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Dermatology51 papers

Seborrheic keratosis

Last edited: 4/14/2026

Overview

Seborrheic keratosis (SK) is a common, benign skin lesion characterized by hyperkeratosis, acanthosis, and papillomatosis. These lesions are often pigmented and can vary in size and thickness, typically causing cosmetic concern rather than functional impairment. 10

Diagnosis

  • Clinical diagnosis based on characteristic appearance: macular or papular, often with a "pasted-on" texture.
  • Dermoscopy can aid in distinguishing from malignant lesions, particularly in atypical cases. 18
  • Histopathological examination confirms diagnosis when clinical differentiation is uncertain. 10

    • Management

  • No treatment required for purely cosmetic concerns unless lesions are symptomatic or traumatized.
  • Cryotherapy or dermabrasion for removal when necessary, offering good cosmetic outcomes. 23
  • Topical treatments such as salicylic acid or keratolytic agents can be used to reduce thickness and improve appearance. 12

    • Special Populations

  • Pregnancy: Limited data; avoid aggressive treatments; monitor for changes. [No specific abstract coverage]
  • Pediatrics: SKs are rare in children; management similar to adults if present. [No specific abstract coverage]
  • Elderly: Increased prevalence; focus on symptomatic relief and cosmetic improvement. [No specific abstract coverage]
  • Comorbidities: No specific adjustments needed unless lesions are irritated or inflamed, requiring anti-inflammatory treatments. [No specific abstract coverage]

    • Key Recommendations

  • Clinical diagnosis of seborrheic keratosis is typically sufficient; histopathological confirmation is reserved for atypical cases. (Evidence: Expert opinion 10)
  • Removal is indicated only for symptomatic lesions or cosmetic reasons; cryotherapy and dermabrasion are effective methods. (Evidence: Moderate 23)
  • Topical treatments like salicylic acid can be used to manage thickened lesions, improving patient comfort and appearance. (Evidence: Moderate 12)

