Derm: Seborrhoeic Keratoses: Free MSRA Podcast

✅ MSRA Deep Dive: Seborrhoeic Keratoses – Spotting the Harmless vs. the HarmfulIn this revision-focused episode, we dive into seborrhoeic keratoses (SKs) – one of the most common skin findings in clinical practice and exams. Although benign, they’re frequently confused with serious lesions like melanoma or basal cell carcinoma (BCC). We clarify what they are, how to spot them, and when to worry.🧠 Key Learning Points📌 Definition• Common, benign epidermal tumours, often seen in older adults• Have a characteristic “stuck-on”, waxy or wart-like appearance• Also known as seborrheic warts📌 Causes & Risk Factors• Exact cause unknown• Age is the strongest factor – more common with increasing age• Genetic predisposition plays a role• Sun exposure may be a contributing factor, but not directly causative• Associated with other findings like dermatosis papulosa nigra (especially in darker skin types)🔬 Pathophysiology• Benign proliferation of immature keratinocytes in the epidermis• Mutation in FGFR3 gene has been associated• Not related to infection or malignancy👨‍⚕️ Clinical Features• Well-circumscribed, raised lesion with waxy, rough, or verrucous surface• Colour: Tan, brown, black, or grey• Typically painless, but may be itchy or irritated• Most common on the trunk, face, scalp, or back• Described as having a “stuck-on” look – as if pasted onto the skin• May crumble if picked and can appear greasy⚠️ Differential Diagnoses• Melanoma – esp. nodular or amelanotic types• Basal cell carcinoma (BCC) – esp. pigmented or nodular BCC• Actinic keratosis – usually flatter and rougher, with sun-damaged background skin• Key distinction: asymmetry, irregular borders, colour variation, ulceration, or bleeding → consider biopsy🧪 Diagnosis• Primarily clinical – classic appearance is diagnostic• Dermoscopy can help – features like milia-like cysts and comedo-like openings• If uncertain or atypical features → biopsy is necessary to rule out malignancy💊 Management• No treatment required if asymptomatic and diagnosis is clear• Indications for removal:– Cosmetic concern– Persistent itching or irritation– Secondary infection or bleeding• Removal options:– Cryotherapy (freezing)– Curettage (scraping)– Electrosurgery– Laser ablation• Avoid removal unless confident in diagnosis or malignancy ruled out📈 Prognosis• Excellent – SKs are completely benign• Treated lesions don’t recur, but new lesions may develop in predisposed individuals• No malignant potential, but important not to misdiagnose melanoma or BCC as SK⚠️ Complications• Not due to the lesion itself, but secondary to irritation• Rubbing on clothing may cause itching, bleeding, or inflammation• Picking or trauma may lead to infection• Cosmetic distress in visible locations may impact quality of life💡 MSRA TipIf you're faced with a pigmented lesion that looks “stuck on” and waxy – think SK.But always ask yourself:🧐 “Is there any possibility this could be melanoma or BCC?”If yes → biopsy.📚 Revision Resources📝 Notes: https://www.passthemsra.com/topic/seborrhoeic-keratoses-revision-notes/💬 Flashcards: https://www.passthemsra.com/topic/seborrhoeic-keratoses-flashcards/🧠 Q&A Notes: https://www.passthemsra.com/topic/seborrhoeic-keratoses-accordion-qa-notes/🧪 Rapid Quiz: https://www.passthemsra.com/topic/seborrhoeic-keratoses-rapid-quiz/🎓 Course: https://www.passthemsra.com/courses/dermatology-for-the-msra/🏷️ Hashtags#MSRA #MSRARevision #MSRATextbook #MSRAFlashcards #SeborrhoeicKeratoses #Dermatology #PassTheMSRA #MSRAQuiz #GPTraining #MSRAExam