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seborrheic keratosis
Old 09-07-2008, 12:07 AM   #1
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seborrheic keratosis

it looks as ugly as it sounds. i've been getting a few "age spots" on my arms here & there, didn't think much of it as they are not very visible, but tonight i noticed a small freckle-sized one crusted over like a flat wart (similar to figure 10 below)

immediately i find myself trying to figure out how to spend all my money before i die in two weeks, but then i check the internet: skin, crusty, age spots. you name it, i searched it. found pictures & descriptions just about identical to what this seems to be so i guess i still have to work on making sure my money will last a little longer than two weeks. damn, it would have been a fun two weeks. so instead i guess i should make an appointment with a dermatologist because that little freckle sure ain't gonna help me get a date. just one more thing to file under "getting old sucks".

Common Benign Skin Tumors - February 15, 2003 - American Family Physician

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Seborrheic Keratosis
Seborrheic keratoses are hyperkeratotic lesions of the epidermis, which often appear to be "stuck on" the surface of the skin. Sebo rrheic keratoses vary in color, from tan to brown to black, and usually have a well-circumscribed border. Most lesions have a rough surface and usually range in size from 2 mm to 3 cm in diameter, but can be larger. Seborrheic keratoses eventually progress from an initial hyperpigmented macule to the characteristic plaque (Figures 9 and 10). The trunk is the most common site, but the lesions also can be found on the extremities, face, and scalp.

FIGURE 10. Mature seborrheic keratosis.


FIGURE 11. Stucco keratoses

.
FIGURE 12. Dermatofibroma.

Men and women are affected equally by seborrheic keratoses, and the incidence increases with age. Stucco keratoses, a variant of seborrheic keratosis, are multiple skin-colored or white, dry, scaly lesions often seen on the extremities (Figure 11). Dermatosis papulosa nigra is another type of seborrheic keratosis consisting of multiple small, brown or black papules commonly found on the face of dark-skinned persons.

Differentiating between seborrheic keratoses and melanomas is a challenge. Both have variable dark colors, the potential for large size, and irregularity. A key differentiating feature is that a melanoma tends to vary more in color, such as browns, blues, black, grays, and reds, whereas a seborrheic keratosis usually is limited to shades of brown and black. Additionally, the surface of seborrheic keratoses tends to be rougher than that of melanomas, which is smooth, yet often friable.

Seborrheic keratoses are often asymptomatic but can become irritated and inflamed spontaneously or because of chafing from clothing. Treatment of seborrheic keratoses is indicated for cosmetic reasons, to decrease irritation, or to rule out malignancy. Numerous methods of treatment are effective, but the most commonly used are cryosurgery, curettage, and excision. Cryotherapy with liquid nitrogen is effective for most seborrheic keratoses, with the exception of extremely thick lesions. Repeat treatments may be necessary. Curettage can be performed with or without electrocautery after administration of local anesthesia. Shave excision provides good cosmesis; excisional biopsy should be reserved for lesions that are suspicious for melanoma. Topical steroids can be used on irritated seborrheic keratoses for symptomatic relief.
eMedicine - Seborrheic Keratosis : Article by Arthur K Balin
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Old 09-07-2008, 12:33 AM   #2
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As you said, it's time to meet Dr Dermatologist. He/she will tell you what's going on, suggest a course of action and you'll be going back every year. Enjoy!
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Old 09-07-2008, 04:32 AM   #3
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ew. DH has a couple of those in fig. 12 on his legs. Good to know that they are not uncommon, anyway. Best of luck w/your treatment; I hope it gives you good results.
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Old 09-07-2008, 08:13 AM   #4
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They are ugly and commonplace. Some people develop hundreds of them on the trunk and scalp.

Liquid nitrogen or scraping them off under local anesthesia is fine.

Be careful though: until they have at least been seen by a knowlegeable physician, the occasional melanoma can present very similarly. I usually recommend at least a baseline visit to the doc when they first occur. After that, they can just be ignored (or followed up as advised).

Then there's the ever-popular actinic keratosis which is often pre-malignant, though not for melanoma. Lentigo is like large freckles. Verrucae are warts. Venous lakes are those puffy purple papules on your lower lip. Cherry red spots are bright red dots on the trun and elsewhere. And let's not forget varicose veins, easy bruisability and telangectasiae (little starburst spots).

If I'd been a dermatologist I'd have been FIREd for a decade.
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Old 09-07-2008, 11:44 AM   #5
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Ugh, I hate growing old and having things popping up all over the body.

