By Gary M. White, MD

Inverted follicular keratosis

The inverted follicular keratosis (IFK) is a rare benign tumor of the follicular infundibulum akin to a seborrheic keratosis. Recent studies have found human papilloma virus in some cases.


A hyperkeratotic papule is typical. It most commonly occurs on the head and neck of an elderly man.


No treatment is needed for this benign lesion. The diagnosis is usually not made clinically. Instead, the diagnosis is usually made incidentally on histology while excluding malignancy. Various destructive modalities may be employed similar to the treatment of a seborrheic keratosis. Freezing, light curettage and electrodesiccation are most commonly used. Topical imiquimod 5% thrice per week for 2 months has been used.

Additional Pictures

Inverted follicular keratosis Inverted follicular keratosis

Inverted follicular keratosis


IFK on the upper lip. Pan Afr Med J. 2014; 18: 304
IFK on the temple treated with imiquimod. Inverted follicular keratosis successfully treated with imiquimod. Indian Dermatol Online J 2016;7:177-9


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