Seborrheic keratosis, xerosis and ichthyosis of the skin are diseases that affect the skin. Keratoses are a category of various non-inflammatory skin diseases characterized by one common symptom - a disruption in the formation of the stratum corneum. Xerosis is dry skin. Ichthyosis is a hereditary skin disease similar to dermatosis. The pathology is expressed by a characteristic disruption of the process of keratinization and the appearance on the body of scales similar to fish scales.

What is seborrheic keratosis?

Seborrheic keratoses are benign growths on the skin. In other words, with keratosis, excessive thickening of the stratum corneum occurs and a delay in normal exfoliation. The most common type of keratosis is seborrheic keratosis.

As people age, older people experience symptoms of seborrheic keratoses. As a rule, these are spots on the skin of different configurations, sizes and colors. Most often, the color range of spots varies from flesh and brown to black. The spots may be flat or protrude above the surface of the skin.

It is known that in children the stratum corneum is thin, exfoliation occurs regularly and by itself. In older people, the skin becomes rough and the stratum corneum thickens. Moreover, keratosis develops on any part of the body: face, chest, arms, neck. Seborrheic lesions can be single or consist of a group of neoplasms that can be located close to each other. The disease develops slowly, once it occurs, most often it does not progress and does not develop into a malignant tumor.

Causes of the disease

The causes of seborrheic keratosis have not been identified to this day. Doctors were inclined towards the viral origin of the disease, but the version was not confirmed. Also, the version about photoreactivity (skin reaction to ultraviolet radiation) was not confirmed. Currently, doctors put forward two causes of seborrheic keratosis:

1. Gerontological factor. The disease develops in people after forty years of age. Most likely, with age, changes occur in the structure of the skin, causing the appearance of keratomas.
2. Genetic predisposition (hereditary nature of the disease).

Seborrheic keratosis is a disease that does not cause discomfort in the form of itching, irritation, and does not negatively affect human health. Aesthetic discomfort is the only negative manifestation of keratosis. However, you should be wary if tumors suddenly show rapid growth. In this case, consulting a dermatologist will not be superfluous. There are cases when a cancerous tumor simulates a keratotic disease, and cancer cells successfully camouflage themselves and develop among the keratoma cells. Immediate consultation with a specialist is required if:

• keratotic formations rapidly increase in size;
• become inflamed or bleed;
• There is a suspicion of skin cancer.

Diagnosis of the disease

In order to determine the nature of the disease, a consultation with a dermatologist is necessary. Seborrheic keratosis is easily diagnosed by external signs, but if the neoplasm is in doubt, a histological examination can be performed. Seborrheic keratosis does not require treatment, but the clinical picture must be observed in order to develop the right strategy of action at any stage of development of the tumor.

There are several stages of this development:

1. The first stage is the formation of a stain. A characteristic feature of aging skin is the formation of age spots. The spots have a variety of shapes, colors and configurations. But usually these spots are flat, do not protrude above the surface of the skin and do not have a rough structure. With age, the number of such spots steadily increases. The risk group includes people who abuse excessive amounts of sunbathing. Keratosis spots can appear at the age of forty, and even earlier with frequent exposure of the skin to ultraviolet radiation. At this stage, there are no senile warts yet.
2. The second stage is the appearance of the papular form. Flat spots begin to rise above the skin and turn into small nodules and papules. This stage is characterized by the absence of peeling and the absence of horny scales on the warts.
3. The third stage is keratotic. At this stage, age-related warts – keratomas – appear. Senile keratomas are brown or black, oval-shaped formations on the skin that rise above its surface. Senile keratomas can bleed if they are injured.
4. The fourth stage is the formation of a cutaneous horn (a new formation of a dense, horny mass, cylindrical in shape, protruding above the surface of the skin). At this stage, there is excessive appearance and keratinization of seborrheic keratoma.

