Seborrheic keratoses are often asymptomatic but they may be a source of constant worry for the patient. The lesions may rub on clothing and become itchy. Following the patient’s indulgement to itching, the lesions can easily become inflamed, begin bleeding or get infected in rare cases [8].

The lesions often have a waxy or wart-like growth typically seen on the face, chest, shoulder or back of the patient. The common characteristics of seborrheic keratosis lesions include:

• Light tan or brown black lesions
• Round or oval shaped in size
• Characteristic “pasted on” appearance
• Flat or slightly elevated with a scaly surface
• Ranges in size from very small to 1 inch
• Can be itchy
• Growths may be single or clustered in patches

• Pain

  Though not painful, seborrheic keratoses may prove bothersome depending on their size and location. Be careful not to rub, scratch or pick them. This can lead to inflammation, bleeding and infection. [web.archive.org]

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  Since it was quite painful at the time of occurrence and took several days to heal, I needed to be careful to avoid biting into the growth while chewing food. [healdove.com]

  The spray is applied to each spot from a thermos-like spray bottle Each spot is sprayed for a few seconds The treatments sting and the area treated may remain sore for 1 to 2 days The treatment may produce blisters This is normal If the blisters are painful [doctorv.ca]

• Falling

  The SK usually falls off within days. Sometimes a blister forms under the SK and dries into a scab-like crust that falls off. After the growth falls off, a small dark or light spot may appear on the skin. This usually fades over time. [mariettaderm.com]

  Cryotherapy: The dermatologist may use cryotherapy to freeze the skin tag with liquid nitrogen so that it falls off. [coloradoskinandvein.com]

  The lesion freezes and falls off in a few days. A blister may form when the growth falls off; this will eventually dry into a crust, which will fall off. [medicalnewstoday.com]

  The seborrheic keratosis tends to fall off within days. Sometimes a blister forms under the seborrheic keratosis and dries into a scab-like crust. The crust will fall off. [pariserderm.com]

• Chills

  Simple device to make perfect iced coffee in one minute; Chills hot coffee by up to … Best Grind And Brew Drip Coffee Maker Finding the best drip coffee maker is a difficult process, mostly because the “ best ” is.. [ssai-starss.com]

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• Keratosis

  With the above findings, a diagnosis of conjunctival seborrheic keratosis was established. The occurrence of seborrheic keratosis on the conjunctiva is rare. [ncbi.nlm.nih.gov]

  Seborrheic keratoses may be divided into the following types: Common seborrheic keratosis (basal cell papilloma, solid seborrheic keratosis) Reticulated seborrheic keratosis (adenoid seborrheic keratosis) Stucco keratosis (digitate seborrheic keratosis [en.wikipedia.org]

  Called also senile or solar keratosis. [medical-dictionary.thefreedictionary.com]

  Seborrheic keratosis Seborrheic keratosis: Overview Seborrheic keratosis: Symptoms Seborrheic keratosis: Causes Seborrheic keratosis: Treatment Seborrheic keratosis: Tips [aad.org]

  Mejia can evaluate for horn cysts which are a classic finding in seborrheic keratosis. On rare occasions melanomas have occurred in association with seborrheic keratosis. [jupiterderm.com]

• Skin Lesion

  A 66-year-old Japanese man had skin lesions on the left side of his trunk and the left upper extremity for approximately 10 years. The skin lesions were asymptomatic but increased gradually, which brought the patient to our hospital. [ncbi.nlm.nih.gov]

  Key Points *Condition consists of common harmless skin lesions that appear during adult life. *Lesions are slightly raised, skin colored or light brown spots that thicken, darken and become wart-like. [ozarkderm.com]

  Pehamberger HSteiner AWolff K In vivo epiluminescence microscopy of pigmented skin lesions, I: pattern analysis of pigmented skin lesions. J Am Acad Dermatol. 1987;17571- 583 Google Scholar Crossref 20. [jamanetwork.com]

  Warts may appear and skin is often oily or greasy. These skin lesions are sometimes mistaken for cancerous growths and tend to appear predominately during middle age. [rarediseases.org]

• Skin Disease

  In Skin Disease: Diagnosis and Treatment, 3rd ed., pp. 424-433. Edinburgh: Saunders. Hall JC (2010). Tumors of the skin. In JC Hall, ed., Sauer's Manual of Skin Diseases, 10th ed., pp. 208-304. Philadelphia: Lippincott Williams and Wilkins. [cigna.com]

  […] other parts of the skin suborder Ceratopsia horned dinosaurs suborder Ceratosaura primitive saurischian dinosaurs seborrheic eczema a chronic skin disease associated with seborrhea and greasy scales on the scalp or eyelids or other parts of the skin [vocabulary.com]

  This investigation was performed to address the subcellular localization of PTTG1 and its possible involvement in proliferative skin diseases. [ncbi.nlm.nih.gov]

• Papule

  On the initial examination, we noticed 5 mm x 5 mm to 15 mm x 5 mm, round or oval, light to dark brown keratotic papules on the left side of chest and abdomen and the left upper extremity. [ncbi.nlm.nih.gov]

