Seborrheic Keratosis: Understanding a Common Benign Skin Growth

Seborrheic keratosis is a prevalent benign skin condition that manifests as harmless growths, often likened to moles. Most individuals will experience at least one such growth during their lifetime, with their occurrence typically increasing with age. While these growths are not medically necessary to remove, some may opt for removal for cosmetic or comfort reasons.

These skin growths are sometimes referred to as epidermal tumors, a term that should not be misconstrued with cancer. The term simply indicates a collection of additional cells on the epidermis, the skin's outer layer. This classification also includes moles and warts and does not imply any increased risk for skin cancer.

Characteristics of Seborrheic Keratosis

Seborrheic keratoses typically present as round or oval patches with a distinctive "stuck on" appearance, often described as waxy or scaly.dermoscopy of actinic keratosis They are palpable, even when not prominently raised, and exhibit a range of colors from brown to black, tan, or less commonly, pink, yellow, or white. The surface of these growths is marked by keratin, a fibrous protein also found in fingernails and horns, which gives them their characteristic texture. This texture can resemble small bubbles, cysts, a scabby surface, or the ridged pattern of a brain.

Who is Affected by Seborrheic Keratosis?

While anyone can develop seborrheic keratosis, certain groups are more commonly affected:

Individuals over the age of 50, with the growths becoming more prevalent as one ages.

Those with a family history, suggesting a potential hereditary component.

Lighter-skinned individuals, although a variant known as dermatosis papulosa nigra is common in darker-skinned individuals.

Causes and Symptoms

The exact triggers for seborrheic keratosis are not fully understood, but factors such as age, sun exposure, and genetics are believed to play a role. These growths usually progress slowly and may evolve in texture over time. A sudden appearance of multiple growths, known as "the sign of Leser Trélat," has been anecdotally linked to internal cancers, though this correlation remains unproven.

Seborrheic keratoses are generally asymptomatic, but some individuals may experience itching, irritation from friction, or bleeding.

Differential Diagnosis

Distinguishing seborrheic keratosis from actinic keratosis is important due to the latter's precancerous nature. While both conditions can appear crusty and scaly, actinic keratosis is typically less pigmented, flatter, and more likely to cluster in sun-exposed areas.

Differentiating seborrheic keratosis from melanoma is also crucial, as melanoma is a serious skin cancer. Key differences include the number of lesions, texture, border definition, color uniformity, and the rate of change.

Diagnosis and Treatment

Diagnosis usually involves a visual examination by a dermatologist, potentially aided by dermoscopy for unclear cases. If cancer is suspected, a biopsy may be performed.

While seborrheic keratosis does not require treatment, removal options are available for those who seek it. These include cryotherapy, electrodessication and curettage, shave excision, laser therapy, and prescription hydrogen peroxide.

Over-the-counter treatments containing tazarotene, alpha hydroxy acids, or vitamin D3 may also be used, though they are generally less effective and require consistent application.

Prognosis and Management

Seborrheic keratoses are not a cause for concern, but a proper diagnosis is essential to rule out other conditions. Removal methods are available for those who wish to eliminate the growths, and while removed keratoses will not return, new ones may develop.

It is advisable to consult a healthcare provider if one notices a new growth, changes in an existing growth, or a sudden increase in the number of growths.

In summary, seborrheic keratosis is a benign condition that, while not requiring treatment, can be managed through various methods if necessary. Regular check-ups and communication with healthcare providers ensure peace of mind and appropriate care.