Seborrheic Keratosis | Cedars-Sinai

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What is a seborrheic keratosis?

A seborrheic keratosis is a
noncancerous (benign) growth on the skin. It’s color can range from white, tan, brown,
or black. Most are raised and appear “stuck on” to the skin. They may look like warts.

Seborrheic keratoses often appear
on a person’s chest, arms, back, or other areas. They’re very common in people older
than age 50, but younger adults can get them as well. With age, more and more people
get
1 or more of these growths. 

The outer layer of your skin is the
epidermis. Cells called keratinocytes make up much of this layer. These cells regularly
flake off as younger cells replace them. Sometimes keratinocytes grow in greater numbers
than usual. This can lead to a keratosis. You may have just 1 or hundreds of these
growths. In most cases, these growths only cause cosmetic problems. In some cases,
they
can cause skin irritation if they’re in a spot that clothes rub.

Seborrheic keratoses are not
cancer. But they can sometimes look like growths that are cancer. Because of this,
your
healthcare provider may need to take a biopsy sample and examine it.

What causes seborrheic keratoses?

It’s not clear what exactly causes
seborrheic keratoses. They tend to run in families, so genes may be a cause. Normal
skin
aging plays a role because the growths are more common with age. Too much sun exposure
may also play a role. They are not contagious. You can’t get them from somebody else
or
spread them to others.

Sometimes, multiple seborrheic
keratoses may suddenly appear. This is unusual. It may be a sign of a cancer not linked
to the skin, such as colon cancer or lung cancer. If you’ve had many of these growths
suddenly appear, tell your healthcare provider. They may want to make sure that you
don’t have any type of cancer.

What are the symptoms of seborrheic keratoses?

The growths can:

• Be slightly raised from the surrounding skin
• Be white or light tan in appearance,
  which may darken to brown or black
• Have a waxy, pasted-on look
• Look scaly or like a wart
• Be well-defined from the surrounding skin
• Not usually cause pain but may
  sometimes itch a little

They occur most often on the chest, belly, back, neck, arms, face, or other areas
that are exposed to sun. You might have only 1 or up to hundreds of these growths.
People tend to develop more of these growths as they age.

How are seborrheic keratoses diagnosed?

A healthcare provider can often diagnose seborrheic keratoses based on how they look.
In some cases, a biopsy may be needed.

If you have a skin growth that concerns you, it is always a good idea to see your
healthcare provider. Your healthcare provider will ask you about your medical history
and symptoms. Your healthcare provider will also give you a physical exam and closely
examine the growth.

It’s important for your healthcare
provider to make sure any growths are not cancer or precancer. Some signs that may
concern your healthcare provider are if the growth:

• Looks smooth on the skin, instead of
  raised and well-defined
• Has blurred borders
• Is not the same shape on both sides
  (asymmetry)
• Has dilated blood vessels around
  it
• Has an open sore in it
• Grew out of a previous mole

If your healthcare provider wants
to check for cancer, you will have a skin biopsy. Your healthcare provider will take
a
sample of the growth or the entire growth. It will then be looked at under a microscope
for cancer.

How are seborrheic keratoses treated?

Seborrheic keratoses usually only
cause cosmetic issues. But many people worry about the possibility of cancer. People
may
also want them removed because they don’t like how they look.

In most cases, they don’t need any
treatment. You can choose to remove one or more of them if they get irritated due
to
clothing, feel itchy, are worried about cancer, or don’t like how they look. They
can be
removed with:

• Liquid nitrogen. This is called
  cryotherapy. It freezes the growth, causing it to fall off within days.
• Minor surgery. This can be done in 2
  ways:
  • With a scalpel and a numbing
    medicine to prevent pain
  • With electricity to burn the
    growth away and a numbing medicine to prevent pain

Most growths that are removed don’t
grow back, but they may occur elsewhere. If they do grow back after treatment, a tissue
sample (biopsy) is needed to make sure that the diagnosis was correct and that the
growth is not cancer.

Don’t try to remove a seborrheic
keratosis yourself. You may be wrong about the diagnosis. The growth may be something
more serious. Removing the lesion at home may also cause an infection.

When should I call my healthcare provider?

See your healthcare provider soon if you have:

• A new skin growth
• A growth that’s not the same shape on both sides
• A mole that’s getting larger
• New itching in an old mole
• A mole with a blurred border
• A known seborrheic keratosis that changes in appearance

Key points about seborrheic keratosis

• Seborrheic keratosis is a benign
  growth on your skin. The growths are not cancer. Usually these growths only cause
  cosmetic problems. They are very common in older people.
• These growths are dark colored and raised, with a waxy, warty look.
• Your healthcare provider can often diagnose a seborrheic keratosis with a physical
  exam.
• If your healthcare provider thinks the growth might be cancer, you may need a skin
  biopsy.
• Most seborrheic keratoses don’t need treatment. You can have them removed if they
  cause problems or you don’t like how they look.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells
  you.
• At the visit, write down the name of a
  new diagnosis and any new medicines, treatments, or tests. Also write down any new
  instructions your provider gives you.
• Know why a new medicine or treatment
  is prescribed and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that
  visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Michael Lehrer MD

Medical Reviewer: Rita Sather RN

Medical Reviewer: Raymond Kent Turley BSN MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Seborrheic Keratoses | Michigan Medicine

Topic Overview

What are seborrheic keratoses?

Seborrheic keratoses (say “seh-buh-REE-ick kair-uh-TOH-seez”) are skin growths that some people get as they age. They are benign, which means they aren’t a type of cancer. The way they look may bother you, but they aren’t harmful.

These skin growths often appear on the back or chest, but they can occur on any part of the body. They grow slowly and seldom go away on their own.

These skin growths are common in middle-aged and older people, but they can appear as early as the teen years. Some women get them during pregnancy or after taking estrogen. Children seldom have them.

What causes seborrheic keratoses?

Experts don’t know what causes seborrheic keratoses. But research has found that:

• They tend to run in families.
• They seem to be related to sun exposure.

What are the symptoms?

Seborrheic keratoses can itch, bleed easily, or become red and irritated when clothing rubs them.

How the growths look can vary widely. They:

• Range in size from tiny to larger than 1 in. (3 cm) in diameter.
• Range in texture from waxy and smooth to velvety to dry, rough, and bumpy.
• Range in color from white to light tan to black. Most are brown. Some are multicolored.

They also:

• May have dry scale, which you can easily pick off, or have a surface that crumbles when picked.
• Can be dome-shaped with tiny white or black “horns” growing from the surface.
• Can occur as a single growth or a cluster of growths.
• Can look like skin tags (small, soft pieces of skin that stick out on a thin stem).
• Can swell and turn red.

These growths may be mistaken for warts, moles, skin tags, or melanoma (skin cancer).

How are seborrheic keratoses diagnosed?

Your doctor will look at the skin growth. He or she may need to take a sample (biopsy) of the growth if it’s not clear what the growth is or if it:

• Itches or bleeds.
• Becomes inflamed and red.
• Is dark brown to black.

How are they treated?

Seborrheic keratoses don’t need to be treated. But if one bothers you or you don’t like how it looks, your doctor can remove it. Your doctor may:

• Freeze it off (cryotherapy).
• Cut it out (curettage or excision).
• Use a tool that burns it off (electrocautery or laser treatment).

Should you worry about seborrheic keratoses?

If you are unsure what type of skin growth you have, see your doctor. It may be hard to tell whether the growth is a keratosis, a mole, a wart, or skin cancer.

If your doctor says your skin growth is a seborrheic keratosis, you usually don’t need to worry about it. But if it is growing fast, looks unusual, or is bleeding or causing pain, see your doctor or dermatologist.

