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Seborrheic Keratoses are benign, genetically determined growths that usually appear first in adulthood. They gradually increase in number. Elderly patients may have a great many keratoses covering the trunk. They are not caused by sun damage. Their former name of Seborrheic verruca is appropriate to the wart like lesions.
Differential diagnosis includes viral warts, nevi, actinic keratoses, basal-cell carcinoma, squamous-cell carcinoma, and when the keratoses are highly pigmented, malignant melanoma.
There are two indications for treatment:
(1) The diagnosis is in question and /or (2) the patient wants the growths removed. Seborrheic keratoses may itch, are often unsightly, or may otherwise be annoying to the patient.
The superficial nature of Seborrheic keratoses makes the removal easy by either curettage or liquid nitrogen freezing. If there's a question of diagnosis, curette them to provide a specimen for histology. Otherwise the choice between liquid nitrogen and curettage depends on the availability of liquid nitrogen and your preference.
While cosmetic results with liquid nitrogen are slightly superior to those obtained by curettage, on the face either method produces excellent results—often without scars. In treating. Seborrheic keratoses of the trunk and extremities, both curettage and liquid nitrogen frequently leave slight scars. Liquid nitrogen may produce temporary hyper pigmentation. The slight scarring that either method may cause is much preferable to the appearance of the original growths.