![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhF7QQ7zgbljda_bW-k4inCto2e2_kcJZGp1-8U6QrImy4WwZUYXU_yA0BpuM26Zf7fLoIgrxE3YAm-53Ev17KTIbUhbcPe0F0WwSHLhtjd9_StXBYHDOvdoPPNR14JF5pubRCyjiAFwEc/s400/skcc0404.jpg)
A 72-year-old man was referred for this scaly lesion on his scalp.
Clinical and dermoscopic evaluation were in favor of a keratotic type of seborrheic keratosis.
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjTrvuLrnk6GNs9TH9Mag_HhLxKuJR5B-3quZSr5r8yueP-oWZao19c_LG6IALIyI5e588OinDq8woiH6lo7Q_hAodrzs9kVbGZ_yodYkSCKhe6WqfbGJFOPcgAAMFh3bJTmIrGJcmVzvA/s400/skcc04044.jpg)
Dermoscopy revealed:
- an unspecific pattern (white to yellow horn masses over a background brown coloration)
- peripheral hairpin vessels
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjznlu2HCWlvJ-wqKuGpb2FFExejbV2YtjbdSDWqsrylQfsJWrdSCpsSsBpTtlTi0gjesewN-cs1HHgo2Hryi1s5GvIsQBT-WMyOyX3ObPvTzF-3VfSmSs1fl64MKycLt-BibieK0Lm8wo/s400/skcc04042.jpg)
Seborrheic keratoses in most cases are clinically and dermoscopically diagnosed.
Main dermoscopic signs are:
- milia-like cysts
- comedo-like openings (crypts, pseudo follicular openings)
- fissures and ridges ("brain-like" or cerebration's appearance)
- fingerprint-like structures
- moth-eaten border
- hairpin blood vessels
- network-like structures
- sharp demarcation
- fat fingers
In our case, dermoscopic examination reveals hairpin blood vessels which is a typical local sign of seborrheic keratosis.