Seborrheic keratosis pictures of scalp. Seborrheic Keratosis: Comprehensive Guide to Diagnosis, Treatment, and Management

07.09.202307.07.2023 by alexxlab

What are seborrheic keratoses. How can you identify seborrheic keratoses. What treatment options are available for seborrheic keratoses. Are seborrheic keratoses dangerous. How can seborrheic keratoses be prevented.

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Understanding Seborrheic Keratosis: A Common Skin Condition

Seborrheic keratosis is a prevalent benign skin growth that affects millions of people worldwide. These growths, often referred to as seborrheic warts or basal cell papillomas, are non-cancerous and typically appear as people age. Despite their harmless nature, seborrheic keratoses can be a source of cosmetic concern and occasional discomfort for many individuals.

The term “seborrheic” is somewhat misleading, as these growths are not related to sebaceous glands or sebum production. Instead, they are believed to result from a combination of genetic factors and prolonged sun exposure. As we delve deeper into this topic, we’ll explore the characteristics, causes, and management options for seborrheic keratosis.

Identifying Seborrheic Keratosis: Appearance and Location

Recognizing seborrheic keratosis is crucial for proper diagnosis and management. These growths can vary in appearance, but they generally share some common features:

Color: Range from light tan to dark brown or black
Texture: Often described as waxy, scaly, or having a “stuck-on” appearance
Shape: Round or oval, with a flat or slightly raised surface
Size: Typically range from a few millimeters to several centimeters in diameter

Can seborrheic keratoses appear anywhere on the body? While they can develop on various parts of the skin, seborrheic keratoses are most commonly found on the following areas:

Face
Chest
Back
Shoulders
Abdomen
Scalp

It’s important to note that seborrheic keratoses rarely appear on the palms of the hands, soles of the feet, or mucous membranes.

The Etiology of Seborrheic Keratosis: Unveiling the Causes

Understanding the underlying causes of seborrheic keratosis can help in developing effective prevention and management strategies. While the exact etiology remains unclear, several factors have been identified as potential contributors:

Genetic Predisposition

Is there a hereditary component to seborrheic keratosis? Research suggests that genetics play a significant role in the development of these skin growths. Individuals with a family history of seborrheic keratosis are more likely to develop them as they age. Certain genetic mutations, particularly in the FGFR3 gene, have been associated with the formation of seborrheic keratoses.

Age-Related Changes

Why do seborrheic keratoses become more common with age? As we grow older, our skin undergoes various changes that can make it more susceptible to the development of these growths. These changes include:

Decreased cell turnover
Reduced skin elasticity
Cumulative sun damage
Hormonal fluctuations

Sun Exposure

Does sun exposure contribute to the formation of seborrheic keratosis? Prolonged and cumulative sun exposure is believed to be a significant factor in the development of seborrheic keratoses. Ultraviolet (UV) radiation can damage skin cells and alter their growth patterns, potentially leading to the formation of these benign growths.

Differential Diagnosis: Distinguishing Seborrheic Keratosis from Other Skin Conditions

Accurate diagnosis of seborrheic keratosis is essential, as these growths can sometimes resemble other skin conditions, including some forms of skin cancer. Healthcare professionals often employ various diagnostic techniques to differentiate seborrheic keratosis from other skin lesions:

Visual Examination

How do dermatologists visually assess seborrheic keratoses? A trained dermatologist can often identify seborrheic keratosis through a thorough visual examination. They look for characteristic features such as:

The “stuck-on” appearance
Symmetrical borders
Uniform coloration
Rough, scaly texture

Dermoscopy

What is dermoscopy, and how does it aid in diagnosis? Dermoscopy is a non-invasive diagnostic technique that uses a specialized magnifying device to examine skin lesions in detail. This method can reveal specific patterns and structures characteristic of seborrheic keratosis, such as:

