Seborrheic Keratosis

Seborrhoeic keratoses are verycommon. It is estimated that over 90% of adults over the age of 60 years have one or more of them. They occur in males and females of all races, typically beginning to erupt in the 30s or 40s. They are uncommon under the age of 20 years

The exact  cause of seborrhoeic keratoses is unknown.

The name can be very misleading, and that us as they are not limited to a seborrhoeic distribution such as on the  scalp, face, chest, upper back) as in seborrhoeic dermatitis, and they  are not formed from sebaceous glands, as is the case with sebaceous hyperplasia, nor are they associated with sebum — which is oil

Seborrhoeic keratoses are considered degenerative in nature. As you age seborrhoeic keratoses become more numerous. Some people tend to develop a very large number of them. Researchers have noted:

• Eruptive seborrhoeic keratoses can follow sunburn or dermatitis.
• Skin friction is also perhaps one of the reason they appear in body folds.

Seborrhoeic keratoses can appear anywhere on the skin , with the exception of palms and soles. They do not arise from mucous membranes.

Seborrhoeic keratoses have a highly variable appearance.

• They can be  falat or raised papule or plaque
• 1 mm to several cm in diameter
• Skin coloured, yellow, grey, light brown, dark brown, black or mixed colours
• Smooth, waxy or warty surface
• Solitary or grouped in certain areas, such as within the scalp, under the breasts, over the spine or in the groin

They appear to stick on to the skin surface like barnacles.

Seborrhoeic keratoses are not premalignant tumours. However:

• Skin cancers are sometimes difficult to tell apart from seborrhoeic keratoses.
• Skin cancer may by chance arise within or collide with a seborrhoeic keratosis.

The diagnosis of seborrhoeic keratosis is often easy.

• A stuck-on, well-demarcated warty plaque
• Other similar lesions

Sometimes, seborrhoeic keratosis may resemble skin cancer, such as basal cell carcinoma, squamous cell carcinomaor melanoma.

Dermoscopy is used in the consultation which  often shows a disordered structure in a seborrhoeic keratosis, as is also true for skin cancer. There are diagnostic dermatoscopic clues to seborrhoeic keratosis, such as multiple orange or brown clods (due to keratin in skin surface crevices), white milia-like clods, and curved thick ridges and furrows forming a brain-like or cerebriform pattern.

If doubt remains, a seborrhoeic keratosis will always  undergo partial shave or punch biopsy or diagnostic excision and a referral made to your GP.

As SK are very common, it would be impossible to routinely treat every individual and every single keratosis. Most patients need no treatment at all as as they are harmless and cause no symptoms; however, for patients who wish to have some of their keratoses removed we use the Ellman Radiowaves surgery method in our clinic. SK are not routinely removed in hospitals or t the local GP clinic.

Such treatments are not be funded by the local NHS service.

Histology will be discussed at the consultation.

What are the symptoms of seborrhoeic keratoses?

SK are harmless, and usually do not cause symptoms. They can sometimes itch, become inflamed, and catch on clothing. Many people dislike the look of them, particularly when they occur on their face.

From £400 using Radiowaves Surgery