Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Inverted follicular keratosis (IFK) is a rare be- nign tumor which usually appears as a firm papule on the face. The diagnosis is gen- erally made by histopathology because the clinical appearance is difficult to differentiate from other lesions. Dermoscopic features of IFK have not been established to date. Here- in we describe the dermoscopic findings of 4 cases of IFK. Radial peripheral hairpin ves- sels surrounded by a whitish halo arranged around a central white-yellowish amorphous area were observed in 3 cases, and glomeru- lar vessels were present in the central area of one of them. The fourth case also presented a central white amorphous area but showed arborizing vessels. Reflectance confocal mi- croscopy (available in 1 case) revealed a broadened honeycomb pattern, epidermal projections and hairpin and glomerular ves- sels. To our knowledge this is the first case series describing the dermoscopic features