What’s This Velvety, Brown Growth on My Skin? Is It a Seborrheic Keratosis?

A seborrheic keratosis is a common, harmless growth on your skin. Doctors call it “benign,” which means it doesn’t cause cancer. It can appear later in life, after about age 40. It’s most likely to happen on your face, scalp, chest, shoulders, abdomen, or back. It can show up anywhere except the palms and soles.

Often, your doctor can tell what a seborrheic keratosis is just by looking at it. If you’re worried that it could be cancer, or your doctor isn’t sure, they’ll remove the growth and study it more closely.

What Does It Look and Feel Like?

Normally, it has a round or oval shape. It ranges from light tan to black in color. At first it looks and feels soft and smooth, like velvet. It might be about the size of a dime.

Over time, a seborrheic keratosis becomes scaly and thick, like melted candle wax that’s stuck to your skin. It can grow to be as large as a half-dollar coin.

It’s not painful. It can feel greasy, rough or soft when you touch it.

It might itch. Sometimes it can rub against your clothes and get in the way of shaving and other things you do. It’s important not to scratch, pick, or rub the area.

What Are the Causes?

Doctors aren’t sure what causes seborrheic keratoses. So there’s no real way to prevent them.

The condition tends to run in families. It can appear during pregnancy, or if you’ve had hormone replacement therapy.

Some studies show sunlight might play a part. But more research needs to be done since the growths show up with or without exposure to the sun.

They aren’t contagious. If you have one, it won’t spread to other people or to other parts of your body, though it is common to have not just one, but many. They usually don’t go away on their own.

When Should I See My Doctor?

Most of the time, a seborrheic keratosis won’t cause problems. But make an appointment if you notice any of the following:

• It bothers you a lot, or becomes irritated or inflamed.
• You notice lots of growths at once. Normally, they appear one or two at a time and increase in number.
• It seems to change, or grow quickly.
• It bleeds and doesn’t heal.

If any of these things happen, or if you just don’t like how a growth looks or feels on your skin, you can have it removed.

What’s Removal Like?

Start with your main doctor. They might refer you to a dermatologist — a skin specialist.

They’ll choose one of the following, simple ways to remove the growth, usually in their office or clinic.

• Burning. This uses an electric current to burn away the seborrheic keratosis. It can take longer than other ways.
• Freezing. Doctors called this “cryosurgery.” It uses super-cold liquid nitrogen to remove the growth. It might require several treatments if it’s very large or thick.
• Laser. A harmless beam destroys the physical structure of the area.
• Scraping. The doctor uses a special tool to raze it off. This is often done along with freezing or burning.

Most seborrheic keratoses don’t return after they’re removed. But a new one can still appear somewhere else on your body.

Sometimes removing one can make your skin a little lighter at that spot. It usually blends in better over time, but not always.

Do Self-Tanners Affect It?

It’s normal for seborrheic keratoses to grow darker over time. But if you use an artificial tanning product that contains DHA, an Omega-3 acid, it can change the color of the growths as well as the skin around them.

Some people who’ve used these products have seen seborrheic keratoses grow darker quickly. That’s because the skin absorbs the artificial tan pigments. Doctors have found that this kind of color change isn’t a sign of cancer.

Mole (Nevus) Condition, Treatments, and Pictures for Parents – Overview

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Information for
ChildAdultTeen

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Images of Nevus, Common Acquired (Mole, Nevus)

Overview

A mole (nevus) is a common skin lesion that is made up of the color-producing (pigment-producing) cells of the skin. A mole that is present at birth is referred to as a congenital nevus. A dysplastic nevus, which is discussed elsewhere, is a mole in which unusual (atypical) growth is noted. Moles (nevi, the plural of nevus) slowly enlarge evenly in all directions. After they stop growing (stabilize), they may persist or they may become smaller (regress) later in life. Sun exposure as well as family tendency (heredity) play a role in the development of moles. Moles may sometimes become inflamed or irritated by friction from rubbing or contact with rough clothing or by other types of injury.

Who’s at risk?

Moles may occur in people of all races and ages, but they most commonly appear between the ages of 10 and 30. Fair-skinned people are most likely to develop moles.

Signs and Symptoms

• Moles may occur anywhere on the body, including the nails, palms, and soles.
• Moles may be raised or flat.
• The color of moles may vary from pink to skin colored, to brown, but they may be darker in people with normally darker skin.
• Non-cancerous (benign) moles are usually alike on both sides (symmetrical), have smooth borders and regular color, and they are generally smaller than the size of a pencil eraser (6 mm).

Self-Care Guidelines

• Protective measures, such as avoiding skin exposure to sunlight during peak sun hours (10 AM to 3 PM), wearing protective clothing, and applying high-SPF sunscreen are essential for reducing exposure to harmful ultraviolet (UV) light.
• Monthly self-examination of the skin is helpful to detect new lesions or changes in existing lesions. Be sure your child’s moles are not signs of skin cancer (melanoma). Remember the ABCDEs of melanoma lesions:
  A – Asymmetry: One half of the lesion does not mirror the other half.
  B – Border: The borders are irregular or vague (indistinct).
  C – Color: More than one color may be noted within the mole.
  D – Diameter: Size greater than 6 mm (roughly the size of a pencil eraser) may be concerning.
  E – Evolving: Notable changes in the lesion over time are suspicious signs for skin cancer.

When to Seek Medical Care

• People with multiple moles and unusual (atypical) moles should be examined by a dermatologist every 4–12 months depending on their past history and family history.
• It may be difficult to tell an atypical mole from a normal mole, so seek medical evaluation for your child if you are unsure about the nature of a mole, if you note changes within a mole, or if a mole becomes irritated or painful.

Treatments Your Physician May Prescribe

• Non-cancerous (benign) moles do not require treatment, though they may be cosmetically removed.
• If benign-appearing moles are inflamed or irritated, they can be surgically removed.

Trusted Links

Clinical Information and Differential Diagnosis of Nevus, Common Acquired (Mole, Nevus)

References

eedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed. pp.889-893. New York: McGraw-Hill, 2003.

Cosmetic, Medical, & Surgical Dermatologists

You see a small, brownish growth on your skin and wonder for a moment what it is. Dismissing it as an inevitable sign of aging or a fact of life, you go on about your day. You continue to pay attention to it for several weeks, however, and can’t help but notice that it is growing. The moment you realize that it has a bumpy texture and has grown to the size of a quarter, you start to worry that it could be skin cancer.

In some cases, such a growth on your skin is actually a seborrheic keratosis. It’s harmless, but it can certainly be scary, as it has many worrisome features: growing, changing, and often asymmetric. Although you should have it checked out by a dermatologist anyway, seborrheic keratosis are non-cancerous and not contagious.

Identifying Seborrheic Keratosis Skin Growths

Seborrheic keratoses are typically tan or brown, but can vary in color. They are thick and can have a warty or waxy texture, often referred to as the “skin barnacles,” referencing their appearance to barnacles stuck on a boat. Their size can be a fraction of an inch to larger than a half-dollar. While they are not painful, they can be itchy.

The growths can appear nearly anywhere on the skin, especially on the trunk. They do not grow on the palms of the hands or soles of the feet.

They also do not “spread” on your own body, although multiple growths may form independently. Most people develop them in middle age or later, and the number tends to increase with age.

Seborrheic keratoses are typically tan or brown. Their size can be a fraction of an inch to larger than a half-dollar.

Seborrheic keratoses are typically tan or brown. Their size can be a fraction of an inch to larger than a half-dollar.

The cause of seborrheic keratoses is unknown, but heredity may be a factor. There also is some correlation between sun exposure and the presence of these growths, even though they can appear on skin that is typically covered.