Treatment methods for seborrheic keratosis

Treatment methods for keratosis most often involve removing it. If seborrheic keratosis does not cause psychological and aesthetic discomfort, does not progress in size, and its shape and color remain unchanged, then there is no need to remove it. In other cases, at the request of the patient and the decision of the dermatologist, keratosis is removed using the following methods:

1. Laser method. This hardware method is accessible and inexpensive. The laser removes keratoma by burning and evaporating tissue. A crust remains at the site of the keratoma, which falls off over time, leaving behind healthy skin.
2. The liquid nitrogen cryodestruction method effectively removes extensive accumulations of keratomas.
3. The radio wave method is similar to the laser procedure. The keratoma also evaporates and a crust forms in its place, which eventually disappears by itself.
4. The electrocoagulation method involves removing the keratoma with an electric scalpel. This method is not very popular, as it requires a certain period of rehabilitation. The procedure is performed by a surgeon, and after the tumor is removed, sutures are placed on the skin.

Conservative treatment methods involve oral consumption of large doses of ascorbic acid. This prevents the development and growth of new keratomas. Treatment is carried out in courses with a monthly break.

Xerosis - what is it?

Most people have suffered from xerosis, or dry skin, in one form or another in their lives. When this problem becomes severe, it can affect people both physically and emotionally.

The key to defeating the symptoms of xerosis is proper daily skin care that does not worsen the condition and provides proper care and hydration. Understanding the various causes of dryness and applying appropriate care can help individualize the process to improve its effectiveness.

Xerosis is the medical name for dry skin. It comes from the Greek words ‘xero’, meaning dry, and ‘osis’, disease, disease. Xerosis is associated with a lack of moisture in the skin, which can occur due to aging (age-related xerosis) or accompany certain diseases such as diabetes. As a result, the skin becomes dry, rough and tight, which can develop into keratinization, leading to peeling and peeling of the skin.

Any time you are in doubt about the condition of your skin, it is important to consult a dermatologist for an accurate diagnosis.

The skin's ability to regulate hydration, or the saturation of its upper layers with moisture, depends on three main processes that occur at different depths in the skin:

• In the upper layers of the skin, molecules of various hygroscopic substances, such as urea, lactic acid, PCA (carboxylic acid pyrolidenes), salts and amino acids, absorb and bind large amounts of water.
• The skin's own protective lipids (such as ceramide-3) perform a vital function in reducing water loss through evaporation.
• In deeper layers, the skin's own natural hydration system transfers water to the surface through aquaporin channels.

This thin system works quite clearly and is able to adapt to the skin's hydration needs, maintaining the necessary moisture concentration when changes in the external environment. However, several internal (endogenous) and external (exogenous) factors can disrupt this system, resulting in dry skin. The severity of symptoms depends on a number of complex factors.

Signs and symptoms of xerosis

Xerosis is a common skin condition experienced by millions of people in either chronic or acute forms. Just as the skin's hydration system is maintained by many factors, lack of moisture in the skin can manifest itself in many ways. Most often, dry skin exhibits only a few of these symptoms, while very dry skin usually exhibits all of these symptoms to varying degrees:

• The thickening is caused by the skin losing its elasticity due to dehydration. When moisture deficiency occurs, the skin becomes less elastic and loses volume.
• Roughness (keratinization) is also caused by dryness, which increases the rate of cell death in the upper layers of the skin, resulting in a thick layer of dead cells on the surface of the skin.
• Skin that is flaky is similar to keratinized skin, except that the outermost stratum corneum becomes dry and inelastic.
• Skin detachment occurs when particles of dry skin separate. Sometimes it only looks like fine dust.
• Itching is another effect that occurs as a result of dry skin and is an acute reaction to the discomfort caused by tight skin that is not functioning properly.
• Sensitivity is caused by dry skin's inability to withstand irritants such as hot water, perfume and other substances that can penetrate the surface of the skin. However, sensitive skin is not always associated with dryness.

Dry skin can appear anywhere on the body, although it mostly occurs in areas that are most exposed to external influences. Inflammatory skin diseases such as atopic dermatitis and psoriasis generally result in localized patches of xerotic skin.

Always seek professional advice and diagnosis from your doctor if you develop any of these symptoms.