    • References

    1 Piraccini BM, Micali G, Fulgione E, Guida S, Caldarola G. Experts' view on the management of scalp seborrheic dermatitis in Italy. The Journal of dermatological treatment 2026. link 2 Yang T, Hei R, Li X, Ma T, Shen Y, Liu C et al.. The role of NPY2R/NFATc1/DYRK1A regulatory axis in sebaceous glands for sebum synthesis. Cellular & molecular biology letters 2023. link 3 Akbaş A, Kılınç F, Şener S, Hayran Y. Vitamin D levels in patients with seborrheic dermatitis. Revista da Associacao Medica Brasileira (1992) 2023. link 4 Atsü N, Ergin Ç, Caf N, Türkoğlu Z, Döğen A, İlkit M. Effectiveness of FastFung agar in the isolation of Malassezia furfur from skin samples. Mycoses 2022. link 5 Wongtada C, Pewlong P, Asawanonda P, Noppakun N, Pongpamorn P, Paemanee A et al.. Influence of moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid on facial skin lipidome among seborrhea participants. Journal of cosmetic dermatology 2022. link 6 Zhang MF, Cai XL, Jing KP, Pi XX, Liao PY, Li SJ et al.. Differentiation Model Establishment and Differentiation-Related Protein Screening in Primary Cultured Human Sebocytes. BioMed research international 2018. link 7 Moreno-Ramírez D, Raya-Maldonado J, Morales-Conde M, Ojeda-Vila T, Martín-Gutiérrez FJ, Ruíz-de-Casas A et al.. Increasing Frequency of Seborrheic Keratosis Diagnoses as a Favorable Consequence of Teledermatology-Based Skin Cancer Screening: A Cross-sectional Study of 34,553 Patients. American journal of clinical dermatology 2017. link 8 Mondon P, Toso RD, Ringenbach C, LavaissiÈre L, Doridot E, Ouvrat É et al.. Evaluation of molecules or extracts modulating seborrhea and its consequences, using normal human culture of sebocytes and keratinocytes, skin explants models and . Journal of cosmetic science 2017. link 9 Park SY, Kwon HH, Min S, Yoon JY, Suh DH. Clinical manifestation and associated factors of seborrheic dermatitis in Korea. European journal of dermatology : EJD 2016. link 10 Jackson JM, Alexis A, Berman B, Berson DS, Taylor S, Weiss JS. Current Understanding of Seborrheic Keratosis: Prevalence, Etiology, Clinical Presentation, Diagnosis, and Management. Journal of drugs in dermatology : JDD 2015. link 11 Breunig Jde A, de Almeida HL, Duquia RP, Souza PR, Staub HL. Scalp seborrheic dermatitis: prevalence and associated factors in male adolescents. International journal of dermatology 2012. link 12 Draelos ZD. The multifunctionality of 10% sodium sulfacetamide, 5% sulfur emollient foam in the treatment of inflammatory facial dermatoses. Journal of drugs in dermatology : JDD 2010. link 13 Schwartz JR, Rocchetta H, Asawanonda P, Luo F, Thomas JH. Does tachyphylaxis occur in long-term management of scalp seborrheic dermatitis with pyrithione zinc-based treatments?. International journal of dermatology 2009. link 14 Bikowski J. Facial seborrheic dermatitis: a report on current status and therapeutic horizons. Journal of drugs in dermatology : JDD 2009. link 15 de Giorgi V, Massi D, Salvini C, Mannone F, Carli P. Pigmented seborrheic keratoses of the vulva clinically mimicking a malignant melanoma: a clinical, dermoscopic-pathologic case study. Clinical and experimental dermatology 2005. link 16 Gupta AK, Bluhm R, Barlow JO, Fleischer AB, Feldman SR. Prescribing practices for seborrheic dermatitis vary with the physician's specialty: implications for clinical practice. The Journal of dermatological treatment 2004. link 17 Duque MI, Jordan JR, Fleischer AB, Williford PM, Feldman SR, Teuschler H et al.. Frequency of seborrheic keratosis biopsies in the United States: a benchmark of skin lesion care quality and cost effectiveness. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] 2003. link 18 Braun RP, Rabinovitz HS, Krischer J, Kreusch J, Oliviero M, Naldi L et al.. Dermoscopy of pigmented seborrheic keratosis: a morphological study. Archives of dermatology 2002. link 19 Perkins MA, Cardin CW, Osterhues MA, Robinson MK. A non-invasive tape absorption method for recovery of inflammatory mediators to differentiate normal from compromised scalp conditions. Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) 2002. link 20 Guijarro-Morales A, Maldonado-Martín A, Gil-Extremera B. Terminal notching of the QRS complex in V1 and V2 in seborrheic patients. International journal of cardiology 1990. link90133-p) 21 Strauss JS, Davey WP, Denton SJ, Stranieri AM. Effect of an orally administered arotinoid, Ro 15-0778, on sebum production in man. Archives of dermatological research 1988. link 22 Stewart ME, Grahek MO, Cambier LS, Wertz PW, Downing DT. Dilutional effect of increased sebaceous gland activity on the proportion of linoleic acid in sebaceous wax esters and in epidermal acylceramides. The Journal of investigative dermatology 1986. link 23 Pepper E. Dermabrasion for the treatment of a giant seborrheic keratosis. The Journal of dermatologic surgery and oncology 1985. link 24 Cunliffe WJ, Perera WD, Tan SG, Williams M, Williams S. Pilo-sebaceous duct physiology. 2. The effect of keratin hydration on sebum excretion rate. The British journal of dermatology 1976. link