Bottom line: Seborrheic keratoses are simply harmless growths that some people may find unsightly. With that said, they are worth getting checked out by your dermatologist at Associated Dermatologists for assurances the growing spots are seborrheic keratoses.

Treatment Options

Even if you believe the growth is harmless, you should still make an appointment with a dermatologist just to be safe. If it looks cancerous, the dermatologist will remove it and have it analyzed.

As benign growth, often nothing is necessary for treatment. However, treatment options do exist. Two of the most common methods of removing seborrheic keratoses are:

• Cryotherapy, which is the application of a very cold liquid nitrogen that destroys the growth. The seborrheic keratosis will then fall off within days, or it will blister and dry out like a scab.
• Electrosurgery, where the growth is numbed with an anesthetic and an electric current is used to destroy the growth. A scoop-shaped instrument known as a curette may be used afterward to scrape off the treated growth. In some cases, only electrosurgery is needed, and in others the use of a curette is sufficient on its own.

To have your skin checked and reassurance that the growth are merely seborrheic keratoses, make an appointment with one of our dermatologists for your full body skin exam by calling (248) 975-SKIN or messaging us online.

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Common Growths | Dermatologist In Prescott, AZ

There are a variety of common benign (noncancerous) growths that can appear on the skin. These growths arise for different reasons, and you may develop many of them at one time. Some appear after an injury to the skin or in response to years of sun damage, while others simply develop due to normal aging. Some individuals may inherit genes from their parents that make them more likely to develop certain growths.

WHAT ARE SOME COMMON GROWTHS?

• Cherry Angiomas
  These small, bright red or purple growths are filled with many small blood vessels. They can grow anywhere on the skin and most often appear on the upper body. Some people develop hundreds of these growths. Cherry angiomas can remain small or grow to the size of a pencil eraser; larger angiomas may need to be removed if they bleed.
• Cysts
  Epidermoid cysts, also known as sebaceous cysts, form when a pore becomes plugged. These growths are most common on the face, neck and back, though they also can form on other parts of the body. This type of cyst may look yellow or white, with what appears to be a blackhead in the center. When squeezed, epidermoid cysts release a foul-smelling, cottage cheese-like discharge made up of dead skin cells.

  Pilar cysts are flesh-colored, dome-shaped growths that form when a hair follicle, typically on the scalp, becomes blocked. You are more likely to develop these growths if a blood relative has had them.

  Cysts do not need to be removed unless they are large, growing or bothersome. These growths can rupture or become infected, so if you have a cyst that becomes painful or inflamed, see a board-certified dermatologist for diagnosis and treatment.

Dermatofibroma

• Dermatofibromas
  Dermatofibromas can appear after an insect bite, a pimple or another minor skin injury, though sometimes they arise without prior known trauma. These small growths, which may resemble a mole or scar, can be pink, dull red or brown, sometimes with a whitish center. These growths may feel firm, but they can pucker or dimple when pinched. While they may appear anywhere on the body, dermatofibromas most often occur on the lower legs.
• Lipomas
  These rubbery lumps of fat, which can be small or large, are generally soft to the touch and easily movable. Lipomas most often appear in adults, and it is common to have more than one lipoma. Treatment is not necessary unless these growths are in a sensitive area or become large or painful.

Milia

• Milia
  These small white bumps, about the size of a pinhead, appear on the eyelids and cheeks when tiny skin flakes get trapped near the skin’s surface.
  They are common in older women and children, as well as people who use heavy, oil-based skin care products. Milia do not need to be treated, but if you find these growths to be cosmetically bothersome, a board-certified dermatologist can offer treatment options.
• Moles
  Moles can appear anywhere on the body; however, most moles occur in areas of sun exposure, like the back, chest and face. Moles can be round or oval, and they may be flat or raised on the skin. Most are brown, but they also can be tan, black, pink, blue, skin-toned or colorless. They typically develop during childhood and adolescence; new moles do not usually appear in adults.
  Most moles are harmless and do not require treatment; however, you may want to get a mole removed if it is irritated by clothes or jewelry, or if its appearance bothers you. If you notice a new or suspicious mole on your skin, or a mole that is changing, itching or bleeding, you should make an appointment to see a board-certified dermatologist, as these symptoms could be signs of melanoma, the deadliest form of skin cancer.
• Neurofibromas
  These soft, skin-colored growths, which often look like moles or skin tags, form along the pathway of a nerve. They are most common in children entering puberty, pregnant women and older adults. If you have multiple neurofibromas, talk to a board-certified dermatologist, as this may be a sign of an underlying medical condition.
• Sebaceous Hyperplasia
  Sebaceous hyperplasia develop as the result of enlarged or clogged oil glands. They appear as small yellow or white bumps, sometimes with an indentation in the center or small noticeable blood vessels. These growths most often form on the faces of adults. Because sebaceous hyperplasia and basal cell carcinoma, a type of skin cancer, can look similar, you should see a board-certified dermatologist for diagnosis if you develop these growths.
• Seborrheic Keratosis
  SKs are rough bumps that usually have a waxy, stuck-on appearance, like a dab of warm candle wax. They are often brown, although they may range in color from light tan to black. They can vary in size from very small to larger than an inch. SKs can form anywhere on the skin, except the palms of the hands and the soles of the feet. Most appear on the chest, back, scalp, face and neck. In people with skin of color, these growths tend to be small and appear around the eyes and on the cheeks.

Seborrheic Keratosis

• Skin Tags
  These small, floppy, flesh-colored growths stick out from the skin, and they may be larger at the top than at the base. Skin tags usually appear after midlife, typically on the neck, trunk or armpits, or in or near skin folds.
  They are more numerous in people who are overweight, obese or diabetic, as well as in pregnant women. If skin tags are irritated by clothes or jewelry, they may bleed or become painful; if this happens, a board-certified dermatologist can remove the growths.

HOW ARE COMMON GROWTHS TREATED?

Many common skin growths do not require treatment. If you notice any growths that are changing, itching or bleeding, however, it’s important to see a board-certified dermatologist, as these could be signs of skin cancer. Your dermatologist may perform a biopsy to diagnose your growth. This in-office procedure, which uses local anesthesia, involves removing all or part of the growth for evaluation in a lab.

Even when growths do not need to be treated, some people may want a growth removed because it has become irritated, painful or inflamed, or because they do not like the way it looks on their skin. A board-certified dermatologist can remove most growths during an office visit.

The type of treatment you receive will depend on the type of growth on your skin. Your dermatologist may remove your growth via excision (cutting), cryosurgery (freezing with liquid nitrogen), curettage (scraping) or electrosurgery (destruction via electric current). The doctor also may recommend laser surgery, a corticosteroid injection, topical cream that you apply to your skin, or photodynamic therapy, during which medicated chemicals are applied to the skin and activated by a special light. Your dermatologist can discuss your options and recommend the best treatment for you.

Your health insurance may not cover the removal of benign growths. If you are concerned about the cost of the procedure, talk with your insurance provider and your dermatologist.

A board-certified dermatologist is a medical doctor who specializes in the diagnosis and medical, surgical and cosmetic treatment of skin, hair and nail conditions. To learn more about these common growths or to find a board-certified dermatologist in your area, visit aad.org or call toll-free (888) 462-DERM (3376).

All content solely developed by the American Academy of Dermatology.

Copyright © by the American Academy of Dermatology and the American Academy of Dermatology Association.

Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides

American Academy of Dermatology P.O. Box 1968, Des Plaines, Illinois 60017

AAD Public Information Center: 888.462.DERM (3376) AAD
Member Resource Center: 866.503.SKIN (7546) Outside the
United States: 847.240.1280
Web: aad.org
Email: [email protected]

Seborrhoeic keratoses (brown warts, basal cell papillomas, seborrheic keratosis)

Author: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand, 1997. Updated, January 2016.

