Update of pathophysiology and treatment options of seborrheic keratosis

Abstract

Seborrheic keratosis (SK) is a common, benign tumor that can occur on everybody site and can be conservatively managed. Cosmetic concerns, especially when a lesion involves the facial area, are the most common reason for excision. SK shows male gender preponderance and increasing age is an independent association with the condition. Even though more prevalent in the elderly, it has also been reported in younger age groups like adolescents and young adults. Precise pathogenesis is still obscure, but ultra-violet exposure represents a predisposing factor to SK by altering the biochemical concentration and expression of factors like Glutamine deaminases, endothelin, and stem cell factor. Moreover, the accumulation of amyloid-associated protein has also been postulated. Involvement of genitalia has been associated with human papillomavirus infection. Recently, Merkel cell polyomavirus nucleic acid was also detected in SK. Several oncogenic mutations involving FGFR-3 and FOXN1 have been identified. SKs are usually classified clinically and histologically. Dermatoscopy is a noninvasive alternative diagnostic technique widely used in differentiating SK from other benign and malignant tumors. In terms of treatment, topical agents, shave dissection, cryosurgery, electrodesiccation, laser application and curettage under local anesthesia are safe methods for eradication of SKs, mostly for cosmetic purposes. Though generally safe, the latter techniques may occasionally cause postprocedure depigmentation, scarring, and recurrence. Nanosecond-pulsed electric field technology is a promising new technique with fewer side-effects.

Seborrheic Keratosis: Report of a Rare Presentation and Reminder of the Current Knowledge of the Problem

“… 7 Clinical variants of SK include stucco keratosis, dermatosis papulosis nigra, lichen planus-like SK, inflammatory SK, large cell acanthoma, flat SK, inverted follicular keratosis, and Leser-Trelat syndrome. 7 , 8 , 10 The latter is a paraneoplastic syndrome characterized by a sudden onset of numerous SK and it is associated with an internal organ malignancy. 7 The size of SK ranges from a few to many millimeters with an average diameter of 0.5 to 1 cm.…”

“… 8 Besides, it has been postulated that SK may be linked to the accumulation of amyloid-associated protein. 10 …”

Artificial Intelligence-Based Distinction of Actinic Keratosis and Seborrheic Keratosis

“…In contrast, seborrheic keratosis is a benign epidermal tumor with no malignant potential [ 9 ]. Clinical management of SK typically involves lesion removal for cosmetic reasons or symptomatic relief [ 20 ]. Treatments for SK include cryotherapy, curettage, electrocautery, laser therapy, and topical agents such as salicylic acid or retinoids [ 20 , 21 ].…”

“…Clinical management of SK typically involves lesion removal for cosmetic reasons or symptomatic relief [ 20 ]. Treatments for SK include cryotherapy, curettage, electrocautery, laser therapy, and topical agents such as salicylic acid or retinoids [ 20 , 21 ]. Additionally, while AK lesions may require regular monitoring and surveillance due to their potential for malignant transformation, SK lesions generally do not necessitate long-term follow-up unless symptomatic or cosmetically concerning [ 20 ].…”

Assessing Excessive Keratinization in Acral Areas through Dermatoscopy with Cross-Polarization and Parallel-Polarization: A Dermatoscopic Keratinization Scale

“…Currently, the gold standard for assessing the severity of keratosis relies on visual evaluation, a subjective approach that employs descriptive terms like mild, moderate, severe, or very severe [28][29][30][31][32][33][34]. Regrettably, these terms often fail to convey a precise clinical picture to the recipient.…”