Facial seborrheic keratosis with unusual dermoscopic patterns can be differentiated from other skin malignancies by in vivo reflectance confocal microscopy.

Different dermoscopic presentations of typical seborrheic keratosis (SK) have been widely described,1 but atypical SKs have not yet been distinguished from cutaneous neoplasms. Despite a retrospective design and absence of control lesions, this study shows that in a reference centre for RCM diagnosis differential diagnosis with RCM of atypical SK facial lesions equivocal upon dermoscopy can significantly reduce unnecessary facial lesion excisions. Facial seborrheic keratosis with unusual dermoscopic patterns can be differentiated from other skin malignancies by in vivo reflectance confocal microscopy. [Extracted from the article]