Histopathological Examination of Seborrheic Keratosis in the Saudi Population

ORIGINAL ARTICLE
Mohammed Saud Alsaidan, Salman Bin Dayel, Wafaey Badawy, Mariyyah Abdulrahman Alnathir, Norah Mohammed Al Kahtani, Lujain Mubarak Aldossari, Razan Saleh Bin Hazzaa, Asma Muneer Alharthi, Ghada Lazzam Allazzam, Faris Majed Almusayfir, et al.

 
For citation: Alsaidan MS, Bin Dayel SB, Badawy W, Alnathir MA, AlKahtani NM, Aldossari LM, Hazzaa RSB, Alharthi AM, Allazzam GL, Almusayfir FM, Almutairi RSR, Ali AHA. Histopathological Examination of Seborrheic Keratosis in the Saudi Population. International Journal of Biomedicine. 2026;16(2):227-231. doi:10.21103/Article16(2)_OA12
 
Originally published June 5, 2026

Abstract: 

Background: One of the most prevalent skin epidermal tumors is seborrheic keratosis (SK). But only a few extensive histopathological studies have been conducted on people with SK. This study's objective was to examine different histological cases of SK.
Methods and Results: The subjects of this retrospective study were 39 patients (28 male and 11 female), aged 50-90 and older, with clinically confirmed SK who presented to the outpatient dermatology departments of Prince Sattam bin Abdulaziz University Hospital and the Military Industries Hospital between January 2024 and June 2025. Pathology sections stained with hematoxylin and eosin were categorized as acanthotic (classic), mixed, melanoacanthoma (pigmented), or irritated based on their histological characteristics.
The highest number of SK cases (13/33.3%) in this study was identified in the age group of 60 to 69 years. The trunk (21/53.8%) was the most common biopsy site for biopsy-proven seborrheic keratosis, followed by the neck (9/23.1%), the face (4/10.2%), and the extremities (5/12.8%). The acanthotic (classic) subtype was the most common histopathological subtype (23/59.0%), followed by the mixed (9/23.1%), irritated (5/12.8%), and melanoacanthoma (pigmented) (2/5.1%) subtypes.
Conclusion: The acanthotic type of seborrheic keratosis was the most common histologic type identified, predominantly observed in patients aged 60–69 years. The trunk is a primary location for seborrheic keratosis.

References: 
  1. Sultana M, Mandal A, Chatterjee A, Das SK, Sinha S, Chatterjee RP. Seborrheic Keratosis Through the Lens of Histopathology: A Case Report. Cureus. 2025 Oct 30;17(10):e95780. doi: 10.7759/cureus.95780. PMID: 41328095; PMCID: PMC12664931.
  2. Roh NK, Hahn HJ, Lee YW, Choe YB, Ahn KJ. Clinical and Histopathological Investigation of Seborrheic Keratosis. Ann Dermatol. 2016 Apr;28(2):152-8. doi: 10.5021/ad.2016.28.2.152. Epub 2016 Mar 31. PMID: 27081260; PMCID: PMC4828376.
  3. Salah B, Mahseeri M, Al-Ali Z, Gaith A, Aldwan T, Al-Rawashdeh B. Giant perianal Seborrheic keratosis: A case report. Int J Surg Case Rep. 2018;51:296-301. doi: 10.1016/j.ijscr.2018.09.001. Epub 2018 Sep 12. PMID: 30243263; PMCID: PMC6148732.
  4. Sepehri N, Babaniamansour S, Karkon-Shayan S, Majidi M, Atarodi A, Mohammadzadeh H, Talaiee M. Giant seborrheic keratosis on the right flank part: a case report. Journal of Skin and Stem Cell. 2020 Sep 30;7(3).
  5. Hafner C, Vogt T. Seborrheic keratosis. J Dtsch Dermatol Ges. 2008 Aug;6(8):664-77. English, German. doi: 10.1111/j.1610-0387.2008.06788.x. PMID: 18801147.
  6. Duque MI, Jordan JR, Fleischer AB Jr, Williford PM, Feldman SR, Teuschler H, Chen GJ. Frequency of seborrheic keratosis biopsies in the United States: a benchmark of skin lesion care quality and cost effectiveness. Dermatol Surg. 2003 Aug;29(8):796-801; discussion 801. doi: 10.1046/j.1524-4725.2003.29211.x. PMID: 12859377.
  7. Jeong YI, Lee WJ, Bak H, Oh SH, Jung HJ, Chang SE, Choi JH. Detection of human papilloma virus DNA in seborrheic keratosis of Korean skin. Annals of Dermatology. 2007 Sep 1;19(3):99-105.
  8. Hafner C, Vogt T, Landthaler M, Müsebeck J. Somatic FGFR3 and PIK3CA mutations are present in familial seborrhoeic keratoses. Br J Dermatol. 2008 Jul;159(1):214-7. doi: 10.1111/j.1365-2133.2008.08626.x. Epub 2008 Jul 1. PMID: 18503601.
  9. Barthelmann S, Butsch F, Lang BM, Stege H, Großmann B, Schepler H, Grabbe S. Seborrheic keratosis. J Dtsch Dermatol Ges. 2023 Mar;21(3):265-277. doi: 10.1111/ddg.14984. Epub 2023 Mar 9. PMID: 36892019.
  10. Gorai S, Ahmad S, Raza SSM, Khan HD, Raza MA, Etaee F, Cockerell CJ, Apalla Z, Goldust M. Update of pathophysiology and treatment options of seborrheic keratosis. Dermatol Ther. 2022 Dec;35(12):e15934. doi: 10.1111/dth.15934. Epub 2022 Nov 1. PMID: 36226729.
  11. Luo W, Liang Y, Yang X, Wu W, Lu J. Histopathological Subtypes and Clinical Presentation of Seborrheic Keratosis: A 15-Year Retrospective Analysis of 1,169 Cases in Hainan, China. Clin Cosmet Investig Dermatol. 2025 Mar 24;18:721-727. doi: 10.2147/CCID.S517318. PMID: 40160436; PMCID: PMC11952144.
  12.  Odom RB, James WD, Berger TG. Andrews’ Diseases of the Skin: Clinical Dermatology. 9th ed. Harcourt Asia/WB Saunders; 2004:804–805.
  13. Salah B, Mahseeri M, Al-Ali Z, Gaith A, Aldwan T, Al-Rawashdeh B. Giant perianal Seborrheic keratosis: A case report. Int J Surg Case Rep. 2018;51:296-301. doi: 10.1016/j.ijscr.2018.09.001. Epub 2018 Sep 12. PMID: 30243263; PMCID: PMC6148732.
  14. Li WR, Lin L. Seborrheic keratosis in a young woman: a mimicker of keratoacanthoma. International Journal of Dermatology and Venereology. 2020 Jun 1;3(02):116-7.
  15. Lee GS, Ahn KJ, Kim JM, Lee ES. A histopathologic study of the seborrheic keratosis. Korean J Dermatol 1992;30:76-80.

Download Article
Received February 27, 2026.
Accepted April 16, 2026.
© 2026 The Author(s). International Journal of Biomedicine is published by IMRDC.
This is an open access article under the CC BY-NC-ND 4.0 license.