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What is a seborrhoeic keratosis?

Seborrhoeic keratosis is a harmless warty spot that appears during adult life as a common sign of skin ageing. Some people have hundreds of them.

Seborrhoeic keratosis (American spelling – seborrheic keratosis) is also called SK, basal cell papilloma, senile wart, brown wart, wisdom wart, or barnacle.  The descriptive term, benign keratosis, is a broader term that is used to include the following related scaly skin lesions:

• Seborrhoeic keratosis 
• Solar lentigo (which can be difficult to distinguish from a flat seborrhoeic keratosis)
• Lichen planus-like keratosis (which arises from a seborrhoeic keratosis or a solar lentigo).

Seborrhoeic keratoses

Who gets seborrhoeic keratoses?

Seborrhoeic keratoses are extremely common. It has been estimated that over 90% of adults over the age of 60 years have one or more of them. They occur in males and females of all races, typically beginning to erupt in the 30s or 40s. They are uncommon under the age of 20 years.

What causes seborrhoeic keratoses?

The precise cause of seborrhoeic keratoses is not known.

The name is misleading, because they are not limited to a seborrhoeic distribution (scalp, mid-face, chest, upper back) as in seborrhoeic dermatitis, nor are they formed from sebaceous glands, as is the case with sebaceous hyperplasia, nor are they associated with sebum — which is greasy.

Seborrhoeic keratoses are considered degenerative in nature. As time goes by, seborrhoeic keratoses become more numerous. Some people inherit a tendency to develop a very large number of them. Researchers have noted:

• Eruptive seborrhoeic keratoses can follow sunburn or dermatitis.
• Skin friction may be the reason they appear in body folds.
• Viral cause (eg human papillomavirus) seems unlikely.
• Stable and clonal mutations or activation of FRFR3, PIK3CA, RAS, AKT1 and EGFR genes are found in seborrhoeic keratoses.
• Seborrhoeic keratosis can arise from solar lentigo.
• FRFR3 mutations also arise in solar lentigines. These mutations are associated with increased age and location on the head and neck, suggesting a role of ultraviolet radiation in these lesions.
• Seborrhoeic keratoses do not harbour tumour suppressor gene mutations.
• Epidermal growth factor receptor inhibitors (used to treat cancer) often result in an increase in verrucal (warty) keratoses.

What are the clinical features of seborrhoeic keratoses?

Seborrhoeic keratoses can arise on any area of skin, covered or uncovered, with the exception of palms and soles. They do not arise from mucous membranes.

Seborrhoeic keratoses have a highly variable appearance.

• Flat or raised papule or plaque
• 1 mm to several cm in diameter
• Skin coloured, yellow, grey, light brown, dark brown, black or mixed colours
• Smooth, waxy or warty surface
• Solitary or grouped in certain areas, such as within the scalp, under the breasts, over the spine or in the groin

They appear to stick on to the skin surface like barnacles.

Seborrhoeic keratoses

Variants of seborrhoeic keratoses

Variants of seborrhoeic keratoses include:

• Solar lentigo: flat circumscribed pigmented patches in sun-exposed sites
• Dermatosis papulosa nigra: small, pedunculated and heavily pigmented seborrhoeic keratoses on head and neck of darker-skinned individuals
• Stucco keratoses: grey, white or yellow papules on the lower extremities
• Inverted follicular keratosis
• Large cell acanthoma
• Lichenoid keratosis: an inflammatory phase preceding involution of some seborrhoeic keratoses and solar lentigines.

Benign keratoses

Complications of seborrhoeic keratoses

Seborrhoeic keratoses are not premalignant tumours. However:

• Skin cancers are sometimes difficult to tell apart from seborrhoeic keratoses.
• Skin cancer may by chance arise within or collide with a seborrhoeic keratosis.

Very rarely, eruptive seborrhoeic keratoses may denote an underlying internal malignancy, most often gastric adenocarcinoma. The paraneoplastic syndrome is known as the sign of Leser-Trélat. Eruptive seborrhoeic keratoses that are not associated with cancer are sometimes described as having pseudo-sign of Leser-Trélat.

Eruptive and irritated seborrhoeic keratoses may also arise as an adverse reaction to a medication, such as adalimumab, vemurafenib, dabrafenib, 5-fluorouracil and many chemotherapy drugs.

An irritated seborrhoeic keratosis is an inflamed, red and crusted lesion. It may give rise to eczematous dermatitis around the seborrhoeic keratosis. Dermatitis may also trigger new seborrhoeic keratoses to appear.

How is a seborrhoeic keratosis diagnosed?

The diagnosis of seborrhoeic keratosis is often easy.

• A stuck-on, well-demarcated warty plaque
• Other similar lesions

Sometimes, seborrhoeic keratosis may resemble skin cancer, such as basal cell carcinoma, squamous cell carcinoma or melanoma.

Dermoscopy often shows a disordered structure in a seborrhoeic keratosis, as is also true for skin cancer. There are diagnostic dermatoscopic clues to seborrhoeic keratosis, such as multiple orange or brown clods (due to keratin in skin surface crevices), white milia-like clods, and curved thick ridges and furrows forming a brain-like or cerebriform pattern.

If doubt remains, a seborrhoeic keratosis may undergo partial shave or punch biopsy or diagnostic excision. [see Seborrhoeic keratosis pathology]

The dominant histopathological features of seborrhoeic keratosis may be described as:

• Melanoacanthoma (deeply pigmented)
• Acanthotic
• Hyperkeratotic or papillomatous
• Adenoid or reticulated
• Clonal or nested
• Adamantinoid or mucinous
• Desmoplastic
• Irritated.

What is the treatment for seborrhoeic keratoses?

An individual seborrhoeic keratosis can easily be removed if desired. Reasons for removal may be that it is unsightly, itchy, or catches on clothing.

Methods used to remove seborrhoeic keratoses include:

All methods have disadvantages. Treatment-induced loss of pigmentation is a particular issue for dark-skinned patients. There is no easy way to remove multiple lesions on a single occasion.

How can seborrhoeic keratoses be prevented?

How to prevent seborrhoeic keratoses is unknown.

What is the outlook for seborrhoeic keratoses?

Seborrhoeic keratoses tend to persist. From time to time, individual or multiple lesions may remit spontaneously or via the lichenoid keratosis mechanism.

Those associated with dermatitis may regress after it has been controlled.

90,000 Difficulties in managing patients with androgenetic alopecia

Prefollicular inflammation and fibrosis.

Treatment of inflammation (acute or chronic with a long-term process) is relevant for all types of alopecia, not just androgenetic. If a patient comes with scaling or dandruff (which the doctor detects during examination) and complains of loss, of course, the doctor will never begin to stimulate hair growth on the inflamed scalp. This sometimes comes as a surprise to some patients: they are in a hurry to start the main treatment, they believe that they are wasting time, and in the meantime the hair will continue to fall out. Here it is necessary to be patient and explain that oily seborrhea, often accompanying AGA and sometimes complicated by seborrheic dermatitis, this is part of the general pathological inflammatory process, since the sebaceous glands, like the hair follicle itself, are an androgen-dependent organ.

And by themselves, seborrheic dermatitis and / or oily seborrhea, even with active itching, does not cause hair loss: this is all one of the manifestations of androgenetic alopecia against the background of a multicomponent inflammatory process.

What will it look like? What signs should the patient pay attention to during trichoscopy? I really like to watch the response, when I describe in detail everything that can be seen in this state on the monitor screen. Inflammatory phenomena on the scalp can be in the form of perfollicular peeling and erythema (redness), pronounced peepillary marks (discoloration around the mouth of the hair follicle), hyperpigmentation, as a result of inflammation, and as a result of exposure to sunlight, especially if you do not wear a headdress: after all, against the background of thinning hair, the scalp becomes more vulnerable.

