{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T01:35:29Z","timestamp":1783128929023,"version":"3.54.6"},"reference-count":21,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T00:00:00Z","timestamp":1715472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Inverted follicular keratosis (IFK) is a benign cutaneous epithelial tumor typically presenting as a small papule on the head and neck. We have encountered deep endophytic tumors on genital skin with some characteristics of IFK but also atypical features, raising concern for squamous cell carcinoma (SCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four such tumors were identified in our database. Histopathologic analysis and ancillary studies were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were young women who presented with a solitary 0.5\u20131.0\u2009cm lesion on the vulva, perineum, or inner buttock. Each showed a squamous proliferation arising from the epidermis, with endophytic growth that was deep and bulbous but not infiltrative. The tumor lobules contained eosinophilic keratinocytes, forming numerous squamous eddies. Small irregular spaces and dyskeratotic cells were frequently found. Nuclear pleomorphism was minimal to absent. All demonstrated wild\u2010type p53 expression and lack of p16 block positivity. In situ hybridizations for human papillomavirus were negative. None of the three cases with follow\u2010up data showed evidence of recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The absence of infiltrative growth or significant pleomorphism, the presence of numerous squamous eddies, the reassuring immunoprofile, and the lack of evidence of recurrence support a variant of IFK and speak against SCC. We propose the term \u201cproliferating IFK\u201d to highlight the florid squamous proliferation. Recognition of this unusual variant would avoid overdiagnosis of SCC.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cup.14644","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T04:39:57Z","timestamp":1715575197000},"page":"634-639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Proliferating inverted follicular keratosis of genital skin: Case series of a challenging variant"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0132-5597","authenticated-orcid":false,"given":"Chelsea","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Pathology Loma Linda University  Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mason","family":"Runge","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3760-1948","authenticated-orcid":false,"given":"Steven M.","family":"Hrycaj","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0802-2883","authenticated-orcid":false,"given":"Paul W.","family":"Harms","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Pathology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2524-4509","authenticated-orcid":false,"given":"Douglas R.","family":"Fullen","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Pathology 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