Seborrheic Keratoses – OnlineDermClinic

In this tutorial, Kevin St.Clair M.D., discusses the diagnosis and management of seborrheic keratoses. Watch our tutorials given by U.S. Board Certified dermatologists at

Key Points
*Condition consists of common harmless skin lesions that appear during adult life.
*Lesions are slightly raised, skin colored or light brown spots that thicken, darken and become wart-like.
*Cause is unknown, thought to be a part of the general aging process.
*There are many variants

Seborrhoeic or Seborrheic keratoses are very common harmless skin lesions that appear during adult life. Seborrheic keratoses may also be called basal cell papillomas, senile warts, brown warts, age spots, or wisdom spots . Seborrheic keratoses are harmless and rarely or never become malignant. They begin as slightly raised, skin colored or light brown spots. Gradually they thicken and take on a rough, warty surface. They slowly darken and may turn black. These color changes are harmless but may result in the lesion looking like a Melanoma. They appear to stick on to the skin like barnacles. Seborrhoeic keratoses appear on both covered and uncovered parts of the body. There may be one or many of them.

The cause of Seborrheic keratoses is not known. The name is misleading, because they are not limited to a seborrheic distribution (scalp, mid-face, chest, upper back) as in Seborrheic dermatitis, nor are they formed from sebaceous glands as is the case with Sebaceous hyperplasia. Seborrheic keratoses are considered as part of the skin aging process. As time goes by, Seborrheic keratoses become more numerous. Some people inherit a tendency to develop a very large number of them. They are not generally caused by exposure to the sun, although they can follow sunburn or other irritating skin conditions including dermatitis.

Skin cancers are sometimes difficult to tell apart from Seborrheic keratoses, so if you are concerned or unsure about any skin lesion consult your doctor. Very rarely, eruptive seborrhoeic keratoses may denote an underlying internal malignancy. The syndrome is known as the sign of Leser-Trelat. Variants of Seborrheic keratoses include maular (flat) seborrheic keratose, stucco keratoses (numerous small dry grey stuck-on lesions usually found on lower legs and feet), Dermatosis papulosa nigra (numerous brown warty bumps on face, neck and chests of dark-skinned people), irritated seborrhoeic keratosis (inflamed lesion, often red and crusted), and Lichenoid keratosis (often pink or grey colored).

Differential Diagnosis (Other conditions with similar appearance)
Arsenical Keratosis
Basal cell carcinoma
Bowen Disease
Squamous cell carcinoma

Key Points
*Diagnosis is typically done through clinical inspection and, sometimes, Skin biopsy

Diagnosis is usually easily made by physical examination. When there is uncertainty about the growth a Skin biopsy may be done to rule out other diagnoses.

Key Points
*Treatment is not necessary as Seborrheic keratoses are harmless.
*Seborrheic keratoses can be easily removed through cryotherapy, curettage & cautery, laser surgery, and shave biopsy.

Seborrheic keratoses can easily be removed but may leave a small scar. The usual reason for removing a seborrheic keratosis is cosmetic or it may Itch or rub against your clothes. Occasionally your doctor may recommend its removal because of uncertainty of the correct diagnosis. Methods used to remove Seborrhoeic keratoses include cryotherapy, curettage & cautery, laser surgery, and shave biopsy.

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