What is seborrheic keratosis
Seborrheic keratosis is a benign tumor of epidermal cells that grow and accumulate horny substance. Despite the name, it is not associated with sebaceous glands and seborrheic dermatitis. Formations usually appear in adulthood, grow slowly and persist throughout life. There can be from one to several dozen. The varieties differ in appearance: flat pigmented spots, convex warty plaques, small dark nodules on the face of people with dark skin, light growths on the legs.
- Classic warty form
- Flat pigment form
- Irritated (inflamed) keratoma
- Black papular dermatosis on the face
- Stucco keratosis on the legs and feet
Causes and risk factors
The main factors are age and heredity: many patients also have keratomas in their parents. Genetic changes associated with skin aging are found in the cells of the formations. The role of the sun is debated: keratomas are also found in closed areas, but more often on the face and back. Friction from clothing causes irritation to existing elements. Seborrheic keratosis is not transmitted by contact and is not associated with the human papillomavirus, diet or hygiene.
- Mature and old age
- Family predisposition
- Light skin
- Ultraviolet exposure
- Friction and skin injury
What it looks like and how it differs from other formations
A typical keratoma is an oval plaque with clear boundaries, rising above the skin, with a matte, rough or fissured surface. Color varies from flesh to black. Sometimes the surface crumbles, and along the edge the formation looks like it can be picked out. Keratomas can itch and become inflamed when rubbed. They need to be distinguished from melanoma, pigmented basal cell carcinoma, viral warts and actinic keratosis, which is considered a precancerous condition.
- Clear boundaries
- Warty rough surface
- Color from light to dark brown
- Type of “glued” plaque
- Small horny dots on the surface
- Itching with irritation
Diagnostics
The dermatologist makes a diagnosis during examination, and dermatoscopy allows you to see the signs characteristic of keratoma: horny cysts, pseudopores, tortuous grooves and ridges. This helps to distinguish it from melanoma and basal cell carcinoma. If the formation is atypical, changes quickly or is inflamed, the doctor recommends removing it surgically and sending it for histological examination. Destructive removal methods without analysis are used only when the diagnosis is certain.
- Examination by a dermatologist
- Dermatoscopy
- Digital photo for control
- Excision with histology if in doubt
Treatment
Seborrheic keratosis does not require mandatory treatment. Removal is carried out for cosmetic reasons, in case of persistent injury from clothing, itching, inflammation or doubts about the diagnosis. Cryodestruction with liquid nitrogen, curettage, electrocoagulation, laser or radio wave removal are used. After the procedure, a crust forms at the site of formation, which disappears after 1–2 weeks. Sometimes a light or dark spot remains. You cannot cut or tear off keratomas yourself: this leads to bleeding and infection.
- Show the formation to a dermatologist before removal
- Do not pick or scratch keratomas
- Remove traumatized formations
- Protect skin from the sun
- Examine the skin annually if there are multiple formations