initial diagnosis. Nine months after surgery, a new mass with similar characteristics was detected during a physical examination. The patient underwent a second surgery, but this time the histopathological examination was negative for neoplastic cells. However, another mass appeared at the same site as the previous surgical excision. A CT scan and MRI of the right chest wall confirmed the presence of a 2 cm x 2 cm nodular mass. The patient then underwent a deeper excision. Histomorphological and immunohistochemical assessments confirmed the recurrence of MGCT.ConclusionThis case highlights the malignant potential of GCTs. The numerous local recurrences necessitated three surgeries and additional procedures. The aggressive nature of this pathology underscores the complexity of managing these tumors, which are poorly understood and lack proven post-operative strategies for controlling local and distant disease.

Background: Although several studies have investigated the accuracy of clinical diagnoses of skin tumors, specific ways to improve diagnostic accuracy have not been identified. This study investigated factors that influence the accuracy of clinical skin tumor diagnostic methods and discusses strategies to improve accuracy. Methods: Study 1 retrospectively analyzed 657 skin tumors excised at our hospital between March 2001 and March 2011. Data were extracted from surgical records to establish a diagnostic template for further research. Study 2 prospectively applied this template to aid clinical diagnosis at four facilities between April 2011 and March 2013. The clinical diagnoses were compared with the histological ones and the concordance was determined. Results: A total of 448 and 209 benign and malignant tumors, respectively, were included in Study 1. The overall diagnostic accuracy was 79.0%. In Study 2, 310 patients were clinically diagnosed using a standardized template, which did not affect the diagnostic accuracy. Age, sex, duration of disease, tumor size and location, skin tone, mobility, stiffness, and years of diagnostic experience did not significantly affect diagnostic accuracy. A high proportion of pathologically malignant tumors were clinically misdiagnosed as benign (16/22; 72%). Other clinical examinations were performed in only 35 cases. Conclusions: Auxiliary diagnostic tools such as dermoscopy and biopsies should be used to accurately diagnose malignant tumors.

The article discusses the use of line-field confocal optical coherence tomography (LC-OCT) as a noninvasive imaging device for diagnosing and differentiating between cutaneous mastocytoma (CM) and juvenile xanthogranuloma (JXG), which are benign skin tumors in children. LC-OCT can help avoid unnecessary skin biopsies, especially in aesthetically sensitive areas. The article presents three cases of CM and three cases of JXG that were evaluated using LC-OCT, highlighting the key features of each disease. The authors recommend acquiring 3D images in patients over 20 months of age and capturing numerous 2D images in younger children to confirm the presence or absence of specific structures. [Extracted from the article]

Distinct solitary dermal nodules, either covered by an alopecic, or sometimes ulcerated, epidermis, were noticed on the head of a stillborn Holstein calf. The head was submitted for autopsy, and the nodules were found to consist of homogeneous, diffuse pale-yellow, soft-tissue masses with distinct margins that elevated the epidermis above the adjacent skin. Histologically, the dermal nodules were well-delineated on the deep margin approaching the cutaneous muscle and consisted of perivascular neoplastic infiltrates of round cells that in some places coalesced into sheets that extended into the dermis and subcutis. Neoplastic cells separated adnexa and collagen. Immunohistochemistry revealed intense tumor cell expression of vimentin, Iba1, E-cadherin, and CD204; expression of CD18 was faint. The masses were diagnosed as Langerhans cell histiocytosis. Congenital cutaneous Langerhans cell histiocytosis has not been reported previously in cattle, to our knowledge, and should be included in the differential diagnosis of congenital nodular skin lesions. [ABSTRACT FROM AUTHOR]