Milia-like cysts
Comedo-like openings
Fissures and ridges
Hairpin vessels

Biopsy

When is a biopsy necessary for diagnosing seborrheic keratosis? In cases where the visual appearance is atypical or there’s suspicion of malignancy, a dermatologist may recommend a biopsy. This involves removing a small sample of the lesion for microscopic examination. A biopsy can definitively distinguish seborrheic keratosis from other skin conditions, including:

Melanoma
Basal cell carcinoma
Squamous cell carcinoma
Pigmented actinic keratosis

Treatment Options for Seborrheic Keratosis: From Conservative to Interventional

While seborrheic keratoses are benign and don’t require treatment for medical reasons, many individuals opt for removal due to cosmetic concerns or discomfort. Several treatment options are available, ranging from non-invasive to surgical approaches:

Cryotherapy

How does cryotherapy work in treating seborrheic keratosis? Cryotherapy involves freezing the growth with liquid nitrogen. This causes the cells to die and the lesion to eventually fall off. The procedure is quick and relatively painless, but it may require multiple sessions for complete removal.

Electrocautery

What is electrocautery, and when is it used for seborrheic keratosis? Electrocautery uses an electric current to burn off the growth. This technique is effective for smaller lesions and can provide precise removal. However, it may cause some discomfort and require local anesthesia.

Curettage

How is curettage performed for seborrheic keratosis removal? Curettage involves scraping off the growth with a special surgical instrument called a curette. This method is often combined with electrocautery for more effective removal and to minimize bleeding.

Laser Therapy

Can laser therapy effectively remove seborrheic keratoses? Various laser treatments, such as erbium:YAG and CO2 lasers, can be used to vaporize seborrheic keratoses. Laser therapy offers precise removal with minimal scarring but may be more expensive than other options.

Topical Treatments

Are there any effective topical treatments for seborrheic keratosis? While less common, some topical medications have shown promise in treating seborrheic keratoses:

Hydrogen peroxide 40% solution (FDA-approved)
Trichloroacetic acid
Retinoids

These treatments may be suitable for smaller lesions or for individuals who prefer non-invasive options.

Complications and Risks Associated with Seborrheic Keratosis

While seborrheic keratoses are generally harmless, they can occasionally lead to complications or be associated with certain risks:

Irritation and Inflammation

Can seborrheic keratoses become irritated? In some cases, these growths can become irritated due to friction from clothing or jewelry. This can lead to inflammation, redness, and discomfort.

Bleeding

Do seborrheic keratoses bleed easily? While not typically prone to bleeding, seborrheic keratoses can bleed if scratched, rubbed, or injured. This can sometimes be mistaken for a more serious condition.

Cosmetic Concerns

How do seborrheic keratoses affect one’s appearance? For many individuals, the primary concern with seborrheic keratoses is cosmetic. Multiple or large growths, especially on visible areas like the face, can affect self-esteem and body image.

Sign of Internal Malignancy

Is there a link between seborrheic keratosis and internal cancers? In rare cases, the sudden appearance of multiple seborrheic keratoses (known as the sign of Leser-TrÃ©lat) may be associated with internal malignancies. However, this is extremely uncommon and requires further investigation to confirm any correlation.

Prevention and Management of Seborrheic Keratosis

While it may not be possible to completely prevent the development of seborrheic keratoses, there are several strategies that can help manage their occurrence and minimize their impact:

Sun Protection

How can sun protection help prevent seborrheic keratoses? Since UV radiation is believed to play a role in the development of these growths, proper sun protection is crucial. This includes:

Using broad-spectrum sunscreen with an SPF of at least 30
Wearing protective clothing, such as wide-brimmed hats and long-sleeved shirts
Seeking shade during peak sun hours (10 am to 4 pm)

Regular Skin Checks

Why are regular skin examinations important for managing seborrheic keratosis? Conducting regular self-examinations and scheduling annual check-ups with a dermatologist can help monitor existing growths and identify new ones early. This allows for timely intervention if necessary and helps distinguish seborrheic keratoses from potentially dangerous skin lesions.

