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Seborrhoeic keratosis (seborrhoea wart)

Seborrhoeic keratosis is a benign skin growth originating from keratinocytes.

Suggested approach to seborrhoeic keratosis OSCE station

Describing lesions

  • Lesion
    • ‘There is a well-demarcated dark brown papule on the upper left part of the patient’s back.’
    • ‘This is 4mm in diameter and has a regular border, with a stuck-on appearance.’
    • ‘The lesion is raised, with a rough surface, but there are no secondary features.’
    • ‘This lesion is characteristic of a seborrhoeic keratosis.’
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Seborrhoeic keratosis

Differential diagnosis

  • Melanoma
  • Melanocytic naevus 
  • Dermatofibroma
  • Pigmented basal cell carcinoma
  • Acanthosis nigricans

Management

  • Reassurance
  • Remove surgically if diagnostic uncertainty
  • Remove using cryotherapy or curettage and cautery if cosmetic concerns
  • Topical corticosteroids for itchy/irritated lesions

Questions

What is a complication of seborrheic warts?

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What is Leser-Trélat sign?

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Dermatological skin exam OSCE station

  1. Dermatological skin exam
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