Seborrheic Keratosis

Seborrheic keratosis is a benign cutaneous tumour of the epidermis. It is a type of benign raised growth on the skin that may look like warts, but do not extend deep into the skin or contain the viruses that cause warts. Also known as Seborrheic Verruca and Senile Wart, these skin lesions tend to appear predominately during middle age.
Seborrheic keratosis before afterA seborrheic keratosis usually appears as a brown, black or light tan growth on the face, chest, shoulders or back. The growth has a waxy, scaly, slightly elevated appearance. Occasionally, it appears singly, but multiple growths are more common.
Seborrheic keratoses don’t become cancerous, but they can look like skin cancer. They are not contagious, do not spread, or do not turn into cancerous tumours. In most cases, treatment is not required.
The direct cause of seborrheic keratosis is unknown, but it may be linked to genetics.
Seborrheic keratosis should not be confused with Solar Keratosis, a different skin condition resulting from skin damaged by the sun.

Classification

Seborrheic keratoses may be divided into the following types:

  1.  Inflamed Seborrheic Keratosis: contains an abundant of inflammatory infiltrate with lichenoid qualities.
  2. Irritated seborrheic keratosis: produced by trauma, they are associated with HPV infection, horn cysts and pseudonym cysts with a range of keratinization patterns
  3. Dermatosis Papulosa Nigra: present mainly on the face, they are commonly found among adults with dark skin.
  4. Melanotic Seborrheic keratosis: contain numerous basaloid, pigmented keratinocytes. It is a darkly pigmented cutaneous condition characterized by a skin lesion with a dull or lacklustre surface.
  5. Genital Seborrheic Keratosis: occur in solitary, resemble pigmented basal cell carcinomas, and have scale

Treatment of Seborrheic Keratosis

Seborrheic keratoses do not pose a threat to your health, so treatment usually is not necessary. However they could be removed if the growth becomes excessively itchy or is irritated by clothing or jewellery, or if the condition affects the personal appearance.
The type of therapy employed for treatment of these lesions should be simple and fast depending on the classification of seborrheic keratosis manifested by the patient. The most used methods are:

  1. Laser treatment: Laser treatment normally causes no scarring. Lasers that can be used are: Pulsed Dye Laser: Flat pigmented seborrheic keratosis repond well to the pulsed dye laser. It works by coagulating blood vessels within the lesions. Alexandrite laser: It targets the pigment within the keratosis leading to the selective destructions of the lesion. CO2 and erbium lasers: Work by vaporizing the growth. An intense beam of light that burns and destroys the growth. Laser light cleans (sterilizes) and seals as it cuts tissue, which reduces bleeding, pain, and healing time.
  2. Cryosurgery: by freezing the growth with liquid nitrogen. It may not work on large, thick growths, and it may lighten the treated skin.
  3. Curettage: by scrapping the skin’s surface with a special instrument. Sometimes it is used along with cryosurgery to treat thinner or flat growths.
  4. Electrocautery: by burning the growth with an electronic current. This procedure can leave scars if it’s not done properly, and it may take longer than other removal methods.

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