Seborrheic keratosis

Source: Wikipedia, the free encyclopedia.
(Redirected from
Stucco keratosis
)
Not to be confused with
seborrheic dermatitis or actinic keratosis
.
Seborrheic keratosis
Other namesSeborrheic verruca, basal cell papilloma, senile wart[1][2]: 767 [3]: 637 
Multiple seborrheic keratoses on the back of a patient with Leser–Trélat sign
SpecialtyDermatology
Diagnostic methodBased on clinical examination, skin biopsy
TreatmentElectrodesiccation and curettage, cryotherapy

A seborrheic keratosis is a non-cancerous (

keratinocytes, in the outer layer of the skin called the epidermis. Like liver spots, seborrheic keratoses are seen more often as people age.[4]

The tumours (also called

human papillomavirus.[7]

Cause

The cause of seborrheic keratosis is not known. The only definitive association is that its prevalence increases with age.[4]

Diagnosis

Micrograph of a seborrheic keratosis (H&E stain, scanning magnification)
Seborrheic keratosis closup

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.

Condylomas and warts can clinically resemble seborrheic keratoses, and dermatoscopy can be helpful to differentiate them. On the penis and genital skin, condylomas and seborrheic keratoses can be difficult to differentiate, even on biopsy.[citation needed
]

A study examining over 4,000 biopsied skin lesions identified clinically as seborrheic keratoses showed 3.1% were malignancies. Two-thirds of those were

squamous cell carcinoma.[9] To date, the gold standard in the diagnosis of seborrheic keratosis is represented by the histolopathologic analysis of a skin biopsy.[10]

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

skin lesions on the face, a condition generally presenting on darker-skinned individuals.[3]: 638–9  DPN is extremely common, affecting up to 30% of black people in the United States.[16]

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

  1. PMID 27294052
    .

References

  1. S2CID 205857121
    .
  2. ^
    ISBN 0-07-138076-0
    .
  3. ^
    ISBN 978-0-7216-2921-6
    .
  4. ^ a b c d "Moles, Freckles, Skin Tags, Benign Lentigines, and Seborrheic Keratoses". Cleveland Clinic. Archived from the original on 2015-05-22.
  5. ^ "Seborrheic keratosis-Seborrheic keratosis - Symptoms & causes". Mayo Clinic. Mayo Clinic. Retrieved 7 August 2023.
  6. S2CID 206650583
    .
  7. S2CID 26756807
    .
  8. 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.
  9. S2CID 11350866
    .
  10. ISBN 9783319749037
    . Retrieved 22 September 2018.
  11. ^ Dermatosis Papulosa Nigra at eMedicine
  12. ^ a b Stucco Keratosis at eMedicine
  13. ^
    ISBN 978-1-4160-2999-1
    .
  14. ^ "Cutaneous Melanoacanthoma: eMedicine Dermatology". 22 March 2023.
  15. PMID 23878739
    .
  16. PMID 6226495
    .
  17. ^ "Seborrheic keratosis-Seborrheic keratosis - Diagnosis & treatment". Mayo Clinic. Retrieved 7 August 2023.
  18. ^ "Seborrheic keratoses". American Academy of Dermatology. Retrieved 22 September 2018.
  19. PMID 21965858
    .
  20. PMID 9349339
    .
  21. PMID 10871940
    .

External links

Wikimedia Commons has media related to Seborrheic keratosis.
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