What are the signs and symptoms of seborrheic keratosis?

Updated: Oct 14, 2020
  • Author: Arthur K Balin, MD, PhD, FACP; Chief Editor: William D James, MD  more...
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Seborrheic keratoses usually are asymptomatic, but they can be an annoyance. Lesions can itch and rub or catch on clothing, thereby becoming inflamed.

Lesions often are unattractive and serve as negative psychological connotations—daily reminders of aging. [20, 21]

Patients are sometimes concerned that these enlarging lesions are malignant. Sometimes a person may have many seborrheic keratoses and not notice a dysplastic nevus or a malignant melanoma that develops among the seborrheic keratoses. A significant danger can arise if a person does not detect a malignant melanoma at an early stage.

Although lesions may resolve on occasion, spontaneous resolution does not ordinarily occur.

The sign of Leser-Trélat is the association of multiple eruptive seborrheic keratoses with internal malignancy. Most commonly, the sign is observed with adenocarcinoma, especially of the gastrointestinal tract; however, an eruption of seborrheic keratoses may develop after an inflammatory dermatosis (eg, eczema, [22] severe sunburn). In this latter case, no associated malignancy is expected.

Seborrheic keratoses usually begin with the appearance of one or more sharply defined, light brown, flat macules. The lesions may be sparse or numerous.

As they initially grow, they develop a velvety to finely verrucous surface, followed by an uneven warty surface with multiple plugged follicles and a dull or lackluster appearance.

They typically have an appearance of being stuck on the skin surface.

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