Introduction: Pilomatrixomas are benign neoplasms derived from hair follicle matrix cells. They are among the most common soft tissue head and neck tumors of childhood. Pilomatrixomas are typically isolated, slow-growing, firm, nontender masses that are adherent to the epidermis but mobile in the subcutaneous plane. This clinical presentation is so characteristic that many experienced surgeons will excise suspected pilomatrixomas without prior imaging. We reviewed the results of this approach to determine whether physical examination alone differentiates pilomatrixomas from other similar soft tissue lesions of the pediatric head and neck. Methods: Computerized review of all pilomatrixomas over a 20-year period in a single academic pediatric otolaryngology practice. Results: 18 patients presented to our pediatric otolaryngology practice between 2001 and 2021 with historical and physical findings consistent with pilomatrixoma. Of the 18 patients, 7 were male and 11 were female. Ages ranged from 1.5 to 14 years, with a mean of 7.5 years. Most of the lesions (12) were located in the head and face, while the rest (6) were found in the neck. All patients were treated with complete surgical excision. Pathology confirmed pilomatrixoma in 15 patients. The remaining 3 children were found to have an epidermal inclusion cyst, a ruptured trichilemmal cyst, and a giant molluscum contagiosum lesion, respectively. One additional patient presented with a small lesion of the auricular helix that was thought to be a dermoid cyst, but proved to be a pilomatrixoma on histologic examination. Discussion: As pilomatrixomas are common and have a very characteristic presentation, surgical excision without prior diagnostic imaging will lead to correct treatment in the majority of cases. High resolution ultrasonography can help to confirm the diagnosis preoperatively, but is not definitive in large case series. Most of the cystic lesions that imitate pilomatrixoma will ultimately require surgical excision. [ABSTRACT FROM AUTHOR]

Cutaneous mast cell tumors are rarely reported in cattle. Although mutations in the c‐KIT gene have been shown to play a central role in the oncogenesis of canine mast cell tumors, few data are available in cattle. This report describes the clinical, histologic, immunohistochemical, and genetic features of a multicentric cutaneous mast cell tumor in an adult cow. An 11‐year‐old Prim'Holstein cow was presented for a 5‐month history of multiple skin nodules. Cytologic and histologic analyses of the nodules led to a diagnosis of mast cell tumors. Immunohistochemical analysis for KIT expression showed a moderate to strong signal in neoplastic mast cells with a cytoplasmic and membranous pattern. Sequencing of the c‐KIT gene coding sequence revealed no mutation. Despite partial response after corticosteroid treatment, euthanasia was elected. No metastases to the lymph nodes, spleen, and liver were identified at post‐mortem and histologic examinations. [ABSTRACT FROM AUTHOR]

Lin Liu, Jin Chen Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Jin Chen, Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, People’s Republic of China, Tel +86 15023188592, Email chenjin19771010@163.comAbstract: Throughout history, alcohol consumption has been an integral part of human culture. Alcohol consumption, alcoholism in particular, influences the onset and progression of liver diseases, neurological disorders, and multiple types of cancer. However, the role of alcohol consumption in influencing skin diseases has often been overlooked. In this review, we present the progress of research investigating the effects and potential mechanisms of action of alcohol consumption on acne, rosacea, psoriasis, atopic dermatitis, melanoma, and non-melanoma skin cancer.Keywords: ethanol, acne, rosacea, psoriasis, atopic dermatitis, skin tumor

Background: Discrepancies have been noted between the clinical and histologic diagnosis of vascular malformations. Objective: To evaluate the effectiveness of the International Society for Study of Vascular Anomalies (ISSVA) classification in diagnosing benign vascular anomalies based on clinical and (immuno) histologic parameters, focusing on lymphatic differentiation and vascular proliferation. Method: A retrospective study of 121 consecutive patients with benign skin and soft-tissue vascular anomalies located in the head and neck region (pyogenic granulomas and angioma senilis were excluded) by applying multiplex immunohistochemistry staining for lymph vessels (D2-40), endothelial blood vessels, and proliferating cells (Ki67). Clinical and histologic diagnosis was revised after the ISSVA classification. Results: Initially, 64 lesions were diagnosed as tumors and 57 as malformations. Revision diagnosis following the ISSVA classification revealed 27 tumors, 90 malformations (22.2% lymphatic), and 4 non-ISSVA. Immunostaining showed lymphatic differentiation in 24 (19.8%) of 121 cases, of which 20 were malformations. Proliferative activity (Ki67+) was found in 41 (33.8%) of 121 cases, of which 8 were arteriovenous malformations. Limitation: Quality and size of materials (biopsies vs resections) and clinical information. Conclusion: The diagnostic accuracy of combined histologic and clinical approaches for identifying vascular anomalies following the ISSVA classification can be substantially enhanced by incorporating additional immunostaining techniques to evaluate lymphatic differentiation and proliferative activity, particularly in identifying the occurrence of vascular malformations.

Dermatoses are highly intuitive, and disease information can be obtained from a large number of visual images. Artificial intelligence(AI) has made progress by leaps and bounds in the field of visual image processing in recent years. The application of AI has become a hot topic for dermatologists. The incidence rate of skin tumors is increasing, while the diagnosis of skin tumors is mainly through visual diagnosis, such as dermoscopy and pathological examination, which are difficult to make diagnosis in a timely manner. Based on skin imaging technology, AI does not only reduce doctors′ workload and improve the early detection rate, but also improves the diagnostic accuracy and sensitivity of skin diseases. This review summarizes the research status of AI in the auxiliary diagnosis of skin tumors in skin imaging and pathology, to provide reference for clinical application and future research of AI in dermatology.

