Introduction & Objectives: Seborrheic keratoses (SK) are common benign skin tumors that are typically easy to diagnose. However, some SKs can be challenging and may be confused with malignant tumors. Our objective was to identify clinical factors in the diagnosis and management of SK Materials & Methods: A single-center, retrospective, descriptive study was performed based on data between 2016 and 2022. A total of 365 cases with a conclusive histopathological diagnosis of SK and complete clinical data were selected. Results: In total, 146/365 (40%) were correctly diagnosed as SK. The remaining 219/365 (60%) were mostly diagnosed as nevi, basal cell carcinoma, squamous cell carcinoma and melanoma. The diagnostic accuracy among physicians varied from 22% to 46%. For one physician, age influenced the clinical diagnosis (p=0.039). In the non-SK group, elderly patients had a tendency to have multiple excised lesions (p=0.045). The COVID-19 pandemic did not significantly affect the assessment criteria evaluated, except for the prioritization of larger SKs in 2020 than those excised in 2019 (p=0.049). Head lesions were more likely to have positive margins: 10/16 in the SK group vs 1/15 in the non-SK group (p=0.0052). The most common histological variant was the hyperkeratotic SK observed in 28.5% of cases. No histological variant had influence on the clinical diagnosis. Conclusion: Although SK are benign, they can present a clinical challenge in specific cases. Age, dimensions, experience and the number of lesions should be carefully considered when excising a lesion. Exposed areas are at risk of incomplete excisions.

javascript:void(0) Background and Objectives: Dermatofibromas (DF) are common benign skin lesions with unclear etiology, possibly reactive or tumoral. This study aims to evaluate the incidence of DF misdiagnosis and correlate histopathological findings with clinical interpretations. Methods: The extraction for this retrospective study was conducted from 8035 excisions performed between 2016 and 2022 by 9 physicians. A total of 50 cases with conclusive histopathological diagnoses of DF and 33 clinical cases of DF were identified. A p-value of <0.05 was considered statistically significant. Results: The clinical arm included 33 cases, with 7 having DF in the differential diagnosis. The mean age for a confident DF diagnosis was 57.86 years, compared to 44.35 years for a probable diagnosis (p=0.023). Diagnosis accuracy was 69% for certain cases vs 43% for probable cases. DF on legs had higher clinical uncertainty, 6/7 vs 9/26 (p=0.016). In the histopathological arm of 50 patients, lesions on lower extremities had higher correct diagnosis rates (p=0.024) and were least accurate on the torso (p=0.009). Conclusions: DF can pose a challenge even for experienced clinicians. Location is crucial as DF may escape diagnosis in less common areas. Patient’s age and physician’s expertise induce uncertainty.