Seborrhoeic keratosis

• Seborrhoeic keratosis/warts:

  • Also known as basal cell papilloma/senile wart
  • They are harmless warty spots that appear during adult life as a common sign of skin ageing - some people have hundreds
  • Very common - over 90% of adults over the age of 60 have at least one
  • Lesions develop over time - typically begin to erupt in 30s or 40s and become more numerous as time goes by
• Clinical features:

  • Can arise on any area of the skin - except palms, soles and mucous membranes
  • Variable in appearance
  • Flat or raised papule or plaque
  • 1mm to several cm in diameter
  • Skin coloured, yellow, grey, light or dark brown, black, mixed colours
  • Superficial crusted lesions with a greasy appearance
  • Smoother, waxy or warty surface
  • Lesions have a stuck-on appearance - seem to be superficially attached to the dermis
  • Solitary or grouped
  • Are usually asymptomatic, but can be itchy and become inflamed or irritated after trauma
• Diagnosis:

  • Clinical +/- dermoscopy
  • If there is any doubt can have shave/punch biopsy or diagnostic excision
• Treatment:

  • Best managed with reassurance and explanation of diagnosis
  • Usually don't need removal but if symptomatic or unsightly can be removed
  • Options for removal:
  • Cryotherapy
  • Curettage and/or cautery
  • Ablative laser surgery
  • Shave biopsy/excision
  • Chemical peel