Moisturizing

Can proper skin hydration help manage seborrheic keratoses? While not directly preventing their formation, keeping the skin well-moisturized can help reduce irritation and improve the overall appearance of seborrheic keratoses. Look for moisturizers containing ingredients like:

Hyaluronic acid
Glycerin
Ceramides

Healthy Lifestyle Choices

Do lifestyle factors influence the development of seborrheic keratoses? While research is ongoing, maintaining a healthy lifestyle may contribute to overall skin health and potentially reduce the risk of developing seborrheic keratoses. Consider the following:

Eating a balanced diet rich in antioxidants
Staying hydrated
Getting adequate sleep
Managing stress levels

Living with Seborrheic Keratosis: Psychosocial Impact and Coping Strategies

The presence of seborrheic keratoses can have varying psychological and social impacts on individuals. Understanding these effects and developing coping strategies is essential for maintaining overall well-being:

Body Image and Self-Esteem

How do seborrheic keratoses affect body image? For some individuals, particularly those with numerous or prominent growths, seborrheic keratoses can negatively impact body image and self-esteem. This may lead to:

Feelings of self-consciousness
Avoidance of social situations
Decreased confidence in personal relationships

Emotional Well-being

Can seborrheic keratoses affect mental health? While not inherently dangerous, the presence of these growths can cause emotional distress for some individuals. This may manifest as:

Anxiety about their appearance
Concern about potential health implications
Frustration with recurring growths

Coping Strategies

What strategies can help individuals cope with seborrheic keratoses? Developing effective coping mechanisms is crucial for maintaining a positive outlook and quality of life. Consider the following approaches:

Education: Learn about the benign nature of seborrheic keratoses to alleviate health-related concerns
Open communication: Discuss concerns with healthcare providers, family, and friends
Support groups: Connect with others experiencing similar issues
Cognitive-behavioral techniques: Challenge negative thoughts and develop a more balanced perspective
Cosmetic camouflage: Use makeup or clothing to conceal growths when desired

By implementing these strategies and seeking professional help when needed, individuals can better manage the psychosocial impact of seborrheic keratoses and maintain a positive self-image.

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Seborrhoeic keratoses

Seborrhoeic keratosis

Seborrheic Keratosis Condition, Treatments and Pictures for Adults

Who’s At Risk?

Seborrheic keratoses can occur any time after puberty, and almost everyone older than 50 has one or more of these skin growths. They may increase in number with age. Members of the same family can have an inherited tendency to grow multiple seborrheic keratoses. Men and women are equally as likely to develop them. People with darker skin colors tend to develop seborrheic keratoses less frequently than those with lighter skin colors.

Signs & Symptoms

Seborrheic keratoses can occur anywhere on the body, except for the palms, soles, and mucous membranes (areas such as in the mouth or anus). They most commonly occur on the chest and back. Seborrheic keratoses do not go away on their own, and they do not become cancerous.

They usually start as light brown or skin-colored, slightly raised areas, which can be round or oval and of varying size (usually smaller than a thumbnail, but sometimes much larger). As they grow thicker, seborrheic keratoses may become dark brown to almost black and appear to be “stuck on” to the surface of the skin. The surface may feel smooth or rough. In lighter skin colors, they may be pink or any shade of brown. In darker skin colors, they may be any shade of brown, purple, gray, or blackish.

Self-Care Guidelines

No treatment is needed unless there is irritation from clothing, such as itching or bleeding.

Note that:

There is no way to prevent new seborrheic keratoses from forming.
Some lotions containing alpha hydroxy acids, salicylic acid, or urea may make the areas feel smoother with regular use but will not eliminate them.
Over-the-counter freezing techniques are available but are usually not effective.

Treatments

Removal can be accomplished with freezing (cryosurgery), scraping (curettage), burning (electrocautery), lasers, or acids. Your dermatologist or other medical professional might conduct a biopsy if the growth looks unusual.

Visit Urgency

If a lesion on your skin is growing, bleeding, painful, or itchy, see your dermatologist or another medical professional. Similarly, consult a medical professional for any growth that is more than one color, that is dark brown or black, or that looks different than any of your other skin growths.

