Seborrheic keratosis
Seborrheic keratosis | |
---|---|
Other names | Seborrheic verruca, basal cell papilloma, senile wart[1][2]: 767 [3]: 637 |
Multiple seborrheic keratoses on the back of a patient with Leser–Trélat sign | |
Specialty | Dermatology |
Diagnostic method | Based on clinical examination, skin biopsy |
Treatment | Electrodesiccation and curettage, cryotherapy |
A seborrheic keratosis is a non-cancerous (
The tumours (also called
Cause
The cause of seborrheic keratosis is not known. The only definitive association is that its prevalence increases with age.[4]
Diagnosis
Visual diagnosis is made by the "stuck on" appearance, horny pearls or cysts embedded in the structure. Darkly pigmented lesions can be challenging to distinguish from nodular melanomas.
A study examining over 4,000 biopsied skin lesions identified clinically as seborrheic keratoses showed 3.1% were malignancies. Two-thirds of those were
Subtypes
Seborrheic keratoses may be divided into the following types:[2][11][12]
Subtype (and alternative names) | Characteristics | Image |
---|---|---|
Common seborrheic keratosis (basal cell papilloma, solid seborrheic keratosis) | Dull or lackluster surface.[2]: 769 | |
Reticulated seborrheic keratosis (adenoid seborrheic keratosis) | Dull or lackluster surface, and with keratin cysts seen histologically.[2]: 769 | |
Stucco keratosis (deratosis alba,[13] digitate seborrheic keratosis, hyperkeratotic seborrheic keratosis, serrated seborrheic keratosis, verrucous seborrheic keratosis) | Common. Dull or lackluster surface, and with church-spire-like projections of distal tibia, ankle, and foot.[12]
| |
Clonal seborrheic keratosis | Dull or lackluster surface, and with round, loosely packed nests of cells seen histologically.[2]: 769 | |
Irritated seborrheic keratosis (inflamed seborrheic keratosis, basosquamous cell acanthoma) | Dull or lackluster surface.[2]: 769 | |
Seborrheic keratosis with squamous atypia | Dull or lackluster surface, and with round, loosely packed nests of cells seen histologically.[2]: 770 | |
Melanoacanthoma (pigmented seborrheic keratosis) | Dull or lackluster surface.[2]: 770 [3]: 687 It involves a proliferation of keratinocytes and melanocytes.[14] | |
Inverted follicular keratosis[notes 1] | Asymptomatic, firm, white–tan to pink papules[13] Microscopically it is characterized as a well-circumscribed inverted acanthotic squamous proliferation containing squamous eddies and without significant atypia.[15] |
Differential diagnoses
Treatment
Medical reasons for removing seborrheic keratoses include irritation and bleeding. They may also be removed for cosmetic reasons.[17][4] Generally, lesions can be treated with electrodesiccation and curettage, or cryosurgery. When correctly performed, removal of seborrheic keratoses will not cause much visible scarring.[18]
Epidemiology
Seborrheic keratosis is the most common benign skin tumor. Incidence increases with age. There is less prevalence in people with darker skin.[19] In large-cohort studies, all patients aged 50 and older had at least one seborrheic keratosis.[20] Onset is usually in middle age, although they are common in younger patients too, as they are found in 12% of 15-year-olds to 25-year-olds, which makes the term "senile keratosis" a misnomer.[21]
See also
- The sign of Leser-Trélat
Notes
- PMID 27294052.
References
- S2CID 205857121.
- ^ ISBN 0-07-138076-0.
- ^ ISBN 978-0-7216-2921-6.
- ^ a b c d "Moles, Freckles, Skin Tags, Benign Lentigines, and Seborrheic Keratoses". Cleveland Clinic. Archived from the original on 2015-05-22.
- ^ "Seborrheic keratosis-Seborrheic keratosis - Symptoms & causes". Mayo Clinic. Mayo Clinic. Retrieved 7 August 2023.
- S2CID 206650583.
- S2CID 26756807.
- PMID 12613727.
§Seborrheic Keratosis: ... Differentiating between seborrheic keratoses and melanomas is a challenge. Both have variable dark colors, the potential for large size, and irregularity.
- S2CID 11350866.
- ISBN 9783319749037. Retrieved 22 September 2018.
- ^ Dermatosis Papulosa Nigra at eMedicine
- ^ a b Stucco Keratosis at eMedicine
- ^ ISBN 978-1-4160-2999-1.
- ^ "Cutaneous Melanoacanthoma: eMedicine Dermatology". 22 March 2023.
- PMID 23878739.
- PMID 6226495.
- ^ "Seborrheic keratosis-Seborrheic keratosis - Diagnosis & treatment". Mayo Clinic. Retrieved 7 August 2023.
- ^ "Seborrheic keratoses". American Academy of Dermatology. Retrieved 22 September 2018.
- PMID 21965858.
- PMID 9349339.
- PMID 10871940.