Hyperkeratotic Lesions

Question 1

SEBORRHEIC KERATOSIS

also known as

Answer 1

‘wisdom spots,’ ‘age spots,’ or ‘barnacles of life’

Question 2

SEBORRHEIC KERATOSIS

Clinical Feature

Answer 2

well-demarcated waxy papule/plaque with classic “stuck on” appearance
• rarely pruritic
• over time lesions appear more warty, greasy and pigmented

Question 3

SEBORRHEIC KERATOSIS sites

Answer 3

face, trunk, upper extremities (may occur at any site except palms or soles)

Question 4

SEBORRHEIC KERATOSIS Pathophysiology

Answer 4

very common benign epithelial tumour due to proliferation of keratinocytes and melanocytes

Question 5

SEBORRHEIC KERATOSIS

Epidemiology

Answer 5

unusual <30 yr old
• M>F
• autosomal dominant inheritance

Question 6

SEBORRHEIC KERATOSIS

Differential Diagnosis

Answer 6

malignant melanoma (lentigo maligna, nodular melanoma), melanocytic nevi, pigmented BCC, solar
lentigo, spreading pigmented AK

Question 7

SEBORRHEIC KERATOSIS

Investigations

Answer 7

biopsy only if diagnosis uncertain

Question 8

SEBORRHEIC KERATOSIS

Management

Answer 8

• none required, for cosmetic purposes only

* cryotherapy, electrodessication, excision

Question 9

Leser-Trelat:

Answer 9

sudden appearance of SK that can be associated with malignancy, commonly gastric
adenocarcinomas

Question 10

CORNS (HELOMATA)Clinical Feature

Answer 10

• firm papule with a central, translucent, cone-shaped, hard keratin core
• painful with direct pressure
• sites: most commonly on dorsolateral fith toe and dorsal aspects of other toes

Question 11

CORNS (HELOMATA)Pathophysiology

Answer 11

• localized hyperkeratosis induced by pressure on hands and feet

Question 12

CORNS (HELOMATA)Epidemiology

Answer 12

• F>M, can be caused by chronic microtrauma

Question 13

CORNS (HELOMATA)Differential Diagnosis

Answer 13

• calluses, plantar warts

Question 14

CORNS (HELOMATA)Management

Answer 14

• relieve pressure with padding or alternate footwear, orthotics
• paring, topical salicylic acid

Question 15

CORNS (HELOMATA) vs. Warts vs. Calluses

Answer 15

Corns have a whitish yellow central
translucent keratinous core; painful
with direct pressure; interruption of
dermatoglyphics

Question 16

Warts

Answer 16

bleed with paring and have a
black speckled central appearance due
to thrombosed capillaries; plantar warts
destroy dermatoglyphics (epidermal
ridges)

Question 17

Calluses

Answer 17

have layers of yellowish keratin
revealed with paring; there are no
thrombosed capillaries or interruption of
epidermal ridges