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Chapter 26: Dermatosis Papulosis Nigra and Seborrheic Keratoses

INTRODUCTION

KEY POINTS

  • Seborrheic keratoses are benign epidermal neoplasms that can occur in any skin color.

  • In lighter skin, they are often pink to tan, while in darker skin, they are often brown to black.

  • In certain populations of color, seborrheic keratoses are considered a manifestation of photoaging.

  • Darker and smaller seborrheic keratoses are called dermatosis papulosis nigra and more commonly present on the face.

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FIGURE 26-1.

Small light-brown papules along the lateral face of an Asian man. (Reproduced with permission from Taylor SC, Kelly AP, Lim HW, et al. Taylor and Kelly’s Dermatology for Skin of Color, 2nd ed. New York, NY: McGraw Hill; 2016, Figure 87-3.)

A patient with light brown skin with several small, hyperpigmented brown papules on the lateral face.
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FIGURE 26-2.

Small brown to large black flat-topped stuck-on papules along the face and neck of a woman with dark skin. (Reproduced with permission from Wolff K, Johnson RA, Saavedra AP, et al. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 8th ed. New York, NY: McGraw Hill; 2017, Figure 9-37.)

A patient with brown skin with hyperpigmented dark brown to black, rough papules of different sizes on the face and neck.
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FIGURE 26-3.

Tan to light-brown macules and papules scattered along the lateral face of a person with light skin. (Reproduced with permission from Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology, 9th ed. New York, NY: McGraw Hill; 2019, Figure 108-4A.)

A photo shows brown, discolored spots on the side of the face of a person with light colored skin.
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FIGURE 26-4.

Discrete dark-brown papule with multiple horn cysts. (From Usatine RP, Smith MA, Mayeaux EJ Jr, et al. The Color Atlas and Synopsis of Family Medicine, 3rd ed. New York, NY: McGraw Hill; 2019, Figure 164-4. Reproduced with permission from Richard P. Usatine, MD.)

A photo shows a dark brown, round, slightly raised lesion with smooth waxy surface and open pores.
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FIGURE 26-5.

Discrete tan waxy stuck-on scaly papule. (From Usatine RP, Smith MA, Mayeaux EJ Jr, et al. The Color Atlas and Synopsis of Family Medicine, 3rd ed. New York, NY: McGraw Hill; 2019, Figure 164-5. Reproduced with permission from Richard P. Usatine, MD.)

A photo shows a pale pink, oval, almost flat lesion with few spots and a smooth surface.
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