Seborrheic keratoses

Epidermal growths including actinic keratoses and thin seborrheic keratoses... 

Epidermal growths such as actinic keratosis, lentigines or thin seborrheic keratoses can all be treated effectively with 25-35% TCA peels. Thicker epidermal growths or growths involving the dermis will be more resistant to treatment such as hypertrophic actinic keratoses and thicker seborrheic keratoses and may even be resistant to a medium-depth peel. Resistant lesions many times are best treated with a combination of a medium-depth chemical peel and other modalities such as manual dermasanding or CO, laser. 

Seborrheic keratoses Hypertrophic keratoses Mixed melasma Mixed hyperpigmentation... 

Seborrheic keratoses (inflammation of) (Leser-Trelat syndrome)... 

Areas of hyperkeratosis (senile keratoses, and flat and seborrheic warts) are a perfect example of this difference in the level of penetration. Keratoses, which are characterized by a localized thickening of the stratum corneum, are less permeable to the acids. Pre-peel preparation with tretinoin evens out the thickness of the stratum corneum and hence the overall permeability of the epidermis. 

DCA is used as a cauterizing agent in the treatment of all types of warts, calluses, corns, xanthelasma, seborrheic keratoses, ingrown toenails, etc. It is just as effective as other methods such as electrodessication or dry ice. 

Before any treatment, a differential diagnosis should be made between SLs and freckles, certain types of flat seborrheic keratoses, early pigmented AKs, lentigo maligna, junctional nevus and some acanthomas. There are different ways to treat solar lentigines on the face, hands, neck and decolletage, from laser to pulsed light, cryotherapy, dermabrasion and peels. 

Seborrheic keratoses and flat warts do not respond well to OT. They can be treated with shave excision followed by a single application of ETCA. 

Seborrheic keratoses (Figure 30.12) are very common and are found on areas of skin that have been exposed to the sun as well as unexposed areas. The lesions are always benign, but can sometimes be difficult to distinguish from malign melanomas. Beyond a certain thickness, the kera-totic layer makes them unresponsive to peels, even to phenol. They can be treated by shave excision with a snare and radiofrequency (Elhnan unit) immediately before applying... 

The diagnosis of melanoma is complicated by a number of pigmented moles (melanocytic nevi) and nonmelanocytic lesions that resemble melanoma. Ordinary nevi, found on the skin of white adults, average between 10 and 40 lesions. These lesions are usually absent at birth and increase in number through adult life, and then gradually decline in number. They appear as tiny pinpoint macules and are usually uniform in color, but increase in size to a maximum of 4 to 6 mm. Nonmelanocytic pigmented lesions such as seborrheic keratoses, pigmented basal-cell carcinoma, and vascular lesions can also appear similar to a melanoma lesion. 

Ellis DL, Nanney LB, King Jr LE. Increased epidermal growth factor receptors in seborrheic keratoses and acrochordons of patients with the dysplastic nevus syndrome. J Am Acad Dermatol. 1990 23 1070-1077. 

Depressed scars (CROSS technique) Variable response Seborrheic keratoses Hypertrophic keratoses Mixed melasma Mixed hyperpigmentation Poor response... 

Uses Despite frequent adverse reactions, many off-label uses of isotretinoin, or 13-c/s retinoic acid, have been reported, the most promising of which are seborrhea, seborrheic dermatitis, severe rosacea, advanced photoageing with multiple actinic keratoses, and prevention of non-melanoma skin cancer in at-iisk patients [67 ]. 

Skin A 56-year-old man with recalcitrant psoriasis treated with efalizumab developed multiple brown patches and papules, in the exact distribution of the previous psoriasis plaques the pathological diagnosis was seborrheic keratoses with overlapping features of solar lentigo [127 ]. 

Types of papillomata were separated by Hodgson and Whitely into four morphologic groups (1) flat shiny lesions (2) sessile lesions resembling plantar warts (3) pedunculated skin tags (fibro-epithelial polyps) and (4) plaques (seborrheic keratoses). 

Seborrheic keratoses have been reported in a 56-year-old man with recalcitrant psoriasis that had responded to efalizumab [231 ]. 

Light chemical peels include 20-35% TCA, 70% glycolic acid, and Jessner s solution (resorcinol, salicylic acid, lactic acid, and ethanol) and penetrate the entire epidermis. These peels are more effective than the very light peels for the treatment of actinic keratoses, solar lentigenes, and epidermal growths such as thin seborrheic keratoses. Skin texture may also be improved. Erythema and scaling will occur postoperatively however healing time is faster if... 

Glycolic acid peels are used as adjunctive treatments in conditions such as acne, postinflammatory hyperpigmentation usually resulting from acne, shallow acne scars, papulopustular rosacea, melasma, seborrheic and actinic keratoses, keratosis pilaris, and some warts resistant to conventional treatments. 

Seborrheic keratoses can be treated with a variety of means, such as cryosurgery, electrodessications and curet-... 

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