Seborrheic Keratoses

By Denise M. Aaron, MD, New, Dartmouth-Hitchcock Medical Center

NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version

Benign Skin Tumors, Growths, and Vascular Lesions
Atypical Moles
Capillary Malformations
Cutaneous Cysts
Dermatofibromas
Infantile Hemangiomas
Keloids
Lipomas
Lymphatic Malformations
Moles
Nevus Araneus
Pyogenic Granulomas
Seborrheic Keratoses
Skin Tags
Vascular Lesions of the Skin

Seborrheic keratoses are superficial, often pigmented, epithelial lesions that are usually warty but may occur as smooth papules.

The cause is unknown, but genetic mutations have been identified in certain types. The lesions commonly occur in middle age and later and most often appear on the trunk or temples. In darker-skinned people, multiple 1- to 3-mm lesions can occur on the cheekbones; this condition is termed dermatosis papulosa nigra.

Seborrheic keratoses vary in size and grow slowly. They may be round or oval and flesh-colored, brown, or black. They usually appear stuck on and may have a verrucous, velvety, waxy, scaling, or crusted surface.

Seborrheic keratoses that are large, multiple, and/or rapidly developing can be a cutaneous paraneoplastic syndrome (Leser-Trélat sign) in patients who have certain cancers (eg, lymphoma, GI cancers).

Diagnosis of seborrheic keratosis is clinical.

Treatment

Removal only if bothersome

Lesions are not premalignant and need no treatment unless they are irritated, itchy, or cosmetically bothersome.

Lesions may be removed with little or no scarring by cryotherapy (which can cause hypopigmentation) or by electrodesiccation and curettage after local injection of lidocaine.

Last full review/revision June 2016 by Denise M. Aaron, MD