Seborrheic Keratoses Diagnosis and Management

Introduction to Seborrheic Keratoses

• The British Medical Journal recommends distinguishing seborrheic keratoses from pigmented basal cell carcinoma, as they can mimic melanoma and other malignant lesions 1

Diagnostic Approach

• The British Journal of Cancer suggests that for any melanocytic lesion thought to be malignant, complete excision with a narrow rim (2 mm) of normal skin is the standard practice rather than partial biopsy, to assess all histological parameters, particularly maximum thickness 5, 6
• The British Medical Journal indicates that any pigmented lesion with one or more major signs, such as change in size, shape, or color, requires referral or excision 2, 3, 4

Treatment Considerations

• The British Journal of Cancer recommends surgical excision, electrocautery, or laser therapy as treatment options for confirmed benign seborrheic keratoses 6

Common Pitfalls

• The British Journal of Cancer advises against using laser or electro-coagulation for initial excision of suspicious lesions, as tissue destruction compromises diagnosis, and suggests that dermatoscopy should only be used by those familiar with the technique 5, 6