EpistemisSeborrheic keratosis
Specialty: Skin.
Why it occurs
- Benign clonal proliferation of mature epidermal keratinocytes associated with intrinsic skin aging and prolonged exposure to environmental factors
- Acquired somatic mutations in the FGFR3 gene (fibroblast growth factor receptor 3) present very frequently
- Family genetic predisposition (inheritance of multiple lesions on the face and trunk)
- Continuous mechanical friction of the skin in fold areas (submammary or axillary region)
- Subclinical hormonal modulation that stimulates keratinocytic growth.
Initial workup
Visual clinical evaluation looking for the characteristic appearance of a raised, greasy lesion that appears "stuck on the skin" with the presence of corneal plugs evident under dermatoscopy. Excisional or shave biopsy indicated only if there are atypical solid black lesions that prevent malignant melanoma from being ruled out with complete certainty.
red flags
Sudden and eruptive appearance of multiple pruritic seborrheic keratotic lesions on the trunk and extremities in a period of a few weeks, accompanied by significant weight loss or dysphagia (Leser-Trélat sign, paraneoplastic manifestation of an underlying gastric adenocarcinoma or lymphoma).
Standard management
- It does not require mandatory medical treatment due to its strictly benign nature. Liquid Nitrogen Cryosurgery — first choice physical destructive treatment for cosmetic or mechanical irritation reasons
- Local curettage with superficial shaving under local anesthesia in voluminous lesions
- 10% salicylic acid ointment — as a local keratolytic if the patient prefers non-invasive softening of the superficial plaque
- They should not be treated with caustic creams or abrasive home remedies due to the risk of unsightly scarring.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Skin
- Listed causes
- 5
- Treatment options
- 4