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Seborrheic Keratosis

WHAT IS SEBORRHEIC KERATOSIS?

A seborrheic keratosis is a type of harmless, benign skin growth. The usually arise in multiples in patients over the age of 40, and sometimes irritate because of their elevated, dry, and scaly nature. However, in some cases, a seborrheic keratosis can be challenging to distinguish from dangerous types of skin cancer. A seborrheic keratosis is easily identified using the following parameters:

Location:

Multiple lesions may appear although there may be just one. Growths can be found in many areas of the body, including the scalp, face, shoulders, chest, back and abdomen. Growths can be found anywhere on the body except on the soles of the feet or the palms.

Texture:

The growths are usually small, rough areas initially (macular seborrheic keratosis) As time goes on, they develop a thick, wart-like surface. They are often described as having a “stuck-on” appearance, with surfaces appearing raised and waxy.

Shape:

The growths are usually round to oval in shape. Sometimes they follow the lines of skin tension, for example, on the back.

Color:

Growths are usually brownish; they sometimes appear to be black, white, or yellow.

EPIDEMIOLOGY

Seborrheic keratoses are very common across all races. It has been estimated that over 9 in 10 adults that are above the ages of sixty years have one or more of them. They occur equally in both sexes and usually begin to erupt between the ages of thirty to forty years. They are not common under the age of twenty years.

SIGNS AND SYMPTOMS

A seborrheic keratosis usually looks like a waxy or wart-like growth with a stuck-on appearance. It typically appears on the face, chest, shoulders or back. Though multiple growths are common, you might develop a single growth. The color varies from brown to light tan or black. It has a round or oval shape with a characteristic “stuck on” look.

It is usually flat but may be slightly raised with a scaly surface. It is varied in size from very small to more than 1 inch across.
Lastly, seborrheic keratosis could be itchy. This may occur for several reasons: growth, irritation, or patient’s picking due to a new or irregular bump. The various fissures and grooves on the surface of the seborrheic keratosis may soak up pigment from spray tanning agents or hair color; they may then appear suddenly darker and concerning.

Dermoscopy is an effective method to diagnose seborrheic keratosis, particularly if there is a need to distinguish it from skin cancer. It is important to let the experts at Pennsylvania Dermatology Specialists diagnose and manage any skin lesions you have; we are experts in dermoscopy and non-invasive diagnosis.

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The doctor may recommend removing the growth if: the diagnosis is not certain, that is, if it is difficult to distinguish from skin cancer; the patient does not want it for cosmetic purposes; or it causes discomfort like itching or irritation...

TREATMENT

In most cases of seborrheic keratosis, there is usually no need for further treatment.

The doctor may recommend removing the growth if: the diagnosis is not certain, that is, if it is difficult to distinguish from skin cancer; the patient does not want it for cosmetic purposes; or it causes discomfort like itching or irritation with clothing or jewelry rubbing against it.

There are several methods of removing seborrheic keratosis.

Cryosurgery

A spray gun or cotton swab is used to apply liquid nitrogen to the growth. At -195°C , liquid nitrogen freezes the seborrheic keratosis and it and falls off after a few days. A blister may appear when the growth falls off; this will subsequently dry into a crust, which will heal in with normal skin.

Electrocautery, curettage, or both

In electrocautery, also known as electrosurgery, the surgeon uses an electric current to burn (cauterize) the growth, under local anesthesia. In curettage, a curette -a scoop-shaped surgical instrument is used to scrape off the burnt growth. Some patients may require just electrocautery, while others require a curettage or both. Sometimes this treatment is combined with shave removal of the lesion.

Home Care

There are no proven home remedies for seborrheic keratosis. Lemon juice or vinegar used by some may irritate and possibly cause the growth to dry and crumble, but there is no evidence that this is safe or effective. Also, it can cause substantial irritation and pain. Substances such as tea tree oil, can trigger allergic contact dermatitis, an immune system reaction that causes itching and swelling around the site. The best thing for you to do when you’re having concerns with your seborrheic keratosis is to visit your dermatologist and dermatology providers where we can safely, easily, and painlessly remove lesions that are concerning or bothersome.

Ablation

Ablation involves vaporizing the growth with a laser to get rid of it.