Pigmented Seborrheic Keratosis

Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist
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Rx Dermatology (A-Z)

Pigmented seborrheic keratosis, often referred to as just “seborrheic keratosis,” is a common skin condition that mostly affects older adults. While it is generally harmless, it can be concerning due to its appearance. In this article, we will break down pigmented seborrheic keratosis into simple terms, covering its types, causes, symptoms, diagnostic tests, treatments, and medications.

Types of Seborrheic Keratosis

Seborrheic keratosis comes in various types, but they all share a common characteristic: they are non-cancerous growths on the skin. Here are some common types:

  1. Common Seborrheic Keratosis: These are the most prevalent type, usually brown or black, and have a waxy or scaly appearance.
  2. Stucco Keratosis: These appear as small, white or grayish papules, often found on the legs.
  3. Dermatosis Papulosa Nigra: Common in people with darker skin, these are small, dark brown to black, slightly raised bumps.
  4. Leser-Trélat Sign: This is a rare type where multiple seborrheic keratoses suddenly appear, often signaling an underlying health issue.
  5. Dermatosis Papulosa Nigra: Typically found in individuals with darker skin, they are small, dark, and raised.
  6. Acanthotic Seborrheic Keratosis: These are thick, waxy, and slightly elevated.
  7. Reticulated Seborrheic Keratosis: They have a network-like appearance on the skin.
  8. Clonal Seborrheic Keratosis: These are flat or slightly raised and often occur in clusters.

    Causes of Pigmented Seborrheic Keratosis:

    1. Age: PSK is more common as people get older.
    2. Genetics: Family history can increase the likelihood of developing PSK.
    3. Sun Exposure: Excessive sun exposure over time may contribute to PSK development.
    4. Skin Friction: Rubbing or friction on the skin can trigger PSK in some cases.
    5. Hormonal Changes: Hormonal fluctuations, such as during pregnancy, can lead to PSK.
    6. Immune System Weakening: A weakened immune system may make you more susceptible to PSK.
    7. Obesity: Some studies suggest a link between obesity and PSK.
    8. Certain Medications: Long-term use of specific medications may be a factor.
    9. Skin Inflammation: Chronic skin inflammation can contribute to PSK formation.
    10. Hormone Replacement Therapy: Women undergoing hormone replacement therapy may be at a higher risk.
    11. Exposure to Chemicals: Prolonged exposure to certain chemicals can be a factor.
    12. Skin Trauma: Previous injuries or scars may trigger PSK development.
    13. Hormone Disorders: Disorders like polycystic ovary syndrome (PCOS) can be associated with PSK.
    14. Viral Infections: In some cases, viral infections may play a role.
    15. Diabetes: Some studies have suggested a connection between diabetes and PSK.
    16. Liver Disease: Liver problems can impact the skin and potentially contribute to PSK.
    17. Stress: High levels of stress may affect the skin’s health.
    18. Smoking: Smoking is linked to various skin issues, including PSK.
    19. Environmental Factors: Pollution and other environmental factors can play a role.
    20. Unknown Factors: Sometimes, PSK can develop without a clear cause.

    Symptoms of Pigmented Seborrheic Keratosis:

    1. Dark Spots: PSK typically appears as brown or black spots on the skin.
    2. Raised or Flat: They can be either slightly raised or completely flat.
    3. Rough Texture: Some PSK growths have a rough, warty texture.
    4. Irregular Borders: The borders of PSK spots can be uneven.
    5. Varying Sizes: PSK can range in size from small to quite large.
    6. Itchiness: Some people may experience mild itching in the affected area.
    7. Change Over Time: PSK spots may change in appearance over the years.
    8. Multiple Growth: It’s common to have more than one PSK spot.
    9. Cosmetic Concern: While harmless, some people seek treatment for cosmetic reasons.
    10. Skin Coloration: The spots are often darker than the surrounding skin.

