Seborrhoeic keratosis (basal cell papilloma / senile keratosis)
Pathology
- Sebhorroeic keratosis: benign overgrowth of the basal cell layer of the epidermis
- Histologically characterised by
- Hyperkeratosis (thickening of the keratin layer)
- Acanthosis (thickening of the prickle cell layer)
- Hyperplasia or the variably pigmented basaloid cells
Approach
- Examine as for any lump
- Inspection
- Commonly found on trunk but found anywhere
- Single or multiple
- Round or oval in shape
- "Stuck on" appearance
- Varying degree of pigmentation - light brown to black
- Surface appears velvety or warty
- Can be picked off the skin leaving behind pink skin and one or two surface capillaries that bleed slightly
- Palpation
Completion
- Ask about similar lesions elsewhere (sudden onset of multiple seborrhoeic keratoses ias associated with visceral malignancy - known as Leser-Trelat sign)
- How the lesion affects life
- Cosmetic
- Catches on clothes
Treatment
- Non-surgical
- Can be left alone as it is a benign condition
- Surgical
- Can be shaved or cauterised
