What is seborrheic keratosis?

From the Guidelines

Seborrheic keratosis is a benign skin growth that can be differentiated from melanocytic lesions using epiluminescence microscopy (ELM) or dermatoscopy, as noted in the study on cutaneous melanoma 1. Seborrheic keratosis is a common, benign skin growth that typically appears during middle age or later. These growths are non-cancerous, wart-like lesions that can vary in color from light tan to black and have a waxy, stuck-on appearance. They commonly develop on the face, chest, shoulders, or back and may be flat or slightly raised with a scaly, rough texture. Some key characteristics of seborrheic keratosis include:

• A benign, non-cancerous nature
• A waxy, stuck-on appearance
• Variation in color from light tan to black
• Common development on the face, chest, shoulders, or back
• Possible flat or slightly raised texture with a scaly, rough surface Seborrheic keratoses are caused by an overgrowth of skin cells, though the exact trigger is unknown, with genetic factors and sun exposure likely playing roles. While these growths don't require treatment since they're harmless, people may choose removal for cosmetic reasons or if they become irritated. The diagnosis of seborrheic keratosis can be made using epiluminescence microscopy (ELM) or dermatoscopy, which can differentiate it from melanocytic lesions, as discussed in the study on cutaneous melanoma 1. Removal options include cryotherapy (freezing), curettage (scraping), electrocautery (burning), or laser therapy, all performed by dermatologists. It's essential to have any changing skin growths evaluated by a healthcare provider to distinguish seborrheic keratosis from more serious conditions like skin cancer, though the distinctive "stuck-on" appearance usually makes diagnosis straightforward.

From the Research

Definition and Characteristics of Seborrheic Keratosis

• Seborrheic keratoses (SK) are the most common skin tumor of humanity, characterized as a purely benign epithelial proliferation 2.
• The incidence of SK increases with age and exposure to ultraviolet light 2, 3.
• SK shows a remarkable variability in its clinical presentation, which can raise differential diagnoses 2.
• SK is a common, benign tumor that can occur on any body site and can be conservatively managed 3.

Pathogenesis and Risk Factors

• The precise pathogenesis of SK is still obscure, but ultraviolet exposure represents a predisposing factor by altering the biochemical concentration and expression of certain factors 3.
• The accumulation of amyloid-associated protein has also been postulated as a factor in the development of SK 3.
• Involvement of genitalia has been associated with human papillomavirus infection, and Merkel cell polyomavirus nucleic acid has also been detected in SK 3.
• Several oncogenic mutations involving FGFR-3 and FOXN1 have been identified in SK, although these do not bear the risk of malignant transformation 2, 3.

Treatment Options

• Classical treatment options for SK include cryotherapy and curettage 2.
• Topical treatment with 40% hydrogen peroxide and the nitric-zinc complex has been investigated as a treatment option for SK 2.
• Ablative laser therapy, including 532-nm diode laser, CO2 laser, and Er:YAG laser, is an effective treatment for SK 4, 5.
• Other treatment options include shave dissection, electrodesiccation, and nanosecond-pulsed electric field technology 3, 5.
• The efficacy and safety of different treatment modalities, including cryotherapy, electrodesiccation, CO2 laser, and Er:YAG laser, have been compared in clinical studies 5.