Korean J Dermatol.  2020 Sep;58(8):512-515.

Clinical Factors for the Differential Diagnosis of Verruca Plana on the Head and Neck: A Study of Biopsy-proven Cases

• Choi S
• Yoon HS

Abstract

Background
Both verruca plana (VP) and seborrheic keratosis (SK) cause a major cosmetic concern. However, it is difficult to discriminate VP from SK presenting multiple tiny papules, especially those located on the face and neck. As VP and SK have different treatment strategies and prognoses, differentiation between them is important.
Objective
The objective of this study was to elucidate the clinical differential characteristics between VP and VP-like SK on the face and neck.
Methods
We retrospectively investigated patients who underwent skin biopsy for differentiating between VP and VP-like SK. Multivariable logistic regression analysis was conducted to identify factors associated with the differential diagnosis.
Results
Among 80 identified cases, 48.7% (n=39) was VP, and 51.3% (n=41) was VP-like SK. In the multivariable logistic regression analysis, larger than 3-mm, skin-like or pink lesion color, and confluent distribution were more likely to indicate VP than VP-like SK.
Conclusion
Our study proposed useful clinical differential characteristics between VP and VP-like SK on the face and neck in a large number of biopsy-proven cases. Still, there are exceptions. Therefore, in such confusing cases, skin biopsy to attain exact diagnosis is recommended.

Keyword

Differential diagnosis; Seborrheic keratosis; Warts