Seborrheic keratoses can be removed, but removal is considered a cosmetic issue and is usually not covered by insurance.

Trusted Links

MedlinePlus: Skin Conditions
Clinical Information and Differential Diagnosis of Keratosis, Seborrheic

References

Bolognia J, Schaffer JV, Cerroni L. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018.

James WD, Elston D, Treat JR, Rosenbach MA. Andrew’s Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier; 2019.

Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology. 9th ed. New York, NY: McGraw-Hill Education; 2019.

Last modified on May 30th, 2023 at 2:11 pm

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Derma Clinic Riga – Seborrheic keratosis

Seborrheic keratosis

What is this?

Seborrheic keratosis, or basal cell papilloma (it is also called “senile keratosis”) is a benign superficial skin formation. These are common skin lesions that occur in approximately 30% of patients over 40 years of age, and up to 75% of patients around 70 years of age. Sometimes found in young people. Sometimes these are separate formations, but some people have them in very large quantities (up to several hundred). For health, these neoplasms are not harmful, not contagious to other people, and do not transform into malignant tumors.

What causes seborrheic keratosis?

Despite the name, there is no connection with seborrhea and the sebaceous glands found in the skin. The reason for their occurrence is unknown. In some people, their appearance can be associated with prolonged exposure to the sun and activation in the body of the human papillomavirus (HPV, human papilloma virus – HPV ). Also, some patients have a genetic predisposition to the formation of seborrheic keratoses.

What are the symptoms and how to recognize?

In typical cases, seborrheic keratoses do not show any symptoms, except for visually noticeable skin formations. Sometimes they can cause itching, depending on the location, they can be injured by clothing and become inflamed. Mostly people do not like the appearance of these formations, especially if they are located on open areas of the skin.

Seborrheic keratosis is characterized by:

rough, keratinized surface;
color from light brown to almost black;
an increase in small, flat seborrheic keratoses in size and thickness;
localization in the chest, abdomen, back, neck and face.

How is seborrheic keratosis diagnosed?

Seborrheic keratoses are much more common than malignant skin tumors, but be aware that dark seborrheic keratoses can look like melanoma. With the help of dermatoscopy, all pigmented formations on the skin should be examined so that the diagnosis is made correctly.

How to remove tumors?

There are various methods for eliminating seborrheic keratoses, but none of them excludes the emergence of new formations.

Given the prevalence of keratoses and their benign nature, treatment is primarily cosmetic. If the formations are regularly injured, then it is recommended to get rid of them.

The most commonly used methods for the elimination of seborrheic keratoses:

cryodestruction (freezing with liquid nitrogen). Within 1-2 weeks after the procedure, the formations are exfoliated from the surface of the skin;
laser destruction. Depending on the size of the removed formations, the procedure is performed under local anesthesia or without anesthesia;
surgical excision (removal) – if during a clinical study it is not possible to exclude the likelihood of developing a malignant process (difficulty determining differences from a malignant tumor).

Prophylaxis:

there are no such means of prevention that would exclude the occurrence of seborrheic keratoses;
pay close attention to any skin growths that increase in size, bleed, change in any way. Ask your loved ones for help in assessing skin changes on the back.

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Keratosis: signs, symptoms and treatment

Keratoses (keratoderma, keratodermatosis) are a group of dermatological pathologies characterized by a violation of the normal process of keratinization of the epidermis. A patient suffering from a disease is faced with the formation of foci of rough skin on the body and limbs. Often zones of dermatosis appear on the palms and soles – relatively large areas of the dermis, devoid of sebaceous glands. The clinical picture of the pathology depends on the form of keratoderma that has developed in a child or adult.

General

Keratoderma can occur in acute or chronic forms. Based on histological analyzes of biomaterials of children and adults, doctors determine the nature of dermatoses, referring them to acquired or hereditary pathologies. The disease affecting the skin of the patient does not have a pronounced seasonality. A significant influence on the likelihood of developing a pathological process in the cells of the epidermis is exerted by race, gender, age and region of residence of a person.