What causes the disease?

It has been proven that three main skin defects lead to dryness:

• Lack of protective skin lipids. The cells of the stratum corneum are connected to each other using epidermal lipids. These lipids are essential for maintaining healthy skin: they create a protective barrier and retain moisture. When lipids are missing, the skin can become dry and feel tight and rough.
• Lack of natural moisturizing factors (NMF). In addition to urea, several other natural moisturizing factors (NMFs) are present in the skin. These include PCA, lactic acid, salts and sugars. Like urea, these natural moisturizing factors tighten and retain moisture near the stratum corneum (the top layer of skin), preventing dryness, flaking and damage.
• Ineffectiveness of the skin's own hydration system. Aquaporins are microscopic water channels located in cell membranes that control the transport of water in and out of the cell. Aquaporins form a system that transfers moisture through the various layers of the epidermis of the skin.

Factors that cause dry skin

Some external factors provoke the physiological changes described above that can lead to xerosis:

Environmental factors affecting the skin are its cleansing, humidity and sun rays.

• Frequent cleansing, especially constant washing, often causes damage to the skin's natural barrier. The danger increases when using aggressive cleaning agents and detergents.
• Dry skin develops more often in conditions of low air humidity, which happens in winter, and sometimes during hot summer.
• The sun's rays can cause dry skin, and UV rays increase the rate of evaporation from the skin's surface, which in the long term can lead to premature aging of the skin, which affects its ability to maintain adequate levels of hydration.

The internal environment of the skin - age, dehydration, nutrition, medication and disease.

• Studies have shown that the concentration of lipids in the stratum corneum decreases with age. This can lead to age-related dryness.
• A dehydrated body cannot afford to supply water to the skin.
• The way you eat is important because healthy skin requires a supply of natural lipids, PPF and nutrients.
• Some medications, especially diuretics, cause dehydration, which in turn can lead to dry skin.
• Skin diseases such as atopic dermatitis, psoriasis and diabetes are characterized by the symptom of dry skin.
• Pharmaceuticals can dehydrate the body.

How to treat xerosis?

Historically, treatment of xerosis has been primarily symptomatic, with the goal of short-term symptomatic relief through topical application of lipids, primarily vegetable oils, humectants, and PPFs such as urea and lactic acid. As the causes and factors of xerosis became known, doctors discovered that a more holistic, comprehensive approach to treating xerosis produced significantly better results.

This strategy consists of avoiding or minimizing the causes and factors that contribute to the development of xerosis, focusing on providing the necessary daily skin care for the face and body, cleansing and moisturizing.

• It is recommended to use mild cleaners

Gentle but effective cleansing of the skin is an important condition not only for the subsequent use of topical products, for example, for atopic dermatitis, but also for moisturizing the face when caring for dry skin. Selecting a tool that is suitable for skin cleansing and does not compromise the skin's barrier function is critical to the effectiveness of subsequent hydration and skin care.

• Improved skin hydration

Skin hydration is regulated in a variety of ways, each dependent on many different factors. To effectively treat xerosis, it is necessary to address every factor that is involved in regulating and maintaining skin hydration.

Dry skin often lacks urea, the main moisturizing component. Additional causes of xerosis are the lack of other natural moisturizing factors (NMFs) and protective lipids of the skin. Local supply of these vital substances can restore the skin's ability to regulate hydration. In addition, the latter humectant - a compound of glycerol and glucose, glycerol glucoside (GG) - has been shown to stimulate the skin's own hydration system.

If symptoms change, or if you are unsure which treatment is best for you, please consult a dermatologist.

Avoiding factors that contribute to xerosis

In addition to good cleansing and moisturizing routines, it is very important to avoid factors that contribute to the development of dry skin. This will help alleviate the problem of dry skin and reduce the need for treatment:

• Avoid dry air by spending less time outside in hot, dry or cold weather and using humidifiers when the heating is on indoors.
• Reduce your time in hot water by taking quick, warm showers instead of long, hot baths.
• Use gloves when washing dishes - this will help avoid exposure to hot water and aggressive detergents.
• Wear clothes made from natural materials, such as cotton and silk, that are gentle on your skin. Wool is also a natural material, but can irritate atopic skin and should be avoided for this condition.
• Try to use laundry detergents without dyes or fragrances, as these can remain on clothes after washing and irritate dry skin.