Biopsy is not a mandatory research method for AGA, but in some difficult diagnostic cases it is absolutely necessary. This will be especially important for severe fibrosis, foci of focal atrichia (a small visible focus of thinning), with suspicion of diffuse alopecia areata and alopecia areata incognita (latent form of alopecia areata), as well as cicatricial diseases – lichen planus (LPP) and frontal fibrous alopecia of typical distribution (FAPD) is a combination of lichen planus and androgenetic alopecia.

What is characteristic of AGA itself?

On histological examination, we will see miniaturization of terminal hair and perfollicular lymphocytic infiltration in the upper third (as in cicatricial alopecia), which ultimately ends in fibrosis. It is FIBROSIS that prevents the follicle from forming normal terminal hair. That is why the use of minoxidil and finasteride does not give the desired results in patients with severe microinflammation, hair growth is observed only in half of the patients. Moreover, there is evidence that the use of minoxidil and other stimulating techniques using growth factors and signaling molecules not only did not have a positive effect, but even increased the inflammatory response and hair loss.

Mesotherapy and other aggressive and traumatic techniques will also provoke inflammation. That is why, taking into account the severity of the process, the prescription and its prevalence, anti-inflammatory therapy will definitely come first.These can be injection techniques using corticosteroids in various dilutions (once a month) or their external forms in the form of an ointment, cream or spray, used daily for 1-1.5 months. But their purpose will be limited if there is a microbial process that will require appropriate treatment.

Thus, the combined effect of dermatological peels, antimicrobial shampoos, therapeutic and cosmetic lotions, physiotherapeutic methods with anti-inflammatory, angioprotective and defibrosing effects will be the most optimal and effective means of treating scalp inflammation and only then it will be possible to start stimulating hair growth.

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Basalioma

General data

Malignant skin diseases are a large group of tumors with a different picture of clinical manifestation, prognosis and treatment. This group includes melanoma, squamous cell carcinoma of the skin, basal cell carcinoma of the skin, Merkel’s cancer, cancer of the cells of the sebaceous and sweat glands, lmphoma of the skin.

Basal cell carcinoma of the skin (BCC) is a tumor of the cells of the basal layer of the epidermis. It is characterized by spreading into the surrounding tissues with their destruction, as well as relatively rare metastasis.

BCC is the most common form of skin cancer in the world, accounting for up to 80% of detected non-melanocytic skin tumors, which is about 2 million new cases per year.

In recent years, a significant increase in the incidence of basal cell skin cancer has been noted in many countries. At the same time, the tumor is mainly detected in representatives of the European population, in whom the risk of developing BCC during their life is ~ 30%. In 2015, about 50,000 patients with this diagnosis were diagnosed in Russia.

The preferred localization of BCC is on the scalp and neck (up to 80% of cases), while multiple lesions are often diagnosed.

Basal cell carcinoma mortality is not high. But due to the high incidence rate and frequent localization in open areas of the body, the disease has a high social significance.

Risk factors for the development of basal cell skin cancer

• Excessive UV exposure ^1–5
• Occupational hazards: beryllium, chromium, etc.
• Permanent trauma
• 1 ^nd skin phototype
• Pigmented xeroderma
• Radiotherapy performed
• Adverse heredity
• Immunosuppressive therapy
• Keratosis, Bowen’s disease

Clinical forms

As one of the most commonly diagnosed malignant neoplasms, basal cell carcinoma has a very diverse clinical picture, well known to dermatologists and dermato-oncologists.

The use of dermatoscopy is important for the diagnosis of early forms of basal cell carcinoma. The diagnosis is established only on the basis of a histological examination of a biopsy specimen or a completely removed lesion.

The superficial form is manifested by an area of ​​limited peeling pink spots with a roller-like edge. Among the surface forms, self-shredding or pagetoidal basal cell carcinomas are distinguished.

With pigment form , the color of the lesion has a bluish, purple or dark brown color.This form is very similar to melanoma.

Nodal form is characterized by the appearance of a nodule, which gradually increases in size.

A characteristic feature of ulcerative form is a funnel-shaped ulceration.

Scleroderma-like , or cicatricial-atrophic, form is a small, clearly demarcated lesion

Pincus fibroepithelial tumor o have a favorable course, appear as a nodule or plaque of skin color, dense elastic consistency.

BKR stages

Determined on the basis of the international TNM classification according to the following algorithm.

To determine the clinical course, treatment tactics and prognosis, it is more important to determine the risk factors for basal cell carcinoma. The group with a high risk (respectively, with a poor prognosis) includes tumors with poorly defined boundaries, measuring more than 6 mm when located in the area of ​​the face, genitals, hands and feet, more than 10 mm when located on the scalp, recurrent tumors, tumors with aggressive histological variants that have arisen against the background of irradiated tissues.

Features of the histological variant, complex anatomical localization predetermining an extremely poor cosmetic result in combination with other high-risk factors determine the group of inoperable basal cell carcinoma. The latter is up to 6%

Metastatic BCC is a rare form with a poor prognosis: the average survival time does not exceed 8-14 months. Metastatic BCC occurs in 0.3% of cases.

Most often, the tumor metastasizes to the bone, lung, liver.

Symptoms of skin cancer and methods of its diagnosis

The terrible word “cancer” is familiar even to people far from medicine. It is generally accepted that this term is synonymous with imminent inevitable death, because everyone has heard tragic stories from the lives of celebrities or acquaintances who were diagnosed with such a diagnosis. Various malignant skin neoplasms were diagnosed in Hugh Jackman (X-Men, Wolverine), Khloe Kardashian ( American television personality, participant in the reality show “The Kardashian Family), the well-known father of Yeralash continues to fight for life with metastases of melanoma -“ It turned out that a big disease has grown from a small mole, ”sighs Grachevsky.From the consequences of the development of a skin tumor died: Bob Marley (Jamaican musician, guitarist), winner of the Miss Universe 2006 contest – Russian model Anna Litvinova. In 2012, Anna was diagnosed with melanoma, she went to Germany for treatment, where she died about a year later, on January 22, 2013, at the age of 31.

However, cancer can be defeated if it is detected at an early stage and qualified medical help is sought. Therefore, let’s talk about one of the most common oncological diseases in Russia – malignant neoplasms of the skin, which are the second most common among all malignant neoplasms in women (after breast cancer) and third in men (after lung and prostate cancer).

The situation in Russia remains alarming: often patients simply ignore the first symptoms of skin cancer and go to the hospital with an advanced stage of the tumor, when there can be no guarantee of recovery. So at the 4th stage of melanoma – the most malignant neoplasm of the skin, even with proper treatment, only half of 10 patients live longer than 5 years. But unlike cancer of internal organs, malignant skin tumors are always in sight.

Causes of skin cancer

The appearance of any malignant neoplasm is a consequence of a malfunction in the body: normally, the immune system destroys defective cells before they start uncontrolled division. If, for some reason, the defense mechanisms do not work, the tumor grows in size and becomes invulnerable to its own defense system. In the case of skin cancer, the most dangerous environmental factors that increase the likelihood of tumor development are ultraviolet and ionizing radiation, as well as exposure to harsh chemicals.

Experts note that malignant neoplasms of the skin, in particular melanoma, are often provoked by visiting a tanning salon: the fashion for bronze tanning has led to a significant increase in the incidence of malignant neoplasms (in the United States, for this reason, more than 170 thousand cases are diagnosed annually).“… White-skinned Anya always tried to follow fashion, she, like many now, visited tanning salons, loved to travel to exotic countries where there is a lot of sun,” recalls Anna Litvinova’s friend, Ksenia Volkova.

