Seborrheic Keratosis (SK)
These waxy, warty, scaly papules can occur on the scalp, face, neck, arms, legs and trunk. Typically, they are pigmented and can be anywhere from tan to dark brown. They are often raised. Most SK’s arise after the 40th birthday. It’s not uncommon for adults in their 70s and 80s to have dozens of these benign growths.
While SK’s pose no health risk, many people dislike their appearance or find them itchy and uncomfortable. Bothersome SK’s may be treated by freezing the growth with liquid nitrogen, or removing it with a sharp instrument using local skin anesthesia.
These small, bright red to purple growths usually appear on the skin after age 40. They are composed of coiled clusters of blood vessels. They can appear anywhere on the skin. They are harmless but sometimes bleed if scratched. They do not require treatment, but they can be treated with light electrocautery or laser treatment.
Warts are skin growths caused by a virus called the human papilloma virus (HPV). The virus hijacks infected skin cells causing them to grow rapidly and produce many copies of the virus. The wart virus cleverly hides its presence from the body’s immune system. That’s why even though it’s an invading virus, the body often does nothing to stop it.
Warts may affect skin on any body area but are most common on the hands, feet, arms, legs, and face. Warts may be both uncomfortable and unsightly. There are many treatments for warts. The most common treatments are freezing (done in the doctor’s office or at home), applying a blister-inducing compound (done in the doctor’s office), or applying a skin peeling compound (salicylic acid liquid or tape, applied by the patient at home).
Like warts, molluscum contagiosum (MC) is caused by a poxvirus. MC generally affects young children and young adults. The infection is harmless and self-limited; however it may take years for the lesions to resolve spontaneously. The lesions appear on any skin area, though in young adults, a distribution on genital skin if often seen. The appearance ranges from small (<1/4 inch) papules, skin colored, with a small central depression (umbilication), to larger, red, tender papules. The larger red papules result from recognition of the infection by the body’s immune system. In other words, when this happens, it’s generally a good sign.
Treatment for MC includes freezing, scraping off the papules, and applying a blister-inducing compound at the doctor’s office. Home treatment (salicylic acid liquid, for example) may speed resolution, too.
Epidermoid cysts (often incorrectly referred to as sebaceous cysts) appear as medium to large-sized lumps below the skin surface. They may develop at any age. The most common sites for epidermoid cysts are the trunk, scalp, and face. They form from hair follicles (there are hair follicles even in apparently non-hairy skin areas), and therefore have a central pore. Often, the contents of the cyst, a whitish, cheesy, malodorous substance composed of shed skin cells, may be squeezed out through the central pore.
Epidermoid cysts are harmless but they may be bothersome. Sometimes, the location of a cyst over a pressure point causes discomfort or it may be cosmetically objectionable. If the cyst lining breaks down (a ruptured cyst), there is a rapid increase in size, pain, and redness. When an inflamed cyst ruptures, it may self-heal, or persist. An in-office surgical procedure can remove problematic epidermoid cysts.