  Topic Resources Seborrheic keratoses are superficial, often pigmented, epithelial lesions that are usually warty but may occur as smooth papules. [msdmanuals.com]

• Blister

  This creates a blister at the site and the lesion resolves upon healing of the blister. Electrocautery cauterizes or burns the growth, fully removing it, after the area is numbed with an anesthetic. [southshoreskincenter.com]

  This is normal If the blisters are painful, pop them with a sterile needle to let the fluid out The treated area requires no special treatment but an antibiotic ointment may be applied daily if desired You may bathe normally A bandage is not necessary [doctorv.ca]

  LN works by creating a small blister just underneath the SK. This blister forms within an hour of treatment, dries up in 7-10 days, and then peels off in one to several weeks depending on the size and location. No wound care is usually needed. [flintderm.com]

  Freezing may result in a blister that crusts and peels. The keratosis should fall off in a few weeks and sometimes leaves a discolored area which usually fades with time. Thicker keratoses will require several treatments. [cahabaderm.com]

  Treatment Removal is not necessary, but if a patient chooses to have seborrheic keratoses removed several options are available: Cryotherapy: Seborrheic keratoses may be frozen lightly with liquid nitrogen which creates a blister at the site of the lesion [evans-dermatology.com]

• Irritability

  Even rarer, an irritated subtype may arise in this location. [ncbi.nlm.nih.gov]

  Individuals frequently do request removal of them, however, because they are itchy and irritated, or because of their unsightly appearance. [insightderm.com]

• Confusion

  These growths may be confused with warts or moles. The primary clinical feature of seborrheic keratoses is they look as though they are pasted onto the surface of the skin. [insightderm.com]

  Cutaneous melanoma may in some instances be confused with seborrheic keratosis, which is a very common neoplasia, more often mistaken for actinic keratosis and verruca vulgaris. [ncbi.nlm.nih.gov]

  Although Seborrheic Keratoses (seb-o-REE-ick Ker-ah-TOE-sees) are often confused with warts, they are quite different. Seborrheic keratoses are non-cancerous growths of the outer layer of skin. [tcdermatology.com]

  Seborrheic keratoses can be easily confused with moles or warts on the skin. It is important to have a dermatologist or dermatology PA evaluate the growth to confirm its diagnosis. [nyccosmeticdermatology.com]

Diagnosis is often clinical following inspection of the growth. In cases where the diagnosis is difficult and a cancer is suspected, a biopsy may be needed [9]. There is no need for laboratory tests in many cases.

• Human Papillomavirus

  Molecular testing detected human papillomavirus type 42 in 3 of 7 cases, with no virus detected in the remaining 4 cases. [ncbi.nlm.nih.gov]

  Some dermatologists refer to seborrheic keratoses as "seborrheic warts", because they resemble warts, but strictly speaking the term "warts" refers to lesions that are caused by human papillomavirus. The cause of seborrheic keratosis is not known. [en.wikipedia.org]

The height of seborrheic keratosis can be reduced following administration of ammonium lactate and alpha hydroxyl acids [10]. Application of pure trichloroacetic acid can be used in treatment of superficial lesions.

Topical treatment with tazarotene cream 0.1% applied twice each day for 16 weeks may bring about clinical improvement in seborrheic keratosis in 7 out of 15 patients. Other forms of treatment include:

• Cryosurgery (Freezing with liquid nitrogen)
• Curettage (Scrapping of the skin’s surface with the aid of a special treatment)
• Electrocautery (Burning with electric current)
• Ablation (Vaporising of growth with laser)

Seborrheic keratosis is benign and rarely presents a danger to the health of an individual. The lesions often do not resolve and they grow larger and thicker over a period of time [7].

The causes of seborrheic keratosis have remained unclear but ultraviolet light is suspected to play a role in the formation of the condition due to the fact that seborrheic keratosis is common in sun exposed areas like the back, arms, face and neck [3]. However the lesions have been found in areas often covered from the sun.

Genetics may play a role because it is seen in individuals with the family history. A mutation of a gene coding for a growth factor receptor (FGFR3) has been associated with this condition.

Seborrheic keratosis is one of the most common types of skin tumors as between 60 and 80% of people aged 50 and show seborrheic keratosis [4]. It is rarely seen in people below 30 years of age and both men and women are equally affected.

This benign skin disorder is seen more in people with white skin when compared to people with dark skin. However, black people develop the dermatosis papulosa nigra variant of keratosis. This variant of lesions affects the face, the upper cheeks and lateral orbital areas. They are often heavily pigmented, having very little keratotic element. The onset of this variant is often earlier than what is obtainable with traditional seborrheic keratosis.

Seborrheic keratosis shows a histologic evidence of proliferation. Following bromodeoxyuridine incorporation studies and immunohistochemistry for proliferation-associated antigens increased cell replication has been noted in seborrheic keratosis [5]. A moderate increase is seen in the rates of apoptosis in all varieties of seborrheic keratosis in comparison to what is obtainable with normal skin.

