Seborrheic keratosis

Classification according to ICD-10
L82	Seborrheic keratosis
ICD-10 online (WHO version 2019)

The seborrheic keratosis (synonyms: seborrheic wart , Alterswarze , Senile wart , Basalzellpapillom ) is the most common benign tumor of the skin. It usually develops in the second half of life, and the frequency of its occurrence increases with age. Almost all people develop one or more seborrheic keratoses in the course of their lives, and both sexes are affected equally often.

causes

When Basalzellpapillom is age-related skin changes. The starting cells of the skin growth are keratinocytes in the basal layer of the epidermis . A family predisposition is assumed. Mutations in various oncogenes such as FGFR3, PIK3CA, KRAS, HRAS, EGFR, AKT1 have been detected in many basal cell papillomas. In line with this mutation theory, factors such as chemicals or UV radiation also play a role in the development.

Designations

Of all the names, basal cell papilloma is probably the most appropriate, as it contains the genesis of the disease, but not such things as warts (verrucae) or seborrhoea .

Clinical picture

Basal cell papillomas on the back of a person with Reader-Trélat syndrome in colorectal cancer

Most commonly, this tumor occurs on the face, the front of the arms, the upper body, and the back of the hands. The basal cell papilloma varies greatly in severity. In terms of color, it appears between light brown tones and black. With a diameter of a few millimeters up to 1 cm, it is usually rather small, but in rare cases it can also be larger. It always has a sharp border to the surrounding skin and grows exophytically, that is to say, beyond the surface. This is dull, field or, in an advanced stage, fissured and feels greasy, greasy, sebum-like, which is where the (misleading) adjective seborrheic comes from when this type of keratosis is named, although seborrhea is neither a cause nor a side effect of the basal cell papilloma.

histology

This type of skin lesion is characterized by papillomatous epithelial proliferation , usually exophytic, and rarely endophytic. Adenoid proliferation and hyperkeratotic pseudo- horn beads are also found in large age warts . Furthermore, they show a distinct melanocytic hyperpigmentation .

Differential diagnosis

Seborrheic warts can be confused with basaliomas and malignant melanomas .

therapy

Therapy is only required if the skin overgrowth becomes bothersome due to its external appearance or constant mechanical irritation :

• Ablation with an electric snare ( cauterization ) or a sharp spoon ,
• Freezing ( cryotherapy ) or
• Laser .

These procedures are only considered if the diagnosis is clear. A prior biopsy with a tissue examination is desirable.

Special forms

• Melanoacanthoma
• Stucco keratosis
• Reader Trélat Syndrome

forecast

The basal cell papilloma is a non-degenerating and therefore benign tumor.

swell

• Dermatology - Dual Series (Eds. Ingrid Moll + Ernst G Jung), 5th edition, published in 2003 by Thieme-Verlag

Web links

Commons : Seborrheic keratosis  - Collection of pictures, videos and audio files

• Photos of seborrheic keratoses in DermIS
• Treatment of the wart

Individual evidence

1. ↑ Ivelina Georgieva Antonova: INCIDENCE OF SOMATIC oncogenic EGFR, HRAS- AND KRAS MUTATIONS IN seborrheic keratoses . Regensburg 2014, p. 96 ( uni-regensburg.de [PDF]).
2. ↑ Martin Röcken, Martin Schaller, Elke Sattler, Walter Burgdorf: Pocket Atlas Dermatology: Basics, Diagnostics, Clinic . Georg Thieme Verlag, 2010, ISBN 978-3-13-162221-1 ( google.at [accessed on May 24, 2019]).
3. ↑ Verruca seborrhoica - P.Altmeyer - Encyclopedia of Dermatology, Venereology, Allergology, Environmental Medicine. Retrieved May 30, 2017 . 
4. ↑ base course dermatohistopathology the ÖGDV, point 93

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !