Seborrheic Keratosis

Question 1

Genetic link with SKs

Answer 1

autosomal dominant

Question 2

Most prominent race with SKs

Answer 2

caucasians

Question 3

Usually appear after this decade

Answer 3

4th

Question 4

Pathogenesis of SKs

Answer 4

sun exposure leads to increased occurrence and earlier onset, caused by a disruption of epidermal growth factor which activates FGFR3 gene

Question 5

clinical features

Answer 5

multiple, sharply defined, variable colors, 1cm-5cm, most commonly on the back, stuck on appearance

Question 6

Acanthotic SK

Answer 6

Smooth, dome shape with slight hyperkeratosis, increased melanin and basaloid cells. Most common type

Question 7

Hyperkeratotic

Answer 7

prominent hyperkeratosis and papillomatosus, epidermal projections resembling church spires

Question 8

Reticulated SK

Answer 8

delicate strands of epithelium extend into the epidermis, double row basaloid cells with increased pigment

Question 9

Inflamed SK

Answer 9

Spongiosis, perivascular. Can occur from rupture or trauma

Question 10

Clonal SK

Answer 10

variation of inflammed Sk with nests of keratinocytes

Question 11

Melanoacanthoma

Answer 11

heavily pigmented, melanocytes within the lesion

Question 12

Tx

Answer 12

reassure, destroy symptomatic ones with cryo, PDL, C02, YAG laser, shave excision, ed&c

Question 13

important dx clue

Answer 13

“stuck on” appearance

Question 14

distinguish between solar lentigo and sk with

Answer 14

dermatoscopy

Question 15

cryo to destroy SK needs this many rounds

Answer 15

3 freeze thaw cycles

Question 16

cryo s/e

Answer 16

blister, pain, hypopigmentation

Question 17

Leser-Trelat Sign

Answer 17

abrupt increase in size and number of SKs may be a sign of internal malignancy