Causes Of Inverted Follicular Keratosis: Symptoms & Treatment

Inverted follicular keratosis is a benign tumor of the hair follicles. It is a skin disorder which is typified by firm, white to pink nodules and is deemed to be a subtype of seborrheic keratosis. It is a slow growing solitary tumor mass which usually develops as a painless nodule in the head, predominantly on the face.

The cause and risk factors for inverted follicular keratosis are unknown. A surgical excision of the tumor mass is considered effective. The prognosis for the condition is very good with appropriate treatment.

The precise cause and etiological factor for inverted follicular keratosis isn’t clear yet. Some experts postulate that the condition is a variation of the verruca vulgaris, which is a benign skin wart that is caused by the human papilloma virus. On the other hand, studies have not yet verified this.

Some hypothesize that the condition may be a variant of seborrheic keratosis. Research and clinical trials are being undertaken to classify the significant etiological factors. As of now, no risk factors have been recognized and established for Inverted Follicular Keratosis.

Symptoms Of Inverted Follicular Keratosis

Typically, the condition is asymptomatic; there will be no significant presenting signs and symptoms.

Occasionally, these clinical features may be evident:

  • A solitary, raised nodule develops on the skin. It does not itch and is not painful.
  • The tumor mass is slow growing with an average size of 0.5 to 1 cm.
  • It is well demarcated and firm to touch.
  • The nodules can develop anywhere in the body, however, they are frequently seen in the head and neck region, commonly on the face (particularly, the upper lip, cheeks and eyelids).
  • Occasionally, the condition is confused with melanoma – which is a malignant skin tumor, given that, they both have a pigmented appearance.
  • Diagnosing the condition correctly is very vital.

Diagnosis Of Inverted Follicular Keratosis

A diagnosis of inverted follicular keratosis comprises of:

  • A medical history and physical exam.
  • Dermoscopy: Your dermatologist will evaluate your skin using a special magnified lens.
  • Wood’s lamp examination: Your dermatologist will examine your skin using UV light. This done to assess the alteration in skin pigmentation.
  • Skin biopsy: It is carried out and sent to a laboratory for a pathological exam. The pathologist will evaluate the biopsy under a microscope and will provide an ultimate diagnosis.

Quite a few clinical conditions have similar manifestations. Your dermatologist may carry out supplementary tests and investigations to rule out other clinical conditions to achieve the correct diagnosis.

Treatment Of Inverted Follicular Keratosis

  • The condition is not malignant and hardly ever recurs; hence, your doctor will advocate shave excision to manage the case effectively.
  • He may also advise superficial destructive therapies like – electrosurgery, cryosurgery, or laser ablation, once the diagnosis has been completely established by histologic analysis. A lesion which tends to recur is generally managed by conservative removal.
  • In most cases, excising the tumor is not needed, unless it produces troublesome signs and symptoms.
  • In case your doctor elects to have surgical intervention, the treatment is complete surgical excision, which brings about cure.
  • Once the tumor mass has been totally removed, it generally does not reappear. On the other hand, a partial excision may result in recurrence.
  • Cauterization of the nodule may also be advised using a CO2 laser.