Symptoms and signs of skin cancer

Any type of malignant tumors first manifests itself locally – at the site of the lesion, and then, if untreated, affects the patient’s well-being as a whole. In the case of skin cancer, the relationship between local and general symptoms is in favor of local symptoms: until the later stages of the disease, others may not suspect that a person is sick.Local symptoms of skin cancer are visible to the naked eye: it can be a wound that does not heal for several weeks or months, a spot that gradually increases in size, or a mole that has changed its shape or color. Depending on the type of tumor, the growth of the neoplasm is slow or fast, but in any case, the change in the skin progresses. In the affected area, itching, pain, bleeding or peeling are often observed, such complaints should alert not only the patient, but also his family – it is strongly discouraged to postpone a visit to the doctor in such cases.

Types, stages and prognosis

Malignant neoplasms of the skin include several cancers at once, with different origins, specific symptoms and prognosis. Tumors such as basal cell carcinoma, squamous cell carcinoma of the skin and melanoma are statistically diagnosed more often than others, but there are also rarer variants. Only a dermatologist oncologist can reliably establish a diagnosis.

Basal cell carcinoma (basal cell skin cancer) is the most common type of skin cancer that develops from epidermal cells.At first, the tumor looks like a small pink nodule, under the surface of which a network of blood vessels is visible. As it grows, the neoplasm can ulcerate and bleed, a crust appears on the surface for no apparent reason, which can pass, but then reappears. Most often, basalioma occurs on the skin of the face, less often on other areas of the skin. Usually, the disease develops slowly and does not give metastases, so the prognosis for patients is favorable, and treatment includes only removal of the tumor.

Squamous cell skin cancer can have several clinical variants, in one case it can be presented, as well as basal cell carcinoma – a single node with a bleeding ulcer or crust on the surface, a long-term non-healing ulcer or local keratosis resembling a “cutaneous horn”. Squamous cell carcinoma is often located on the red border of the lips, open areas of the skin exposed to ultraviolet radiation. This cancer is capable of invasive growth and metastasis – i.e. penetrates into the deep layers of the skin and is transported with the blood stream through the body to other organs and tissues.

Melanoma is a tumor that develops from pigmented skin cells – melanocytes. As a rule, it develops at the site of moles, which are an accumulation of pigment, or appears on their own.

With progression, melanoma is prone to rapid aggressive growth and is able to form metastases (distant tumors). However, before the beginning of invasive growth, it usually takes several years until melanoma grows within the epidermis (the uppermost layer of the skin) – the “stage of horizontal growth” and treatment, which consists in removing the tumor, at this moment almost completely eliminates the risk of the formation of distant metastases and development formidable complications for life. That is why it is so important to monitor the appearance of moles: if one of them has changed its shape, color, or looks swollen, itches or bleeds, an urgent need to consult a doctor.

On the contrary, in the older age group, nodular or nodular melanoma is more often formed, which practically does not have a stage of intraepidermal growth and quickly becomes invasive, therefore it is also very important to monitor the appearance of new dark nodular neoplasms on the skin of our elderly relatives and friends.

People who have been diagnosed with cancer are always interested in the prognosis of the course of the disease. “Doctor, how long will I live?” Is a popular question in the practice of oncologists.If we are talking about skin cancer, the prospects for recovery in most cases are good, because the most common tumor, basalioma, does not metastasize, and a small surgical intervention is enough to eliminate it. The key parameter in oncology is the survival rate. He talks about, for example, how many patients with this stage of cancer were able to live more than 5 years after the tumor was detected. So, with basal cell carcinoma, the survival rate approaches 100%, regardless of the size of the neoplasm.And with stage 2 melanoma, only 50% of patients step over the 5-year line even with proper treatment.

Diagnostic methods

Physicians specializing in the diagnosis of skin cancer have an impressive arsenal of diagnostic techniques to confirm or deny the diagnosis, and also to classify the tumor. Examination is the most obvious and simplest way to suspect a neoplasm. If you are worried that you are developing skin cancer, show the unusual area of ​​your body to the doctor.He will compare a suspicious mole or sore to other pigment cell clusters. If there are grounds for concern, the doctor will prescribe additional diagnostic methods. For a more accurate diagnosis, oncologists-dermatologists use a dermatoscope – a device that allows you to see the structure of a neoplasm in detail, in polarized light. For the final confirmation of the nature of the tumor, a biopsy is used, in which the doctor takes a small section of the patient’s tissue from the affected area in order to study it under a microscope in the laboratory. Ultrasound and tomography are required to detect possible metastases

Doctors sometimes say that when detecting cancer, it is important not to give the diagnosis “paralyze consciousness.” Awareness of modern diagnostic and treatment options and cooperation with doctors will help to defeat an insidious disease!

How often do you need to see a doctor in order to detect a disease in a timely manner?

The frequency of inspections is 6-12 months.

How to pass the examination at the Center.V.P. Avayev?

In our Center, patients are received by an oncologist-dermatologist, Candidate of Medical Sciences Dubensky Vladislav Valerievich

Registration by phone: (4822) 633-123.

make an appointment with a dermatologist oncologist

HAIR STRUCTURE

The structure and growth cycle of hair is an interesting and useful topic for a hairdresser. Here we will go into detail about the main stages of hair growth.

Hair under the skin forms in the hair follicle (hair follicle).Body hair is different from each other. For example, eyelashes do not come out of the hair follicles in which they are formed.

On the scalp, depending on the sectional shape, the hairs differ in their appearance (see the image “Types of hair structure”). For example, straight hair has a round section, while wavy and curly hair has an oval and flat section. The shape of the hair depends on the shape, size and curvature of the hair follicle.

The hair follicle is located in both layers of the skin – the epidermis and the dermis, more precisely, from the upper layer of the dermis to the inner layer of the epidermis.The base of the follicle is the hair papilla. It also contains cells that produce pigments that give the hair its natural color. This area is called the hair funnel.

1. Slightly higher is the zone of keratinization (see the image “Hair structure in cross section”). This is where the keratin hardens, which makes the hair strong.

2. The papilla is a formation at the base of the hair follicle. The papilla mainly consists of connective tissue and a network of blood vessels, which supply nutrients to the bulb.The hair follicle covers the hair papilla with its base (see the image “Hair papilla in cross section”).

3. The dermis consists of three different layers. The outer, thin layer of connective tissue includes blood vessels and nerve endings. The middle, dense layer consists of fusiform cells. The inner layer consists of flat, mirrored cells.

The epidermis surrounds the hair, forming an inner and outer bed. The cuticle of the inner root bed is in contact with the hair cuticle (see.(See image “Hair follicle in the dermis in cross section”). The inner surface of the cuticle of the root bed completely coincides with the outer surface of the hair cuticle. The inner bed consists of two layers: the Henle layer (oblong cells with invisible nuclei) and the Huxley layer (consisting of keratinized, flat cells with nuclei).

The core of the hair is called the medulla (see the illustration “Hair follicle in cross section”). While the hair is forming inside the skin, the medulla has a liquid consistency, with inclusions in the form of air bubbles.The medulla is surrounded by a cortex of elongated cells – a fibrous structure that gives the hair its natural strength. Pigment granules are found in the voids between these cells. As the cells of the cortex move outward, to the outer layers, their surface part acquires a flatter, scaly shape, forming the cuticular hair layer .

90,000 how does it arise, causes, symptoms and methods of treatment in a clinic in St. Petersburg

Table of Contents

Basal cell carcinoma (basal cell carcinoma, basal cell carcinoma, basal cell epithelioma) is the most common cancer in humans.Consists of cells similar to those of the basal layer of the epidermis. It differs from other cancers in its extremely rare metastasis, but it is capable of extensive local growth, which leads to significant cosmetic and functional disorders.