Objective Sentinel node lymphoscintigraphy and biopsy is an essential procedure in theranostics of skin tumors.The aim of this study is to determine the role of SPECT/CT in localization of sentinel lymph node of skin tumors. Methods This study retrospectively reviewed the sentinel node lymphoscintigraphy and biopsy data in patients with skin tumors diagnosed in Peking Union Medical College Hospital from April 2019 to February 2023, and analyzed the role of SPECT/CT in sentinel lymphoscintigraphy. Results Thirty-seven patients were retrospectively enrolled.The primary skin tumor included melanoma (32 patients), squamous cell carcinoma (3 patients), and basal cell carcinoma (2 patients).The sentinel nodes localized in inguinal (23 patients), popliteal (2 patients), axilla (8 patients), trochlea (2 patients), and parotid/periauricular regions (2 patients).Sentinel lymph nodes were localized by SPECT/CT in 36 cases (one patient only underwent planar dynamic imaging).SPECT/CT detected multiple focus in the lymphatic drainage in 16 patients, and in 13 patients they were confirmed to be local retention of the tracer in the lymphatic duct instead of the sentinel lymph node, suggesting false positive uptake.Thirty-four patients underwent sentinel node biopsy 1-4 h after localization, and localization of the sentinel node was consistent with preoperative sentinel node lymphoscintigraphy.Sentinel node biopsy found nodal metastasis in 6 patients (all of them had melanoma in the foot or lower limb). Conclusions Sentinel node lymphoscintigraphy is an important step for localization before sentinel node biopsy.SPECT/CT can help improve the accuracy of localizing sentinel lymph node.

Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive intermediate soft tissue neoplasm that occurs in the dermis. DFSP generally occurs in young to middle-aged adults and rarely in infancy. Because of its extreme rarity, DFSP is difficult to diagnose and treat, especially when it occurs in infancy. In this paper, we reported a case of infantile DFSP in which we performed additional wide resection with a 3-cm horizontal margin for a mass that had previously undergone unplanned excision. No tumor recurrence has been seen for 3 years postoperatively. We suggest that the possibility of DFSP should always be considered when an enlarging superficial mass is identified on the trunk, even in an infant. Additionally, radical local treatment is as important for DFSP in infancy as it is for DFSP in adults, even after unplanned excision.

A five‐year‐old male English Bulldog was presented with a firm, well‐circumscribed, 1 cm in diameter cutaneous mass on the left flank. Fine‐needle aspiration (FNA) biopsy samples were collected for cytologic analysis. Cytology revealed a highly cellular sample consisting of spindle cells, numerous bundles of thick, glassy eosinophilic material (hyalinized collagen), and inflammatory cells. Spindle cells showed moderate anisocytosis and anisokaryosis, had oval nuclei with coarsely stippled chromatin, 1–3 prominent round nucleoli, and moderate amounts of wispy cytoplasm. Cells were occasionally associated with an eosinophilic extracellular matrix. Binucleated and trinucleated spindle cells were often noted. Low numbers of macrophages, small lymphocytes, and individual well‐granulated mast cells were also present. The lesion was excised and submitted for histopathologic examination, revealing a well‐delineated, nonencapsulated mass composed of hyalinized collagen fibers separated by spindle‐shaped mesenchymal cells in the deep dermis and subcutis. Mild anisocytosis and anisokaryosis and less than one mitosis per 10 × high power fields were present. Excision of the mass was complete. The findings were consistent with a keloidal fibroma, a rare benign variant of fibroma. Neoplastic cells showed positive immunoreactivity for vimentin, and a small‐to‐moderate number of tumor cells showed positive immunoreactivity for α‐smooth muscle actin. This is the first cytologic description of a keloidal fibroma correlated with histopathologic findings and immunolabeling. In cases where keloidal neoplasia is suspected, and since moderate cellular atypia can be present on cytologic examination even in cases of keloidal fibroma, histopathologic examination is necessary to differentiate between keloidal fibroma and keloidal fibrosarcoma. [ABSTRACT FROM AUTHOR]