Make sure you drink enough water.

Causes and treatment of ichthyosis

Ichthyosis is a hereditary skin disease similar to dermatosis. The pathology is expressed by a characteristic disruption of the process of keratinization and the appearance on the body of scales similar to fish scales. Hence the name of the disease, it comes from the Greek word ichthys - fish.

The main cause of the disease is a gene mutation that can be transmitted through generations. Scientists have still not figured out the biochemical process that underlies the disease. Characteristic symptoms are increased cholesterol levels, excessive accumulation of amino acids, and metabolic disorders.

The mutation caused by ichthyosis leads to a decrease in metabolic processes: their activity decreases, the thermoregulation of the skin is disrupted, and the participation of enzymes in oxidative processes in the outer layers of the skin increases. In people suffering from ichthyosis, a decrease in the functions of the thyroid and gonads, adrenal glands is noticed, difficulties arise with the activity of the sweat glands, deviations in keratinization of the skin appear, the rejection of dead epidermal cells slows down, and the process of absorption of vitamin A is disrupted.

The patient’s body looks very unsightly, it is covered with scales, and between them amino acid complexes accumulate that have not been absorbed by the body. Stagnation of substances gives a cementing effect on the skin, as a result of which dead cells tightly adhere to each other with healthy cells. The separation of scales causes severe pain to the patient.

Types of ichthyosis

There are several types of ichthyosis:

• vulgar (ordinary);
• serpentine;
• pearlescent (shiny);
• needle;
• black;
• lamellar.

There is another form of ichthyosis, divided into a separate group - congenital ichthyosis. It occurs in the fetus while still in the womb and is expressed by a disruption of the process of normal keratinization of the skin. A child is born with this pathology if he has the genes of both parents. However, a specific expression of a gene may not cause 100% transmission. Usually the congenital form of ichthyosis is not compatible with the life of the child.

Ichthyosis vulgaris is the most common hereditary form of ichthyosis. Usually develops during puberty.

Black ichthyosis develops in older people when aging skin is prone to structural changes and increased formation of age spots.

The symptoms of the disease are especially pronounced in young children. The areas of tissue damage are very significant and impossible to miss. The skin becomes dry due to impaired sebum production. The hair on the head thins and falls out, becoming dry and brittle. Children lag behind their peers in development not only in physiological indicators, but also in mental development. The immune system weakens, allowing infectious and inflammatory diseases to develop.

Symptoms of ichthyosis

Clinical symptoms of ichthyosis depend on the form of the disease. The following symptoms are characteristic of vulgar ichthyosis:

• dry skin;
• roughness;
• formation of light gray or dark gray scales;
• the appearance of horny plugs at the base of the hair follicles;

In other forms of ichthyosis the following are observed:

• black-brown scales;
• cracks appear between the scales, which makes them look like snake skin;
• affected areas are localized on the back, neck, lower and upper limbs, abdomen and scalp.

Diagnosis and treatment of the disease

Diagnosis of the disease is not difficult. A dermatologist can easily diagnose the disease. In some cases, histological studies are performed to accurately confirm it.

Treatment of ichthyosis is carried out by a dermatologist in a hospital or on an outpatient basis (depending on the severity of the disease).

The patient is prescribed vitamins A, E, B, C and nicotinic acid for a long time in multiple courses in high doses. Drugs that help soften the scales (lipotropic action) are also prescribed. To increase the body's resistance, medications containing microelements, blood plasma transfusion, gamma globulin, and aloe extract are prescribed.

If systemic lesions of the thyroid or pancreas are observed, appropriate treatment is prescribed: thyroidine in the first case and insulin in the second.

