Seborrheic Keratosis of the Auricular and Post-Auricular Region: A Systematic Review of Clinical Features and Management

Abstract Seborrheic keratosis (SK) is a prevalent benign epidermal tumor in elderly patients, usually on the face, trunk, and limbs. Auricular and post-auricular involvement is rare, often mimicking malignancy and posing diagnostic challenges for otolaryngologists. This systematic review analyzes 20 studies (30 cases) on SK in these sites, examining clinical/histopathological features, potential environmental links (e.g., para-phenylenediamine [PPD] in hair dyes, copper), and treatments. Searches across PubMed, Scopus, Embase, and Google Scholar until July 2025 yielded English-language reports with confirmed histology. Lesions appeared as hyperpigmented, verrucous plaques with irritated variants showing hyperkeratosis and inflammation. Dermoscopy helped, but histopathology was essential. Observational data suggest chronic irritants like PPD or copper may modify morphology, though causation remains unproven due to small sample size. Surgical excision offered optimal diagnosis and cosmetics. Further research is needed on regional factors, especially in India.