    Diagnostic Tests for Pigmented Seborrheic Keratosis:

    1. Visual Inspection: Dermatologists can often diagnose PSK through a visual examination.
    2. Dermoscopy: A dermatoscope helps magnify and examine PSK closely.
    3. Skin Biopsy: In some cases, a small sample of the growth may be tested.
    4. Wood’s Lamp: Ultraviolet light can help highlight PSK spots.
    5. Reflectance Confocal Microscopy: A non-invasive technique for examining skin lesions.
    6. Histopathological Examination: Microscopic examination of a skin biopsy.
    7. Computer-Aided Diagnosis: Advanced software may assist in diagnosis.
    8. Medical History: Discussing your medical history can provide important clues.
    9. Rule Out Other Conditions: Doctors may perform tests to exclude other skin conditions.
    10. Mole Mapping: Tracking changes in PSK over time with specialized imaging.

    Treatment Options for Pigmented Seborrheic Keratosis:

    1. Observation: Many PSK cases require no treatment and can be monitored.
    2. Cryotherapy: Freezing the growth with liquid nitrogen to remove it.
    3. Curettage: Scraping the PSK growth off the skin’s surface.
    4. Electrocautery: Burning off PSK growths using an electrical current.
    5. Laser Therapy: Using lasers to target and remove PSK spots.
    6. Shave Excision: Cutting off the PSK growth with a scalpel.
    7. Topical Medications: Prescription creams may help fade PSK.
    8. Chemical Peels: Using chemicals to peel away the PSK growth.
    9. Photodynamic Therapy: Combining light and photosensitive drugs to treat PSK.
    10. Microdermabrasion: Exfoliating the skin to improve PSK appearance.
    11. TCA Chemical Peel: Trichloroacetic acid peel for PSK removal.
    12. CO2 Laser: A precise laser treatment for PSK.
    13. Radiofrequency Ablation: Using radiofrequency energy to remove PSK.
    14. Liquid Nitrogen Spray: Targeted freezing of PSK growths.
    15. Scalpel Excision: Surgical removal of PSK spots.
    16. Hyfrecator: Using electrical energy to destroy PSK growths.
    17. Over-the-Counter Treatments: Some OTC products may help reduce PSK appearance.
    18. Home Remedies: Home treatments like apple cider vinegar are not recommended.
    19. Dermabrasion: A surgical procedure to remove the top layer of skin.
    20. Combination Therapy: Combining different treatments for better results.

    Drugs Used in Pigmented Seborrheic Keratosis Treatment:

    1. Hydroquinone: Helps lighten PSK spots.
    2. Tretinoin: A topical medication that may improve PSK appearance.
    3. Imiquimod: An immune response modifier used in PSK treatment.
    4. 5-Fluorouracil: Topical chemotherapy for PSK.
    5. Tazarotene: A synthetic retinoid used in PSK therapy.
    6. Diclofenac Sodium: A nonsteroidal anti-inflammatory drug for PSK.
    7. Calcipotriene: A synthetic form of vitamin D for PSK treatment.
    8. Cryosurgery Agents: Liquid nitrogen for freezing PSK growths.
    9. Lidocaine: Local anesthesia for PSK removal procedures.
    10. Epinephrine: Helps control bleeding during PSK removal.
    11. Laser-Assistive Dyes: Used with lasers to target PSK growths.
    12. Salicylic Acid: An exfoliating agent for PSK management.
    13. Benzoyl Peroxide: May help with PSK appearance.
    14. Glycolic Acid: An alpha-hydroxy acid used in PSK skincare products.
    15. Lactic Acid: Another alpha-hydroxy acid for PSK management.
    16. Hydrocortisone: Topical corticosteroid for PSK-related itching.
    17. Antibiotics: Used in some cases to prevent infection after PSK removal.
    18. Pain Medications: Prescribed for post-procedure pain management.
    19. Antiviral Drugs: If a viral infection is related to PSK.
    20. Moisturizers: Hydrating the skin can improve PSK appearance.

    Conclusion:

    Pigmented Seborrheic Keratosis may seem intimidating, but it’s a common and generally harmless skin condition. It can come in various forms, develop for numerous reasons, and show various symptoms. Diagnosing PSK involves visual inspection and, in some cases, medical tests. Fortunately, several treatment options are available, ranging from simple procedures to medications. If you suspect you have PSK or have concerns about your skin, consult a dermatologist for guidance tailored to your specific situation. With the right knowledge and care, managing PSK can be straightforward and effective, ensuring your skin stays healthy and beautiful.

    Disclaimer: Each person’s journey is unique, always seek the advice of a medical professional before trying any treatments to ensure to find the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this page or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.

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    References


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