This article discusses a case of basosquamous carcinoma (BSC), a rare type of skin tumor, in a 37-year-old woman. It provides information on the risk factors, symptoms, diagnosis, and treatment options for BSC. The article emphasizes the importance of early diagnosis and proper surgical management for this condition. BSC has the potential to invade surrounding tissues and metastasize, and treatment options are complex with varying outcomes. Surgical excision with wide margins is the standard treatment, but radiotherapy may be considered if surgery is not possible. Further research is needed to establish clear management guidelines for BSC. [Extracted from the article]

The most common challenge faced by dermoscopy images is the automatic detection of lesion features. All the existing solutions focus on complex algorithms to provide accurate detections. In this research work, proposed Online Tigerclaw Fuzzy Region Segmentation with Deep Learning Classification model, an intellectual model is proposed that provides discrimination of features with classification even in fine-grained samples. This model works on four different stages, which include the Boosted Anisotropic Diffusion filter with Recursive Pixel Histogram Equalization (BADF-RPHE) in the preprocessing stage. The next step is the proposed Online Tigerclaw Fuzzy Region Segmentation (OTFRS) algorithm for lesion area segmentation of dermoscopic images, which can achieve 98.9% and 97.4% accuracy for benign and malignant lesions, respectively. In the proposed OTFRS, an accuracy improvement of 1.4% is achieved when compared with previous methods. Finally, the increased robustness of lesion classification is achieved using Deep Learning Classification –DenseNet 169 with 500 images. The proposed approach was evaluated with accuracy classifications of 100% and 98.86% for benign and malignant lesions, respectively, and a processing time of less than 18 sec. In the proposed DensetNet-169 classification technique, an accuracy improvement of 3% is achieved when compared with other state-of-art methods. A higher range of true positive values is obtained for the Region of Convergence (ROC) curve, which indicates that the proposed work ensures better performance in clinical diagnosis for accurate feature visualization analysis. The methodology has been validated to prove its effectiveness and throw light on the lives of affected patients so they can resume normalcy and live long. The research work was tested in real-time clinical samples, which delivered promising and encouraging results in skin cell detection procedures. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical utility of identifying circulating tumor cells (CTC) and circulating tumorigenic endothelial cells (CTEC) in skin malignancies. Methods Subtraction enrichment-immunostaining and fluorescence in situ hybridization (SE-iFISH) were used to detect the number of CTC and CTEC in the peripheral blood of 5 patients with skin tumor (tumor group) and 14 healthy individuals (healthy controls), and the detection rate was calculated. The subtype characteristics of CTC/CTEC and the correlation between the number of CTC/CTEC and the clinical characteristics of the patients were analyzed. Results The positive rates of CTC and CTEC in the tumor group were 100%. The average CTC were (6.93±8.18) /mL and CTEC were (1.60±1.03) /mL in the peripheral blood of the tumor group. The positive rates of CTC and CTEC in the healthy controls were both 64%. The average CTC were (0.19±0.21) /mL, and CTEC were (0.30±0.33) /mL in the peripheral blood of the healthy controls. Patients with larger diameter of tumor, lymph node metastasis, and clinical stages of III and IV had higher levels of CTC and CTEC; Large CTC accounted for 88.46% (184/208) of the total tumor cells, while large CTEC accounted for 81.25% (39/48) of the total tumor cells, which mainly were ≥ pentaploid CTC and CTEC. Conclusions Using SE-iFISH, the detection rates of CTC/CTEC are high in patients with skin tumors. The amounts of CTC and CTEC are correlated with the clinical features of patients. A higher proportion of CTC and CTEC is large multiploid cells in peripheral blood of subjects with skin tumors.

The most commonly detected non-melacytic skin tumor in humans is "basal cell carcinoma". There are many clinical varieties of this tumor, some of which are quite rare. The attention of specialists is brought to the attention of a clinical observation of an elderly woman who was observed on an outpatient basis by a dermatologist with a rare form of basal cell carcinoma of the skin of the back. Of particular interest is a long history of the disease for about 15 years, the presence of a scar-like large lesion on the back of more than 11 cm in diameter, the absence of lymphadenopathy and weight loss, with a histologically confirmed sclerodema-like basalioma of the skin.

