What are the signs and symptoms of seborrheic keratosis (SK)?

Updated: Jan 30, 2020
  • Author: Ginard I Henry, MD; Chief Editor: Gregory Gary Caputy, MD, PhD, FICS  more...
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Seborrheic keratoses usually present as small, flesh-colored, waxy papules that have a "stuck-on" appearance. Epidermal hyperplasia can persist, and exophytic growth can cause the lesions to be raised and appear as a cutaneous horn or wart. They can also become pedunculated and have a stalklike growth. Seborrheic keratoses lesions can occur as solitary or multiple lesions. Multiple keratotic papules that occur on the dorsum of the hands, feet, and legs are another variant of seborrheic keratosis and termed stucco keratosis.

In persons with darker skin, multiple small black or dark-brown waxy papules can develop on the forehead, malar, and neck regions. This variant is called dermatosis papulosa nigra and has a familial predisposition. Older seborrheic keratosis lesions can progress to become dark brown or black, causing some concerning confusion with melanoma. Their elevated position, distinct borders, and greasy appearance give clues to the benign nature even when melanotic.

Seborrheic keratoses may be mildly pruritic, but are often asymptomatic. However, if multiple lesions suddenly erupt, this is called the sign of Leser-Trelatand may be a sign of internal malignancy, particularly gastrointestinal neoplasms.

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