Pseudoepitheliomatous Hyperplasia
Christine J. Ko, MD
Key Facts
Terminology
Pseudoepitheliomatous hyperplasia (PEH)
Florid proliferation of epidermis that mimics squamous cell carcinoma
Etiology/Pathogenesis
Tumors
Inflammatory conditions
Infections
Tattoos
Microscopic Pathology
Hyperplasia of epidermis
Minimal keratinocyte atypia
Varying depth (but never into subcutis)
Top Differential Diagnoses
Squamous cell carcinoma (SCC)
Keratoacanthoma
Hypertrophic lupus erythematosus
Hypertrophic lichen planus
 Pseudoepitheliomatous hyperplasia associated with a tattoo shows irregular downgrowths of the epidermis with bulbous rete  . Black tattoo pigment and inflammation are present in the dermis. |
 Medium-power view of pseudoepitheliomatous hyperplasia associated with a tattoo shows irregular downgrowths of epidermis without cytologic atypia. Dermal black tattoo pigment is present  . |
TERMINOLOGY
Abbreviations
Pseudoepitheliomatous hyperplasia (PEH)
Synonyms
Pseudocarcinomatous hyperplasia
Definitions
Florid proliferation of epidermis that mimics squamous cell carcinoma
Reaction pattern that may be secondary to chronic irritation/trauma
ETIOLOGY/PATHOGENESIS
Associated or Underlying Conditions
Tumors
e.g., granular cell tumor
Inflammatory conditions
e.g., lupus erythematosus, lichen sclerosus
Infections
Particularly deep fungal
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