Epidemiology

Basal cell carcinoma is the most common epithelial neoplasm of the skin, accounting for 45-90% of all malignant epithelial tumors of this localization. According to domestic authors, in the structure of the total oncological morbidity, assessed under conditions of continuous medical examination over a 10-year observation period, basal cell carcinoma was 86.8%, melanoma – 9.4% a, squamous cell carcinoma and other malignant skin tumors – 3.8 %.

The disease occurs mainly in people over 50, but it also occurs at a younger age – 20-49 years. Basal cell carcinoma develops equally often in men and women.

Basal cell carcinoma usually develops in open, sun-exposed places: on the skin of the nose, nasolabial folds, in the periorbital and periauricular regions, on the auricles, scalp, forehead in the temporal regions, neck.

Less often, basal cell carcinoma is localized on the trunk, limbs.As rare localizations, areas of axillary folds, soles, palms, buttocks, anus are marked. “Atypical” localization in 39% of cases was determined with primary multiple basal cell carcinoma.

Pathogenesis

Basalioma is a tumor consisting of undifferentiated but highly pluripotent cells, presumably associated with cells of the hair follicle.

Basal cell carcinoma can develop de novo or, less commonly, in areas of the skin damaged by chemical, thermal and other agents.The appearance of a tumor is associated with prolonged sun exposure (especially for persons with fair skin), exposure to chemical carcinogens, and ionizing radiation. In this case, the latent period after exposure to ionizing radiation was 20-30 years.

A certain role in the development of a tumor is assigned to hereditary and immunological factors. Neoplastic transformation of a cell is believed to occur as a result of a series of abnormalities in its genome, which lead to a progressive loss of control over the growth and differentiation of the cell.In the 9th chromosome of the human genome there is a gene, mutations of which lead to the development of basal cell carcinoma. The likely cause of the mutations is ultraviolet radiation (UVR). UV radiation leads to several types of gene damage, including the formation of photodimers, DNA chain breaks. Point mutations of the gene under the influence of ultraviolet irradiation are detected in 40-56% of cases of basaliomas.

Basal cell carcinoma is known to grow slowly. On the basis of autoradiographic studies with a thymidine label, it was shown that mitotic activity in nodular basaliomas is observed mainly in the peripheral zones of tumor complexes.In more aggressive histological subtypes, such as infiltrating or morphe-like basaliomas, mitotic figures are more common and are found throughout the entire area of ​​the complexes.

In conclusion, it should be emphasized that while squamous cell carcinoma can develop almost anywhere there is an epithelial lining, there are no analogs of cutaneous basal cell carcinoma in internal organs.

Clinical picture

The clinical manifestations of basal cell carcinoma are diverse. The main clinical forms are: nodular, superficial, scleroderma-like basal cell carcinoma and Pincus fibroepithelioma. The pigment form can be a kind of nodular or superficial form, in connection with which, it is impractical to consider it an independent form.

Nodular basal cell carcinoma

Nodular basal cell carcinoma – “classic”, the most common form, accounting for 60-75% of all forms of basal cell carcinoma.It is characterized by the formation of a waxy, translucent, hard to the touch, rounded nodule with a diameter of 2-5 mm, the color of unchanged skin (micro-nodular type of basal cell carcinoma). Over the course of several years, due to peripheral growth, the tumor acquires a flat shape, reaching 1-2, less often more than centimeters in diameter. The surface of such a node is smooth, dilated full-blooded capillaries (tele-angiectasias) appear through a translucent or pearly plaque of various sizes.

As a result of the fusion of several nodular elements, a scalloped tumor focus with a ridge-shaped edge and a tuberous surface (conglobate type of basal cell carcinoma) can form. The central part of the node often ulcerates and becomes covered with a hemorrhagic crust, with violent rejection of which, punctate bleeding appears, then the crust grows again, masking the ulcerative defect (an ulcerative variety of basal cell carcinoma). In some cases, ulceration becomes more significant, acquiring a funnel-shaped form, and a process is formed like ulcus rodens with a dense inflammatory infiltrate along the periphery up to 0.5-1 cm wide (an infiltrative type of basal cell carcinoma).Ulcerative infiltrative basal cell carcinoma can significantly destroy tissues, especially if they are localized near natural openings (nose, auricles, eyes) – perforating basal cell carcinoma. When located on the head, ulcerative infiltrative basal cell carcinoma can reach gigantic proportions. Such types of ulcerative basal cell carcinoma are difficult to distinguish from metatypical and squamous cell carcinomas, they are difficult to treat, persistently recur, and can metastasize.

Nodular tumors may contain melanin, which gives the lesion a brown, blue, or black color (pigmented basal cell carcinoma). The tumor can be pigmented either completely or only partially. Such cases require differentiation from melanoma. However, close examination usually reveals the pearly raised border characteristic of basal cell carcinoma.

Superficial basal cell carcinoma

Superficial basal cell carcinoma – the least aggressive form of basal cell skin cancer, usually characterized by a single (rarely multiple) plaque-like rounded pink lesion with a diameter of 1 to several centimeters, on the surface of which peeling, small crusts, areas of hyper- and hypopigmentation, atrophy , which together represents a clinical picture similar to foci of eczema, mycosis, psoriasis.A distinctive feature of superficial basal cell carcinoma is its non-protruding filamentous edge, consisting of small shiny whitish translucent nodules. In some cases, the tumor may be superficially infected, making differential diagnosis difficult.

Superficial basal cell carcinoma is usually localized on the trunk and extremities in areas of moderate sun exposure, less often on the face. The frequency of this form is 10% of all basaliomas. This form of basal cell carcinoma is marked by slow growth over many years.

The types of superficial basal cell carcinoma include: pigmented basal cell carcinoma, characterized by a brown focus; self-scarring basal cell carcinoma of Little, characterized by pronounced centrifugal growth with the formation of a focus of cicatricial atrophy in the central zone of the tumor at the site of spontaneously scarring erosive nodules, along the periphery of which the formation and growth of new erosive areas continues. In rare cases, in the later stages of its development, infiltration, ulceration of the focus and the formation of large nodules are possible, i.e.e. transformation of superficial basal cell carcinoma into more aggressive varieties.

Scleroderma-like basal cell carcinoma

Scleroderma-like (morphea-like, sclerosing, desmoplastic form) basal cell carcinoma is a rare aggressive form of basal cell carcinoma, characterized by the formation of an infiltrative hard plaque with a yellowish waxy surface and telangiectasias resembling plaque scleroderma. Scleroderma-like basal cell carcinoma accounts for 2% of all forms of basal cell carcinoma, it does not have a favorite localization.This type of basal cell carcinoma is characterized by primary endophytic growth, therefore, at first, a flat, slightly elevated lesion can gradually become depressed, like a rough scar. The tumor is fused with the underlying tissues, its edges are indistinct, tumor growths usually go beyond the clinically visible border, invading the surrounding skin. In the later stages, ulceration (ulcerative type) of the tumor is possible.

During evolution, a zone of atrophy can form in the central part of some plaques, while in the peripheral part small tumor nodules can be seen – a cicatricial-atrophic type of basalioma.

Fibroepithelioma Pincus

Pinkus fibroepithelioma is a very rare form of basal cell carcinoma, characterized by a hyperplastic, swollen, mucoid-rich stroma, in which thin anastomosing strands of basaloid cells are located. Fibroepithelioma is usually a solitary, flat, moderately dense, smooth nodule of normal skin color or slightly erythematous, resembling dermatofibroma or a plaque of seborrheic keratosis.It is usually localized on the trunk, more often in the back, lumbosacral zone, less often on the limbs: thighs, soles. It can be combined with seborrheic keratosis, superficial basal cell carcinoma.