Skin tumors are common. Recommended treatment in most cases is surgery, with margins adapted. Except in the case of simple resection and suture, it is necessary to know the status of the margins before reconstructing the defect. A one-stage technique is possible with frozen section analysis, which gives the surgeon an intraoperative assessment of resection quality. The aim of our work is to study the reliability of the frozen section procedure. A retrospective study included 689 patients who underwent surgery for skin tumor (excluding melanoma) between January 2011 and December 2019 at the University Hospital of Caen, France. In 639 patients (92.75%), the frozen section analysis found healthy margins. There were 21 cases of discrepancy between the frozen section analysis and final histology. Infiltrating and scleroderma-like basal cell carcinomas showed a significantly higher frequency of affected margins on frozen section analysis (p < 0.001). The tumor size and location played a significant role in the margin status. In our department, the frozen section procedure is the reference examination indicating immediate flap reconstruction. The present study demonstrated its interest and overall reliability. However, it is to be used according to histologic type, size, and location. [ABSTRACT FROM AUTHOR]

Dermatoses are highly intuitive, and disease information can be obtained from a large number of visual images. Artificial intelligence( Ai) has made progress by leaps and bounds in the field of visual image processing in recent years. The application of Ai has become a hot topic for dermatologists. The incidence rate of skin tumors is increasing, while the diagnosis of skin tumors is mainly through visual diagnosis, such as dermoscopy and pathological examination, which are difficult to make diagnosis in a timely manner. Based on skin imaging technology, Ai does not only reduce doctors' workload and improve the early detection rate, but also improves the diagnostic accuracy and sensitivity of skin diseases. This review summarizes the research status of Ai in the auxiliary diagnosis of skin tumors in skin imaging and pathology, to provide reference for clinical application and future research of Ai in dermatology. [ABSTRACT FROM AUTHOR]

Jie Dong,1 Yuntao Duan,2 Kunning Zhang,3 Xiuying Zhang1 1Department of Dermatology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Dermatology, Dali Bai Autonomous Prefecture People’s Hospital, Dali Medical College, Yunnan, People’s Republic of China; 3Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Xiuying Zhang, Department of Dermatology, Beijing Chaoyang Hospital, Capital Medical University, 8&num; South Road, Worker’s Stadium, Chaoyang District, Beijing, 100020, People’s Republic of China, Tel +86 15810698436, Email pfk2020@126.comAbstract: Cutaneous lymphadenoma (CL) is an uncommon epithelioid tumor that is usually present on the head and face. It was first described by Santa Cruz and Barr in 1987, as a lymphoepithelial tumor, and was renamed as CL in 1991. Although CL is considered as a benign tumor, there are cases of recurrence after shave excision and metastasis to regional lymph nodes. Correct diagnosis and complete resection are of great importance. Here, we report a typical case of CL and make a comprehensive review of this rare skin tumor.Keywords: cutaneous lymphadenoma, skin tumor, carcinoma

Objective To investigate the clinical utility of identifying circulating tumor cells (CTC) and circulating tumorigenic endothelial cells (CTEC) in skin malignancies. Methods Subtraction enrichment-immunostaining and fluorescence in situ hybridization (SE-iFISH) were used to detect the number of CTC and CTEC in the peripheral blood of 5 patients with skin tumor (tumor group) and 14 healthy individuals (healthy controls), and the detection rate was calculated. The subtype characteristics of CTC/CTEC and the correlation between the number of CTC/CTEC and the clinical characteristics of the patients were analyzed. Results The positive rates of CTC and CTEC in the tumor group were 100%. The average CTC were (6.93±8.18)/mL and CTEC were (1.60±1.03)/mL in the peripheral blood of the tumor group. The positive rates of CTC and CTEC in the healthy controls were both 64%. The average CTC were (0.19±0.21)/mL, and CTEC were (0.30±0.33)/mL in the peripheral blood of the healthy controls. Patients with larger diameter of tumor, lymph node metastasis, and clinical stages of III and IV had higher levels of CTC and CTEC; Large CTC accounted for 88.46% (184/208) of the total tumor cells, while large CTEC accounted for 81.25% (39/48) of the total tumor cells, which mainly were ≥ pentaploid CTC and CTEC. Conclusions Using SE-iFISH, the detection rates of CTC/CTEC are high in patients with skin tumors. The amounts of CTC and CTEC are correlated with the clinical features of patients. A higher proportion of CTC and CTEC is large multiploid cells in peripheral blood of subjects with skin tumors. [ABSTRACT FROM AUTHOR]