RIT, I agree with you, I have seen my dermatologist more over the past 3 years than I have my PCP. I've had all kinds of things show up, and as soon as they do I am in to see what they are and how can we make them go away.

I had Photodynamic Therapy on my face this past week in an effort to remove anything that may have been pre cancerous with the added bonus of removing a big keratosis I had on my face about the size of a nickel. I am pleased with the results as some of the smaller brown spots appear to be lessened as well.
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Old 09-07-2008, 12:12 PM   #6
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pretty confident is not melanoma as no odd coloring at all (no blues or reds or purples). will do a doc on initial visit per suggestion though i don't believe rich would have fired already as a dermatologist because of any different dollar factor.

thanks for the, um, heads up that this could wind up on my face. that'll look good at the disco. i've read this is hereditary and actually mom got old age spots on her face but not until her late 60s. by then no one at the disco will want me anyway. maybe that's when i'll put sex aside and start working on my meditations.
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Old 09-07-2008, 03:19 PM   #7
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... though i don't believe rich would have fired already as a dermatologist because of any different dollar factor.


Probably would have, since in that case I would have hated my job .
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Old 09-07-2008, 07:18 PM   #8
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but you only deal with life and death. obviously you've never been a teenager with acne.
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Old 09-08-2008, 01:59 PM   #9
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My plastic surgeon spoke with disdain when he said it’s easy to be a dermatologist.
“All you need to remember is that if it’s dry, wet it and if it’s wet, dry it.”


I don’t know how that applies here but it’s my only exposure to the subject.
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Old 09-08-2008, 02:33 PM   #10
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My plastic surgeon spoke with disdain when he said it’s easy to be a dermatologist.
“All you need to remember is that if it’s dry, wet it and if it’s wet, dry it.”


I don’t know how that applies here but it’s my only exposure to the subject.
I have no disdain for dermatology (it's among the more popular and competitive specialties these day$ ).

It just wouldn't provide me with the personal satisfaction I got from what I do. Each to his own. Heck, some of my best friends are dermatologists.
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Old 09-08-2008, 02:44 PM   #11
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Yeah, but would you want one to move in next door?
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Old 09-08-2008, 03:10 PM   #12
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Yeah, but would you want one to move in next door?
Hmm.. tough question.

Now marrying my daughter, that's a whole other thing.
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Old 09-09-2008, 03:33 PM   #13
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hey doc, my ugly freckle is gone already. there's just a tiny spot now where the skin isn't tan. if i didn't know it was there i wouldn't be able to find it. should i be more worried or less worried? i'm particularly concerned about what might fall off next.
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Old 09-09-2008, 04:08 PM   #14
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hey doc, my ugly freckle is gone already... should i be more worried or less worried..
Of course the only responsible thing I can say is to have it checked out by a doctor.

Or, could be leprosy. Remember that scene in Ben Hur?
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Old 09-09-2008, 05:13 PM   #15
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Of course the only responsible thing I can say is to have it checked out by a doctor.

Or, could be leprosy. Remember that scene in Ben Hur?
I went to my derm today. It reminded me of when my grandmother used to play "This little piggie went to market, this little piggie stayed home, this little piggie went wheeee all day long..

How many piggies I had, that is how things I had today to be frozen, burned or whatever.

Overall though, a good report.

Ha
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Old 09-09-2008, 05:18 PM   #16
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I had a skin check back in May, they said there was nothing to worry about; I must have inherited my mother's Polish sun resistance.
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Old 09-10-2008, 07:28 AM   #17
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grrrr. found my ugly freckle. turns out i was looking in the wrong spot. when the hell did i get all these freckles on me (not the ugly freckle, just the regular ones). this sucks.

what did i do before wiki...

Quote:
Freckles can be found on anyone no matter the background, however, having freckles is genetic and is related to the presence of the dominant melanocortin-1 receptor MC1R gene variant.[1] The formation of freckles is triggered by exposure to sunlight.
could it be living in florida maybe?
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Old 12-16-2008, 12:53 AM   #18
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Originally Posted by cantlogin View Post
My plastic surgeon spoke with disdain when he said it’s easy to be a dermatologist.
“All you need to remember is that if it’s dry, wet it and if it’s wet, dry it.”


I don’t know how that applies here but it’s my only exposure to the subject.
I thought the standard doctor joke was that you want to be a dermatologist
because: your patients never die, and they never get better.
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Old 12-16-2008, 07:52 PM   #19
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thanks so much for sharing the skin thingie link - figure 8 just about did me in.
now i know why i gravitated toward Mr. Spock vs Dr. McCoy (Bones).
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Old 12-16-2008, 09:40 PM   #20
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Meet Tree-man.

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