Reticulated seborrheic keratosis is usually seen on sun-exposed skin. The reticulated type of seborrheic keratosis is believed to develop from solar lentigines.

Epidermal growth factors as well as their receptors have been observed in the progression of seborrheic keratosis and no difference was noted in the expression of immunoreactive growth hormone receptors in keratinocytes from normal epidermis and keratinocytes arising from seborrheic keratosis [6]. BCL2, an apoptosis-suppressing oncogene is low in seborrheic keratosis unlike what is obtainable in squamous cell and basal cell carcinoma where high values of expression are observed. In comparison to normal skin also, no increase is observed in the sonic hedgehog signal transducers patched (ptc) and smoothened (smo) messenger RNA (mRNA) in seborrheic keratosis. Seborrheic keratoses also have varying degrees of pigmentation.

There is no clear prevention path for this condition.

Seborrheic keratosis is a benign and non-cancerous skin condition which often originates in the keratinocytes [1]. It is also known as seborrheic verruca, senile wart and seborrheic warts in some quarters. This condition is seen mostly in older individuals.

The lesions arising from seborrheic keratosis vary in colour ranging from light tan to black. The shape of the lesions is either oval or round and may be flat or slightly elevated. The size of the lesions also varies from small to as much as 2.5 centimetres across the skin surface. Although they bear close resemblance to warts, they do not have any viral connections. They are also unrelated to melanoma but resemble melanoma skin cancer.
Seborrheic keratosis is often described as having a “pasted on” appearance due to the fact that the condition only affects the top layers of the epidermis.

Seborrheic keratoses may be divided into the following types [2]:

• Common seborrheic keratosis (basal cell papilloma, solid seborrheic keratosis)
• Reticulated seborrheic keratosis (adenoid seborrheic keratosis)
• Stucco keratosis (digitate seborrheic keratosis, hyperkeratotic seborrheic keratosis, serrated seborrheic keratosis, verrucous seborrheic keratosis)
• Clonal seborrheic keratosis
• Irritated seborrheic keratosis (basosquamous cell acanthoma, inflamed seborrheic keratosis)
• Seborrheic keratosis with squamous atypia
• Melanoacanthoma (pigmented seborrheic keratosis)
• Dermatosis papulosa nigra
• Inverted follicular keratosis

Seborrheic keratosis refers to one of the most common skin growths not as a result of cancer, seen in older individuals.
A seborrheic keratosis often appears as growths on the face, chest, shoulders or back and the growth is often brown, black or light tan in colour.

The growth is most of the time waxy, scaly and slightly elevated in appearance. It may appear single in places but most of the time multiple growths are seen in one place. Although these look like skin cancer or warts, they are not cancerous or infectious.
The growth is usually painless, requiring no treatment. However, people who are not comfortable with it often seek treatment. Treatment may be via the use of creams/substances to be rubbed on surfaces or surgery.

1. Ginarte M, Garcia-Caballero T, Fernandez-Redondo V, Beiras A, Toribio J. Expression of growth hormone receptor in benign and malignant cutaneous proliferative entities. J Cutan Pathol. Jul 2000;27(6):276-82.
2. Groves RW, Allen MH, MacDonald DM. Abnormal expression of epidermal growth factor receptor in cutaneous epithelial tumours. J Cutan Pathol. Feb 1992;19(1):66-72.
3. Nanney LB, Ellis DL, Levine J, King LE. Epidermal growth factor receptors in idiopathic and virally induced skin diseases. Am J Pathol. Apr 1992;140(4):915-25.
4. Nakagawa K, Yamamura K, Maeda S, Ichihashi M. bcl-2 expression in epidermal keratinocytic diseases. Cancer. Sep 15 1994;74(6):1720-4.
5. Tojo M, Mori T, Kiyosawa H, Honma Y, Tanno Y, Kanazawa KY, et al. Expression of sonic hedgehog signal transducers, patched and smoothened, in human basal cell carcinoma. Pathol Int. Aug 1999;49(8):687-94. 
6. Yeatman JM, Kilkenny M, Marks R; The prevalence of seborrhoeic keratoses in an Australian population: does exposure to sunlight play a part in their frequency? Br J Dermatol. 1997 Sep;137(3):411-4
7. Busam Klaus J., Dermatopathology s.341; 2010 Saunders ISBN 978-0-443-06654-2
8. Hafner C, Hartmann A, Vogt T (2007). "FGFR3 mutations in epidermal nevi and seborrheic keratoses: lessons from urothelium and skin". J. Invest. Dermatol. 127 (7): 1572–3.
9. Tindall JP, Smith JG Jr. Skin lesions of the aged and their association with internal changes. JAMA. Dec 21 1963;186:1039-42.
10. Memon AA, Tomenson JA, Bothwell J, Friedmann PS. Prevalence of solar damage and actinic keratosis in a Merseyside population. Br J Dermatol. Jun 2000;142(6):1154-9.