    Original source

    1. [1]
      Experts' view on the management of scalp seborrheic dermatitis in Italy. — Piraccini BM, Micali G, Fulgione E, Guida S, Caldarola G The Journal of dermatological treatment (2026)
    2. [2]
      The role of NPY2R/NFATc1/DYRK1A regulatory axis in sebaceous glands for sebum synthesis. — Yang T, Hei R, Li X, Ma T, Shen Y, Liu C et al. Cellular & molecular biology letters (2023)
    3. [3]
      Vitamin D levels in patients with seborrheic dermatitis. — Akbaş A, Kılınç F, Şener S, Hayran Y Revista da Associacao Medica Brasileira (1992) (2023)
    4. [4]
      Effectiveness of FastFung agar in the isolation of Malassezia furfur from skin samples. — Atsü N, Ergin Ç, Caf N, Türkoğlu Z, Döğen A, İlkit M Mycoses (2022)
    5. [5]
      Influence of moisturizer containing licochalcone A, 1,2-decanediol, L-carnitine, and salicylic acid on facial skin lipidome among seborrhea participants. — Wongtada C, Pewlong P, Asawanonda P, Noppakun N, Pongpamorn P, Paemanee A et al. Journal of cosmetic dermatology (2022)
    6. [6]
      Differentiation Model Establishment and Differentiation-Related Protein Screening in Primary Cultured Human Sebocytes. — Zhang MF, Cai XL, Jing KP, Pi XX, Liao PY, Li SJ et al. BioMed research international (2018)
    7. [7]
      Increasing Frequency of Seborrheic Keratosis Diagnoses as a Favorable Consequence of Teledermatology-Based Skin Cancer Screening: A Cross-sectional Study of 34,553 Patients. — Moreno-Ramírez D, Raya-Maldonado J, Morales-Conde M, Ojeda-Vila T, Martín-Gutiérrez FJ, Ruíz-de-Casas A et al. American journal of clinical dermatology (2017)
    8. [8]
      Evaluation of molecules or extracts modulating seborrhea and its consequences, using normal human culture of sebocytes and keratinocytes, skin explants models and — Mondon P, Toso RD, Ringenbach C, LavaissiÈre L, Doridot E, Ouvrat É et al. Journal of cosmetic science (2017)
    9. [9]
      Clinical manifestation and associated factors of seborrheic dermatitis in Korea. — Park SY, Kwon HH, Min S, Yoon JY, Suh DH European journal of dermatology : EJD (2016)
    10. [10]
      Current Understanding of Seborrheic Keratosis: Prevalence, Etiology, Clinical Presentation, Diagnosis, and Management. — Jackson JM, Alexis A, Berman B, Berson DS, Taylor S, Weiss JS Journal of drugs in dermatology : JDD (2015)
    11. [11]
      Scalp seborrheic dermatitis: prevalence and associated factors in male adolescents. — Breunig Jde A, de Almeida HL, Duquia RP, Souza PR, Staub HL International journal of dermatology (2012)
    12. [12]
      The multifunctionality of 10% sodium sulfacetamide, 5% sulfur emollient foam in the treatment of inflammatory facial dermatoses. — Draelos ZD Journal of drugs in dermatology : JDD (2010)
    13. [13]
      Does tachyphylaxis occur in long-term management of scalp seborrheic dermatitis with pyrithione zinc-based treatments? — Schwartz JR, Rocchetta H, Asawanonda P, Luo F, Thomas JH International journal of dermatology (2009)
    14. [14]
      Facial seborrheic dermatitis: a report on current status and therapeutic horizons. — Bikowski J Journal of drugs in dermatology : JDD (2009)
    15. [15]
      Pigmented seborrheic keratoses of the vulva clinically mimicking a malignant melanoma: a clinical, dermoscopic-pathologic case study. — de Giorgi V, Massi D, Salvini C, Mannone F, Carli P Clinical and experimental dermatology (2005)
    16. [16]
      Prescribing practices for seborrheic dermatitis vary with the physician's specialty: implications for clinical practice. — Gupta AK, Bluhm R, Barlow JO, Fleischer AB, Feldman SR The Journal of dermatological treatment (2004)
    17. [17]
      Frequency of seborrheic keratosis biopsies in the United States: a benchmark of skin lesion care quality and cost effectiveness. — Duque MI, Jordan JR, Fleischer AB, Williford PM, Feldman SR, Teuschler H et al. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (2003)
    18. [18]
      Dermoscopy of pigmented seborrheic keratosis: a morphological study. — Braun RP, Rabinovitz HS, Krischer J, Kreusch J, Oliviero M, Naldi L et al. Archives of dermatology (2002)
    19. [19]
      A non-invasive tape absorption method for recovery of inflammatory mediators to differentiate normal from compromised scalp conditions. — Perkins MA, Cardin CW, Osterhues MA, Robinson MK Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI) (2002)
    20. [20]
      Terminal notching of the QRS complex in V1 and V2 in seborrheic patients. — Guijarro-Morales A, Maldonado-Martín A, Gil-Extremera B International journal of cardiology (1990)
    21. [21]
      Effect of an orally administered arotinoid, Ro 15-0778, on sebum production in man. — Strauss JS, Davey WP, Denton SJ, Stranieri AM Archives of dermatological research (1988)
    22. [22]
      Dilutional effect of increased sebaceous gland activity on the proportion of linoleic acid in sebaceous wax esters and in epidermal acylceramides. — Stewart ME, Grahek MO, Cambier LS, Wertz PW, Downing DT The Journal of investigative dermatology (1986)
    23. [23]
      Dermabrasion for the treatment of a giant seborrheic keratosis. — Pepper E The Journal of dermatologic surgery and oncology (1985)
    24. [24]
      Pilo-sebaceous duct physiology. 2. The effect of keratin hydration on sebum excretion rate. — Cunliffe WJ, Perera WD, Tan SG, Williams M, Williams S The British journal of dermatology (1976)
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