A 65-year-old man visits the office because he has skin lesions on his back. He initially saw the marks five years ago and claims that they are getting increasingly common. The lesions are occasionally itchy, but typically are asymptomatic. The patient had previously declined evaluation because he "didn't care about them," but arranged an appointment today at the demand of his wife. The patient's medical history includes hypertension, hyperlipidemia, and type 2 diabetes mellitus. There are several pigmented plaques on inspection, as illustrated in the photograph below. Which of the following is the most likely diagnosis?

Question

A 65-year-old man visits the office because he has skin lesions on his back. He initially saw the marks five years ago and claims that they are getting increasingly common. The lesions are occasionally itchy, but typically are asymptomatic. The patient had previously declined evaluation because he "didn't care about them," but arranged an appointment today at the demand of his wife. The patient's medical history includes hypertension, hyperlipidemia, and type 2 diabetes mellitus. There are several pigmented plaques on inspection, as illustrated in the photograph below.  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Seborrheic keratosis is a kind of epidermal tumor that appears as a spherical, tan or brown lesion with a well-defined border and a "stuck-on" look. A microscopic inspection reveals tiny basal-like cells with pigmentation, hyperkeratosis, and keratin-containing cysts. The rapid emergence of many lesions is frequently associated with internal cancer (the Leser-Trélat sign).

A 65-Year-Old Man Visits the Office Because He Has Skin