In very severe cases or in congenital forms of the disease, hormone therapy is prescribed. During the period of normalization of the condition, routine examinations are carried out to monitor the general condition of the patient and prevent the development of complications.

Local therapy includes taking baths with a solution of potassium permanganate, salt, starch and lubricating the affected areas with cream. Bath water is saturated with vitamin A, sodium chloride and urea.

Ultraviolet irradiation of the affected areas, swimming in the sea and moderate sunbathing help improve the condition of the skin. Sulfide and carbon dioxide baths are recommended for patients with ichthyosis, which stimulate metabolic processes in the dermis. In a state of remission, silt and peat mud are indicated as preventive measures.  An improvement in the patient's condition is observed in the case of sanatorium-resort treatment.

At home, you can take baths with sea salt, borax and glycerin. It is better to alternate such baths: one day - with borax and salt, on the other - glycerin in combination with borax. Baths with the addition of pine needles, tea and hay dust are also very effective.

Prevention and prognosis

It is impossible to prevent the development of ichthyosis, but modern medicine can prevent the birth of a sick child. The main prevention of the disease is monitoring married couples to determine genetic risk. For couples whose families have had cases of ichthyosis, consultations are held to educate and explain the causes of the disease.

Some couples are contraindicated to have children if at least one parent has a family history. Such couples are recommended to adopt orphans, since the risk of having a sick child is too great.

Unfortunately, the prognosis of the disease is always unfavorable. Because even in a mild form there is a risk of the addition of systemic diseases and the progression of metabolic diseases.

Seborrheic keratosis (basal cell papilloma) is a pathology of non-infectious nature, which is characterized by excessive thickening of the stratum corneum of the epidermis. Most often, this disease is registered in patients over 40 years of age, and therefore it is also called senile or senile keratosis. Benign neoplasms appear on the surface of the skin, and their number may increase with age.

Etiology

Many patients faced with a diagnosis of seborrheic keratosis ask what it is and why this pathology occurs. There are many reasons that provoke the development of the disease. The main ones include the following:

• genetic predisposition;
• diseases of the liver, intestines, endocrine glands;
• decreased body resistance;
• hypo- and vitamin deficiencies;
• pregnancy;
• taking hormonal medications;
• regular exposure to stress factors on the body;
• frequent mechanical damage to the skin;
• aggressive exposure to ultraviolet radiation;
• unbalanced diet.

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Connection with oncological processes

Surely many have heard about such a disease as seborrheic keratoma. What it is, however, not everyone knows. In fact, the anomaly leads to the appearance of single or multiple keratomas on the skin - benign neoplasms.

Until now, doctors have not been able to find out the main reason that provokes the development of pathology. Some of them are of the opinion that the etiology of the disease is associated with a genetic factor. Others do not exclude the involvement of the factors mentioned above in the occurrence of the anomaly. Accordingly, answers to questions about how to treat seborrheic keratosis of the skin will also vary.

Important! Scientists have been able to prove a connection between skin cancer and seborrheic keratoma. Visually it is very difficult to determine whether this formation is malignant or seborrheic keratosis. The diagnosis can only be established by histological examination of the biomaterial.

The appearance of multiple foci of senile keratoma on the patient's skin may indicate the development of an oncological process in the internal organs. Analysis of statistical data showed that 10% of patients diagnosed with seborrheic keratosis of the skin have various forms of skin cancer.

Clinic

The appearance of single or multiple neoplasms on the skin is the main symptom of seborrheic keratosis. These elements most often appear on the back, the front surface of the chest, in the area of ​​the external genitalia, and less often on the neck, face, and scalp. Very rarely, senile warts are localized on the palms and plantar surfaces of the feet. The size of a benign tumor varies over a wide range - from a few millimeters to 10 cm.

Keratomas can be yellow, pink, black, dark cherry or brown in color. These neoplasms are covered with a thin membrane, when damaged they often bleed.

Therapy methods

Treatment of age-related keratomas (senile warts) can be carried out using radical and conservative methods. Doctors strongly do not recommend self-medication, as this can trigger the development of squamous cell skin cancer. Only an experienced doctor should treat seborrheic keratoma.

