E.R., 79-year-old female, with a black, warty-surface, and pedunculated on her left thigh.
Initially, my considerations were: verrucae vulgaris, melanoma, and seborrheic keratosis. The histopath result showed seborrheic keratosis.
No clear-cut base – spreading base
As I said, initially my considerations were verrucae vulgaris (because of the warty growth) and melanoma (black and no clear-cut base). Seborrheic keratosis was a third consideration (last consideration because the lesion was not sessile, was pedunculated, and warty).
Seborrheic Keratosis – from Mayo Clinic
Seborrheic keratosis is one of the most common noncancerous skin growths in older adults.
A seborrheic keratosis usually appears as a brown, black or light tan growth on the face, chest, shoulders or back. The growth has a waxy, scaly, slightly elevated appearance. Occasionally, it appears singly, but multiple growths are more common. Seborrheic keratoses don’t become cancerous, but they can look like skin cancer.
Seborrheic keratoses are normally painless and require no treatment. You may decide, however, to have them removed if they become irritated by clothing or for cosmetic reasons.
A seborrheic keratosis usually has the appearance of a waxy or wart-like growth. It typically appears on the face, chest, shoulders or back of the body. A seborrheic keratosis:
- Ranges in color, usually from light tan to brown or black
- Is round or oval shaped
- Has a characteristic “pasted on” look
- Is flat or slightly elevated with a scaly surface
- Ranges in size from very small to more than 1 inch (2.5 centimeters) across
- May itch
You may develop a single growth or cluster of growths. Though not painful, seborrheic keratoses may prove bothersome depending on their size and location. Be careful not to rub, scratch or pick them. This can lead to inflammation, bleeding and, in rare cases, infection.
See your doctor if:
- Many growths develop over a short time of a few weeks to months. Normally, seborrheic keratoses appear one or two at a time over many years.
- The growths get irritated or bleed when your clothing rubs against them. You may want the growths removed.
- You notice suspicious changes in your skin, such as sores or growths that grow rapidly, bleed and don’t heal. These could be signs of skin cancer.
Seborrheic keratosis can be seen in extremities.
It is usually seen in elderly people.