Current and forecast

The course of basal cell carcinoma is chronic, the tumor grows slowly, rarely metastasizes. However, in severe cases, the tumor can lead to severe destruction of tissues, including cartilage, bones, and also take an aggressive course. The most aggressive course is scleroderma-like and ulcerative infiltrative form of basal cell carcinoma.Nodular non-ulcer and superficial basal cell carcinomas are less aggressive.

Basalioma treatment

The choice of a method for treating basal cell carcinoma and its effectiveness often depend on the nature of the tumor (primary, recurrent), its clinical morphological characteristics, the number of foci and their localization, the size of the tumor and the depth of invasion, the age of patients and the presence of concomitant diseases, etc.

In the therapy of basal cell cancer, in addition to surgical removal, they use close-focus X-ray therapy, cryodestruction, laser therapy, photochemotherapy, electrocoagulation and curettage, chemotherapy, immunotherapy and complex therapy.

Near-focus X-ray therapy is usually used to treat solitary basaliomas up to 3 cm in size.However, the recurrence rate in this case is from 1.6 to 18%, and when basal cell carcinoma is localized on the face – from 10 to 30% of cases, especially in anatomically complex areas (auricle , corners of the eyes, etc.). In this regard, a combination of surgical excision of the tumor and radiation therapy is possible, but this can lead to significant cosmetic defects.

The most common cryodestruction is effective in 70-98% of cases with limited forms of basal cell carcinoma.

Laser therapy provides a good therapeutic and cosmetic effect with a sparing local effect on the tumor in pulsed (neodymium laser) or continuous (carbon dioxide laser) modes, causing coagulation tissue necrosis with clear boundaries. Laser therapy is used mainly for superficial types of basal cell carcinoma.

Recurrences of basal cell carcinoma with the impulse method of therapy are 1.1-3.8% – with primary 4.8-5.6% in relapsed variants of basal cell carcinoma; with continuous exposure – respectively 2.8 and 5.7-6.9%.

One of the new methods is photodynamic therapy, which uses photosensitization using photoheme followed by light radiation with a wavelength of 630-670 nm. This method of treatment is used both for superficial foci and for nodular ulcerative forms of basaliomas, both solitary and multiple.

When electrocoagulation and curettage are used as independent methods, tumor recurrence is observed in 10-26% of cases.

Of the chemotherapeutic agents, cytostatic ointments are used: 5% 5-fluorouracil, 5-10% fluorofuric, 30-50% prospidin, etc.within 2-4 weeks. usually in the elderly, with multiple superficial basal cell carcinomas.

A complex method of treating basal cell carcinoma, including parenteral administration of prospidin and subsequent cryodestruction of the tumor, is used for multiple variants of basal cell carcinoma, large tumor sizes, and ulcerative forms.

It is also possible to use isotretinoin and etretinate in the treatment and prevention of basal cell carcinomas, drugs that normalize the activity of enzymes of the cyclase system, as well as intron-A or interferon-A injections of basal cell carcinomas.

Prevention

Prevention includes active detection of the tumor; formation of high-risk groups and identification of risk factors; organizational and methodological work among general practitioners for the early diagnosis of skin cancer; sanitary and educational work among patients.

When forming groups of increased oncological risk, it is necessary to take into account the peculiarities of epidemiological and immunogenetic studies, which makes it possible to reduce the number of patients requiring increased oncological alertness.It is to these groups that the limitation of sun exposure and the use of photoprotectors are recommended, as well as the compulsory treatment of precancerous dermatoses.

Patients with single forms of basal cell carcinoma without aggravating risk factors are observed for no more than 3 years. This observation period is quite enough to clarify the prognosis and identify a possible relapse of the disease. In this case, the examination by a dermatologist is carried out 4 times in the first year, and 1 time in the next 2 years. Patients with primary multiple recurrent basal cell carcinoma are recommended to be actively monitored immediately for life.

This is due to the fact that in patients with multiple primary forms of the disease, the number of relapses at the site of tumor treatment was 7.8 times higher than in patients with a single tumor. Relapses at the site of removal of basal cell carcinoma in patients with a single form of the disease occur during the first 3 years of follow-up, and with multiple – at the 3rd and 5th years.

Mesotherapy for hair and scalp in Moscow. Price from 2 100 rubles in the medical center Tkachev

Mesotherapy for hair and scalp treatment is injections of special cocktails that are delivered directly to the hair follicles to treat hair loss, improve hair growth, repair structural damage to the hair, and heal the scalp.

Preparations for hair mesotherapy

In our Educational and Clinical Medical Center Tachev, injection methods are used that are approved for use on the territory of the Russian Federation. The choice of drugs, the frequency of administration and the number of procedures per course, the period between courses, the methods of administration are determined by the disease, its severity and duration of the course.

In our practice, we use preparations based on natural placenta (melsmon, curasen), preparations based on peptides and growth factors, hyaluronic acid, amino acids, coenzymes – pluryal hair, hair X, NCTF, etc.

Research conducted, including on the basis of our center, indicates that injectable drugs should not be injected too deeply, although there are exceptions. So, the drug Melsmon is injected deeper than other drugs, subcutaneously.

The more superficial the injection, the slower the diffusion, which leads to an increase in the residence time of the drug in the upper dermis. 50% of the drug injected at a depth of less than 4 mm remains at the injection point after ten minutes, while only 16% of the drug injected at a depth of more than 4 mm remains at the injection point after 10 minutes.

We also take into account that not only the pharmacological properties of the drug (activated platelet plasma, medicinal cocktails, ozone-oxygen mixture) determine the effectiveness of the procedure.

It is well known that the fact of microtraumatization of the skin with a needle starts a whole cascade of complex biological reactions, as a result of which a large number of cellular growth factors are released, cell division is activated in the bulge zone, where the upper niche of mesenchymal stem cells is located, and the expression of genes regulating hair growth is activated.In this regard, we usually carry out complex procedures that include not only the administration of drugs, but also combine mesotherapy with fractional impact on the problem area.

This approach allows you to get significantly more pronounced results than classical mesotherapy sessions.

Mesotherapy of the head is prescribed in the following cases:

• Deterioration of the hair structure: fragility, dryness, dull color, thin hair with split ends.
• Postpartum and seasonal hair loss.
• Slow hair growth.
• Early appearance of gray hair.

How is scalp mesotherapy performed?

Stage 1: once a week for 2-4 months (8-16 procedures).

Stage 2: once every 2 weeks, from 2 to 6 months (4-12 procedures)

Supporting stage – once a month. Our experience shows that carrying out mesotherapy procedures in a supportive mode, once a month, is not effective enough.If necessary, platelet-rich plasma * (PRP) therapy is more appropriate as a maintenance treatment. In the chronic course of the disease, courses are repeated after 1-1.5 years. The optimal treatment tactics are determined at a consultation, based on each specific case.

The procedure takes about 20-30 minutes, on an outpatient basis in the office of the medical center. For scalp mesotherapy, specialized medical syringes with thin needles are used. The introduction of the medicinal solution occurs by immersing the needle into the scalp.

Almost any (effective) stimulation of hair growth can cause a temporary increase in hair loss (a well-known example, at the beginning of the use of minoxidil), this is due to the fact that during treatment, hair loss in the telogen phase is accelerated, and, therefore, after hair loss, new ones should appear. healthier hair.

Reception in the direction of scalp mesotherapy

In the Educational and Clinical Medical Center of Dr. Tkachev, procedures are carried out that will help to cope with various trichological problems.We widely use laser stimulation of hair growth (we use high-intensity fractional erbium laser), injection of platelet-rich plasma (Cortexil PRP) and ozone-oxygen mixture, trichological peelings and fractional methods of therapy.