Assessment of Clinical and Pathological Characteristics of Inverted Follicular Keratosis - Five Years Comprehensive Review Publisher Pubmed



Hamzelou S^{1, 2} ; Aryanian Z^{1, 2, 3} ; Maqbool F¹ ; Kamyab K^{1, 4} ; Shakoei S^{1, 5} ; Azhari V^{1, 4} ; Razavi Z^{1, 2} ; Khayyat A^{1, 6} ; Ansari M^{1, 2} ; Hatami P¹ ; Smoller BR⁷ Show Affiliations
Source: Archives of Dermatological Research Published:2025

Abstract

Inverted Follicular Keratosis (IFK) is a uncommon benign tumor, that presents a diagnostic challenge because of its varied clinical and histological appearance. This study aimed to dissect the clinical and pathological features of IFK in patients who have been presented to a tertiary care hospital for five years. Through a cross-sectional analysis, the medical records of 56 patients diagnosed with IFK for four years were meticulously reviewed. The study focused on demographic data, lesion characteristics, pathological findings, and treatment outcomes. The cohort included 56 patients with a mean age of 50.71 ± 19.76 years who were predominantly male (73.2%), with lesions most commonly located on their face (57.1%). The lesions varied in size from 0.3 to 3 cm, with an average size of 1.01 cm. The majority were papular, followed by nodular, plaque, verrucous, and ulcer types, in descending order of frequency. A significant portion of patients (95%) had solitary lesions, predominantly of short duration (less than 3 months). Surgical excision was the primary treatment modality. Pathologically, 50% of lesions exhibited both exo- and endophytic characteristics, with a notable presence of squamous eddies (80%), parakeratosis (79%), and hyperkeratosis (41.1%). Other findings included dyskeratotic cells (62.5%) and a predominance of lymphocytic inflammation when present. A notable association was found between the presence of keratin plugs and lesion location, but no significant correlation was observed between lesion duration and pathological features. This study highlights the clinical and pathological diversity of IFK, with a predominance in males and middle-aged individuals. The findings emphasize the importance of recognizing the variable presentation of IFK to ensure accurate diagnosis and effective management. Surgical excision remains the treatment of choice, reflecting the benign nature of the condition. Further research is warranted to explore the underlying mechanisms and potential for non-surgical treatment options. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025.