What is a Seborrheic Keratosis?

Due to her pale hair and skin, Erika had always made it a point to stay out of the sun. With her Scandinavian ancestry and two relatives already diagnosed with skin cancer, she didn't want to take any chances. A few days before turning 50, she was shocked to see a pale growth on the bridge of her nose. She worried constantly until the dermatologist was able to see her two weeks later and assure her that it was a seborrheic keratosis.

Overview

This skin disorder is quite common in a person's middle or older years. According to the Mayo Clinic, the cause of this benign skin growth remains unknown. Those with the highest risk factors are individuals older than 50 or who have a family history of seborrheic keratoses.

MedlinePlus reports that while it's a rare occurrence, a patient who develops a lot of these growths rapidly might also suffer from gastric cancer. Once a seborrheic keratosis is removed, it normally doesn't return. However, an individual who develops one is likely to spot more over time. While these skin growths aren't cancerous, they can look like cancer.

Signs and Symptoms

To many people, a seborrheic keratosis resembles a waxy, raised patch of skin or a wart. The most common places where these growths appear are on an individual's face, chest, back, shoulders and neck. In color, the growth can be yellow, light tan, brown, black or pale and usually has a scaly, slightly raised appearance. Some are flat. Multiple growths are more common than a single keratosis.

The typical shape is round or oval. Many patients remark that the growth looks somehow pasted onto their skin. The typical size is up to 1 inch in diameter. While most seborrheic keratoses are painless, some itch and become irritated.

Diagnosis and Treatment

The majority of doctors diagnose a seborrheic keratosis based on its appearance. If there is any additional need to rule out another type of skin condition, the doctor will biopsy the growth and send a specimen to a lab for analysis. The biopsy usually occurs in the physican's office under a local anesthetic.

Most of these benign skin growths need no treatment. However, if they become irritated from itching or rubbing against clothing, a doctor will probably recommend removing them.

Most patients who want to their growths removed visit a dermatologist for the procedure. There are three types of treatment:

Cryosurgery. This is the preferred treatment for smaller growths. The doctor freezes the keratosis with liquid nitrogen. One of the risks is a lightening of the skin under the growth, particularly if it's located on the patient's trunk. This procedure is sometimes ineffective on large or thick growths.

Curettage. It involves scraping the skin with a curette and is ideal for thin or flat keratoses. Sometimes doctors pair it with electrocautery.

Electrocautery. An electric current burns away the growth. If done skillfully, it shouldn't leave any scars, though the procedure tends to take longer than other types of treatment. Sometimes doctors combine this procedure with curettage.

The majority of health insurance companies consider removal of a seborrheic keratosis solely because of the way it looks or feels a cosmetic procedure and will not pay for it. The most common reasons supporting the medical necessity of removal include pain, severe itching, bleeding, inflammation and infection.

Sources:

http://www.mayoclinic.com/health/seborrheic-keratosis/DS00846

http://www.nlm.nih.gov/medlineplus/ency/article/000884.htm