Skin tumor acts as a premier factor for high death rate throughout the world. It is difficult for the radiologists to segment the skin tumour cells. Various research work focus on accurate segmentation but not on the time of processing. The intention of this research work is to provide an efficient enhancement method and tumor detection from other unaltered regions. This work relies mainly on computed tomography (CT) tumor images of the skin, benign or malignant, that has been implemented efficiently. In this research paper, a novel methodology called Online Tiger Claw Region Based Segmentation (OTCRBS) is proposed which is used mainly to detect the boundary of unaffected Skin Cell, similar to tiger which uses its claws to tear off the skin of its prey during the search for its food. By using metric for the region, various properties can be formulated for the detection of anomalous skin cells. 98.68 and 97.71% accuracy is produced for procurement of benign and malignant nodule in MATLAB 2018a, respectively. Computation time was only 7.65 s. Comparative analysis is made with different segmentation methods. Experimental results establish that the proposed flow outperforms all the existing segmentation methods for the proper detection of tumor cells. [ABSTRACT FROM AUTHOR]

Skin segmentation participates significantly in various biomedical applications, such as skin cancer identification and skin lesion detection. This paper presents a novel framework for segmenting the skin. The framework contains two main stages: The first stage is for removing different types of noises from the dermoscopic images, such as hair, speckle, and impulse noise, and the second stage is for segmentation of the dermoscopic images using an attention residual U-shaped Network (U-Net). The framework uses variational Autoencoders (VAEs) for removing the hair noises, the Generative Adversarial Denoising Network (DGAN-Net), the Denoising U-shaped UNet (D-U-NET), and Batch Renormalization U-Net (Br-U-NET) for removing the speckle noise, and the Laplacian Vector Median Filter (MLVMF) for removing the impulse noise. In the second main stage, the residual attention unet was used for segmentation. The framework achieves (35.11, 31.26, 27.01, and 26.16), (36.34, 33.23, 31.32, and 28.65), and (36.33, 32.21, 28.54, and 27.11) for removing hair, speckle, and impulse noise, respectively, based on Peak Signal Noise Ratio (PSNR) at the level of (0.1, 0.25, 0.5, and 0.75) of noise. The framework also achieves an accuracy of nearly 94.26 in the dice score in the process of segmentation before removing noise and 95.22 after removing different types of noise. The experiments have shown the efficiency of the used model in removing noise according to the structural similarity index measure (SSIM) and PSNR and in the segmentation process as well. [ABSTRACT FROM AUTHOR]

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Dermatofibroma (DF) is a mesenchymal tumor of the dermis, but its exact differentiation lineage is still uncertain. A progenitor cell that may be able to differentiate into fibroblastic, myofibroblastic, or fibrohistiocytic cells has been hypothesized. Some authors have also proposed the possibility of a monocytic-histiocytic origin. We stained 47 consecutive dermatofibromas with CD64, CD34, CD14, CD163, and CD68 to test which marker is more reliable for the diagnosis and to gain insight into their histogenesis. From the 35 cases stained with the whole immunohistochemical panel, all were positive for CD64, mostly showing a strong and diffuse pattern. Regarding all the other staining, CD14 was strongly positive in 77% of the lesions and CD163 in 20%. The CD68 stain was intense and diffuse only in 20% of the cases. All lesions were negative for CD34, but two of them showed patchy and weak staining. DFs were immunohistochemically stained positively with a set of macrophage/monocyte/histiocyte lineage markers such as CD14, CD68, CD163, and CD64. This finding favors an active pro-inflammatory immature monocyte-lineage cell as the more suitable origin for DF. CD64 seems to be more sensitive than other markers to confirm the diagnosis.

Death receptor pathway and perforin/granzyme pathway are the main mechanisms for immune system to kill tumor cells. SerpinB9 is the only known human protein that is able to inhibit the proteolytic activity of granzyme B (GrB). Expression of SerpinB9 has been observed in various human tumors, such as lung cancer and prostate cancer, and SerpinB9 can protect tumor cells from cytotoxic lymphocytes-mediated killing through the perforin/GrB pathway. In skin tumors, SerpinB9 expression has been detected in cells of malignant melanoma, cutaneous squamous cell carcinoma, cutaneous lymphomas, in which SerpinB9 contributes to tumor progression by mediating immune escape, resistance to immunotherapy and interference of the tumor microenvironment. In addition, researches have shown that inhibitor of SerpinB9 could retard the growth of melanoma, indicating the potential anti-tumor therapeutic application of SerpinB9 inhibition. The research status of SerpinB9 in skin tumors is reviewed in this paper.

