Concerning the clinical observation titled "Melanoma Simulating Seborrheic Keratosis: A Major Dermoscopy Pitfall,"1 we consider the case an instructive example of potential difficulties found in the differential diagnosis of melanoma and seborrheic keratosis. Most doubtful diagnoses may be solved with dermoscopic examination; however, in some situations, as in the case presented, it is necessary to perform excisional biopsy. We report 2 cases of seborrheic keratosis, and, unlike the cases reported by Argenziano et al,1 the absence of dermoscopic criteria for seborrheic keratosis, together with the presence of dermoscopic structures simulating criteria for melanocytic lesions, may induce false diagnosis of these lesions.
Hirata SH, Almeida FA, Tomimori-Yamashita J, Enokihara MS, Michalany NS, Yamada S. "Globulelike" Dermoscopic Structures in Pigmented Seborrheic Keratosis. Arch Dermatol. 2004;140(1):128-129. doi:10.1001/archderm.140.1.128