Background/Epidemiology
- Very common and benign skin lesions which typically present later in adult life (also known as senile warts)
- Despite also known as seborrhoeic keratosis- they do not have sebaceous origin
- Extremely common- thought to be the most common benign tumour
- 8.3% of males and 16.7% of females <40 years old. With age, this increases hugely to >85% in patients 65+
Appearance
- Start as slightly raised, skin coloured or light brown spots with a well circumscribed border. They gradually thicken and appear rough, pitted, or warty. They can darken. Characteristically, they have a ‘stuck-on’ appearance
- They can appear almost anywhere on the body (most commonly the trunk) and are usually asymptomatic, although they can occasionally be itchy or irritated if in an area prone to rubbing/irritation
Cause
- Considered to part of the aging process- a degenerative condition of the skin. Not generally cause by sun exposure. Cause is really unknown.
- Abnormality of basal cell layer (not sebaceous glands)
- Very rarely, eruptive seborrhoeic keratosis may be a sign of underlying internal malignancy e.g. colorectal cancer.
- Sign of Leser-Trelat.
Management
- If concerned about melanoma, excision biopsy is sensible
- If not, then reassurance- no active management unless the patient is concerned about appearance
- Cryotherapy (often best for aesthetic purposes), curettage and cautery, shave biopsy or excision may be possible if removal is decided
Rarer forms of BCP
- Stucco keratoses- multiple skin-coloured/white, dry, scaly lesions often on the extremities
- Dermatosis papulosa nigra- multiple small, brown/black pedunculated lesions seen on the face of dark-skinned individuals, often <50 years old.
- Irritated BCP can appear inflamed, red, crusted and may be painful
Notes on Medicine/Surgery 