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Therapeutic Approach

Seborrheic keratoses (SKs) are common benign epidermal neoplasms often found on the trunk and with greater incidence among older individuals. Clinically, SKs can range from flat, macular lesions to verrucous plaques and are often more pronounced in intertriginous areas. Variants include dermatosis papulosa nigra (DPN), macular SK, stucco keratosis, inverted follicular keratosis (IFK), large cell acanthoma and lichenoid keratosis. Although these are benign lesions, many patients desire removal for cosmesis or if lesions are symptomatic. Directed therapies should consider skin type, size, and location of the lesion. The choice of procedural modality is dependent on cosmetically sensitive locations or deeply pigmented skin. In the author’s experience, cryotherapy is the preferred first-line therapy in lighter skin types, while curettage or electrosurgery are reserved for darker skin types, larger lesions, or cosmetically sensitive locations. See Table 97-1.

Table 97-1Seborrheic Keratoses Treatment Table

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