Skin brachytherapy is a successful practice for treating skin cancer patients. Although a gamma source like an Iridium-192 (Ir-192) is commonly used in the skin brachytherapy, the use of a beta source like Yttrium-90 (Y-90) has also been investigated for this purpose. In the current study, we simulated the dose distribution of a proposed Y-90 applicator and an Ir-192 Leipzig applicator in a skin phantom, and compared the performance of each of the methods in treating three tumors in three hypothetical scenarios. Results of this simulation study showed that because of the sharp dose falloff of beta radiation in tissue, the Y-90 applicator may lead to better protection of the bone and/or cartilage under thin tumors. However, it may lead to excessive skin surface dose if thick skin tumors are treated. To choose between the Ir-192 and Y- 90 applicators, one may need to consider the thickness of the tumor and the thickness of the adipose layer between the tumor and the bone.

Objective To observe the effect of retroauricular pedicle flap on repairing skin defect after auricle skin tumor resection. Methods From June 2019 to June 2021, a total of 8 patients with auricle skin tumor were admitted to our hospital. The skin defect left after intraoperative expanded resection of the tumor was repaired with retroauricular pedicle flap. Results All the wounds healed after operation with slight scar along with good color and texture. The auricle shape was satisfactory after more than 6 months of follow-up. Conclusion The auricle skin defect can be repaired with retroauricular pedicle flap after auricle skin tumor resection. The operation is simple, effective and worthy of clinical application.

An epidermal nevus is known to appear at birth or in early childhood. Generally, it does not undergo major changes throughout life and can be left untreated. We report a case of basal cell carcinoma arising from an epidermal nevus in a 79-year-old man with congenital linear brown epidermodysplasia and nodular lesions on the right posterior neck. He had no other symptoms that could be attributed to epidermal nevus syndrome. He reported leakage of exudate from the nodule in recent years. Upon resection, the histopathological examination revealed an eccrine sweat gland tumor and basal cell carcinoma in a portion of the epidermal nevus. Cases of malignant tumors (e.g., squamous cell carcinoma and basal cell carcinoma) arising from an epidermal nevus have been reported previously. Nevertheless, preventive resection is not recommended in all cases. Epidermal nevi, even those left untreated or with changed properties, are rarely malignant.

We describe here a rare case of pilomatrix carcinoma in the right parotid region, arising in a young patient.Pilomatrix carcinoma is a rare, locally aggressive tumor with a tendency to recur. Pilomatrixoma is a superficial benign skin tumor arising from the matrix cells of the hair follicle generally located in the scalp, face, and upper limbs. Clinically, it usually presents as a solitary subcutaneous blue-black nodule which grows slowly.An 18-year-old male, non-smoker, in good health, was referred to our Unit after the onset of a swelling in the right parotid region. The lesion had been present for 1 year but the patient did not seek medical attention in that time. Clinical examination showed an exophytic mass in the right parotid region measuring 20 × 20 mm. An ultrasound of the major salivary glands showed an oval lesion of the right parotid gland; contrast-enhanced MRI appeared to show an oval lesion in the right intraparotid region, approximately 20 × 25 mm, which was hypointense in T1 images, and hyperintense in T2 images, with inhomogeneous contrast-enhancement; Fine Needle Aspiration Cytology (FNAC) was indicative of a lesion with high suspicion of malignancy.We elected to carry out a facial nerve sparing total parotidectomy, under general anesthesia, and facial reconstruction of the remaining gap with a sternocleidomastoid muscle flap. Histopathological analysis demonstrated basaloid cell proliferation beneath granulation tissue, hemorrhage, and large number of “ghost cells” with high mitotic activity. This confirmed the diagnosis of pilomatrix carcinoma. Postoperative outcome was uneventful.

Background: Tumors have been rarely documented in the Arabian dromedary (Camelus dromedarius). Methods: Post-slaughter inspections of different skin tumors in one-humped Dromedary camels slaughtered at different abattoirs in Egypt during the period from January 2019 and February 2022. The age of the examined animals ranged from 4 to 15 years. The pathological swelling was collected from affected camels and then subjected to a detailed study to record the different gross and microscopic findings. Results: Our study revealed the presence of 13 cases out of 988 showed neoplasia with an incidence rate of 1.3% including papilloma (0.1%), fibropapilloma (0.1%), lipomas (0.2%), adenoma (0.1%), squamous cell carcinoma (0.1%), and myxosarcomas (0.7%). Conclusions: Myxosarcomas is the most common tumor diagnosed in this study that was immunohistochemically confirmed by positive cytoplasmic immunoreactivity for vimentin. Meanwhile, benign cutaneous tumors are less frequent in camels such as papilloma, fibropapilloma, lipoma, and adenoma. [ABSTRACT FROM AUTHOR]

Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive intermediate soft tissue neoplasm that occurs in the dermis. DFSP generally occurs in young to middle-aged adults and rarely in infancy. Because of its extreme rarity, DFSP is difficult to diagnose and treat, especially when it occurs in infancy. In this paper, we reported a case of infantile DFSP in which we performed additional wide resection with a 3-cm horizontal margin for a mass that had previously undergone unplanned excision. No tumor recurrence has been seen for 3 years postoperatively. We suggest that the possibility of DFSP should always be considered when an enlarging superficial mass is identified on the trunk, even in an infant. Additionally, radical local treatment is as important for DFSP in infancy as it is for DFSP in adults, even after unplanned excision. [ABSTRACT FROM AUTHOR]

Correlative imaging of cutaneous tumors provides additional information to the standard histopathologic examination. However, the joint progress in the establishment of analytical techniques, such as Laser-Induced Breakdown Spectroscopy (LIBS) and Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) in clinical practice is still limited. Their combination provides complementary information as it is also shown in our study in terms of major biotic (Ca, Mg, and P) and trace (Cu and Zn) elements. To elucidate changes in the elemental composition in tumors, we have compiled a set of malignant tumors (Squamous Cell Carcinoma, Basal Cell Carcinoma, Malignant Melanoma, and Epithelioid Angiosarcoma), one benign tumor (Pigmented Nevus) and one healthy-skin sample. The data processing was based on a methodological pipeline involving binary image registration and affine transformation. Thus, our paper brings a feasibility study of a practical methodological concept that enables us to compare LIBS and LA-ICP-MS results despite the mutual spatial distortion of original elemental images. Moreover, we also show that LIBS could be a sufficient pre-screening method even for a larger number of samples according to the speed and reproducibility of the analyses. Whereas LA-ICP-MS could serve as a ground truth and reference technique for preselected samples. [Display omitted] • Correlative imaging of various malign and benign tumors with LIBS and LA-ICP-MS. • Pipeline for numerical correlations of LIBS and LA-ICP-MS images. • Referencing LIBS images of Mg with LA-ICP-MS, a potential key biomarker for high-throughput LIBS analysis. [ABSTRACT FROM AUTHOR]

Wilson–Jones angiosarcoma is one of cutaneous angiosarcomas, which is a rare aggressive tumor of blood vessels of the skin. In this case report, we present a 72-year-old female who developed multiple episodes of facial edema of 2-year duration along with partial hair loss of the scalp. Investigations, including a skin biopsy, were diagnostic of scalp angiosarcoma.

Jacek Calik,1 Monika Migdal,1 Tomasz Zawada,2 Torsten Bove2 1Old Town Clinic, Wroc&lstrok;aw, Poland; 2TOOsonix A/S, Hoersholm, DenmarkCorrespondence: Torsten BoveTOOsonix A/S, Agern Alle 1, Hoersholm, DK-2970, Denmark, Tel +45- 2059 2999, Email torsten.bove@toosonix.comPurpose: High intensity focused ultrasound operating at 20 MHz has been demonstrated as a safe and efficient treatment modality for a range of dermatological indications. The method is potentially also applicable to removal of seborrheic keratosis.Patients and Methods: A total of 54 seborrheic keratoses in 11 volunteer subjects (8 women and 3 men, average age 51.5 ± 13.2 years) were treated in a single session with a medical 20 MHz high intensity focused ultrasound device developed for dermatological conditions. Handpieces with nominal focal depths of 0.8 mm below the skin surface were used to administer acoustic energy of 0.99– 1.2 J/dose. An integrated dermoscope in the handpiece was used to monitor the treatment in real-time. Treatment efficacy and side-effects were assessed directly after treatment and at follow-up 4– 15 weeks after treatment.Results: The treatment showed positive results in 96.3% of the cases. About 68.5% of the cases were classified as complete response and 27.8% of the cases as partial response. Two cases (3.7%) did not respond to treatment and were classified as stable condition. No subjects experienced worsening of their condition, and no treatment received the classification of progressive condition. Side effects were primarily redness in the treatment area due to superficial telangiectasia, mild scarring, and persisting and slow-healing lichen planus-like keratosis. No adverse events were observed.Conclusion: HIFU is concluded to be a safe and efficient skin treatment for seborrheic keratoses. It has advantages over conventional treatments that can lead to pain during treatment and scarring after healing.Keywords: seborrheic warts, solar lentigo, skin tumor, HIFU, dermoscopy, dermatology