Classification of keratoderma

Dermatologists distinguish three main types of keratoses:

follicular,
seborrheic,
actinic.

Dermatoses of the first type are the result of the formation of horny plugs in the mouths of the hair follicles. Seborrheic keratoderma are neoplasms in the form of nodules or plaques, painted in brown or black. Actinic keratosis is a disease that occurs in people over 60 years of age. Dermatoses of this form look like a cluster of small scaly spots.

Etiology of disease

The reasons for the development of keratoderma are diverse. Pathology can develop against the background of endocrine disorders, viral or bacterial infections, malignant neoplasms. Excessive insolation has a significant impact on the condition of the skin of children and adults. Often, pathological processes are the result of an insufficiently varied diet of the patient.

External and internal factors lead to changes in the well-established process of reproduction of epidermal cells. In the body of a healthy person, dead skin particles undergo keratinization and exfoliate. These scales are saturated with keratin and practically devoid of moisture. Keratodermatosis provokes a doubling of the growth rate of epidermal cells. The structures of the dermis of the previous generation do not have time to go through a full life cycle. Because of this, a dense plate is formed on the surface of the skin from a mixture of cells and keratin.

Symptoms of pathology

The symptoms of keratosis correspond to the form of the disease from which the patient suffers. Common signs of keratoderma of all forms are well-marked keratinization foci and excessive skin flaking. Primary neoplasms on the surface of the epidermis have different sizes, shapes and colors. Often the first manifestation of pathology is a red rash. As symptoms increase, the elements merge with each other and form a continuous hyperkeratotic surface. Typical localization sites of seborrheic keratosis are the face, neck and scalp. Follicular dermatitis often develops on the body and lower extremities. The actinic type of pathology affects the skin of the neck, back and arms.

The pathological process can proceed in dry and wet forms. In the first case, dehydrated epidermal cells form a hard, inelastic surface, which is covered with cracks. Skin flakes with residual moisture can cause erosion and weeping. In this case, a secondary infection joins the primary pathology. The launched inflammatory process can become chronic – the patient will suffer from periodic relapses.

Diagnostic measures

Confirmation of the diagnosis is performed by a dermatologist based on the clinical picture of the pathology and histological analysis data. A laboratory study of skin scrapings obtained by a doctor during an examination of a child or adult allows you to establish the form of keratosis and determine the causes of the development of the disease. Differential diagnosis gives dermatologists the opportunity to exclude seborrhea, psoriasis, lichen planus, Bowen’s disease, melanoma, and basal cell skin cancer from the patient’s history.

Therapeutic course

Treatment methods for keratosis are determined by a dermatologist based on the symptoms identified in the patient and the results of a clinical and laboratory examination. Drug therapy allows you to achieve a quick effect with a small area of skin lesions. A child or an adult is prescribed preparations based on fluorouracil – ointments or gels.

The threat of malignant degeneration of neoplasms and the development of a secondary infection in a patient can be a reason for doctors to choose radical methods of treating keratosis. Most often, dermatologists resort to cryo-, radio- or electrical destruction. Surgical removal of keratoderma foci is carried out in the chronic course of the disease and the absence of signs of tissue malignancy.

Forecast and preventive measures

Patients who seek medical help in a timely manner can expect a full recovery. The dermatologist will form a treatment plan that will prevent the transition of the disease to the chronic stage. The neglected course of dermatoses can lead to malignant degeneration of foci of pathology or the addition of secondary bacterial infections to keratosis.

Prevention of pathology involves the observance by patients of precautionary measures during their stay on the street. Excessive insolation often causes disruption of the normal processes of skin keratinization. The use of sunscreens will minimize the risk of formation of cellular keratin plaques.

Diagnosis and treatment of keratosis in Moscow

JSC “Medicina” (clinic of Academician Roitberg) has all the necessary equipment for the diagnosis and treatment of keratoses in children and adults.