Advice! If the keratomas do not cause any discomfort, then it is best to leave them alone. Without adequate treatment, tumors continue to grow in size. It is worth noting that they grow very slowly (about 2 mm per 10 years).

Today there are four main ways to remove keratoma:

1. Surgical excision. This is a traditional method of radical treatment of actinic keratoses of the skin. Removal of tumors is carried out using a surgical scalpel. After surgery, scars remain on the skin.
2. Electrocoagulation method. In this case, keratomas are removed using an electric scalpel. This method is not particularly popular, as it requires a significant recovery period.

Cryodestruction is one of the most accessible methods of removing tumors on the surface of the skin.

1. Using a laser- the most effective way to remove benign tumors. This method eliminates the occurrence of relapses, does not cause complications and has virtually no contraindications.
2. Radiosurgical method. During the operation, the surgeon uses a special instrument (radio knife), due to which the tissue around the tumor being removed remains intact.
3. Curettage- cleaning using a special tool. This method is effective for removing small flat growths. Electrocoagulation is often performed in combination with curettage.
4. Cryodestruction. The method is based on the use of liquid nitrogen. Removal of tumors is painless. This method has proven itself in the treatment of multiple keratomas.

Laser therapy is the most effective way to remove keratomas, as well as other tumors on the surface of the skin

Conservative treatment gives little effect, although patients are often prescribed large doses of ascorbic acid to stop pathological processes. This medicine blocks the growth of old and the development of new keratomas. Drug therapy involves the prescription of vitamin and hormonal medications. This treatment is symptomatic: it is not aimed at removing the tumor, but at eliminating unpleasant sensations (itching and skin irritation).

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Treatment of seborrheic keratosis at home

If keratomas do not cause any particular inconvenience, but you want to get rid of them, you can try using traditional medicine recipes. These products are used for local action and to achieve a general strengthening effect. Treatment of age-related warts (keratomas) with folk remedies will require patience, as this process can take several months.

Note! Recipes from traditional healers cannot completely remove keratoma, but they are safe for health and cope well with inflammatory processes.

Aloe vera

To prepare the preparation, the thickest aloe leaves are cut off, after which they are doused with boiling water. The leaves are wrapped in clean gauze and placed in the refrigerator for 5-7 days. Under such conditions, non-protein biogenic stimulants (carboxylic acids, low molecular weight peptides, amino acids) are formed in plant tissues. After the above period has expired, the leaves are removed from the refrigerator and cut into thin slices. The resulting aloe plates are applied to the affected areas of the skin, then fixed with adhesive tape or polyethylene. These compresses are best applied before bedtime. In the morning, the compress is removed and the skin is wiped with salicylic alcohol.

Onion peel

Dry onion peels are scalded with boiling water and dried. After this, 4 tablespoons of the husk are poured into a glass of 9% vinegar solution. The solution is infused in a dark, warm place for two weeks. The extract is applied to abnormal areas of the skin.

Bay leaf

Bioactive substances that are part of the leaves of the noble laurel relieve pain and inhibit the growth of keratomas. To achieve the maximum therapeutic effect, a medicinal ointment is made from bay leaves. Bay leaves are crushed into powder and poured with butter. Next, you can add a few drops of lemon, lavender, fir or eucalyptus essential oil to the resulting mixture and apply it to the keratomas.

Celandine

This plant also slows down the development of keratoma. To make the ointment, celandine powder is used, which is poured with pork fat. This ointment is used to treat the affected areas of the skin.

Conclusion

In order not to miss the development of cancer when senile tumors appear on a person’s skin, you should definitely consult a doctor. The doctor will tell you how to get rid of this problem!

Seborrheic keratosis is a benign form of growth that appears on the skin; manifests itself as dark brownish spots, as a rule, the spots are slightly convex, raised (see photo below). The surface of areas affected by seborrheic keratosis tends to become scaly and form greasy crusts that are prone to flaking.

Unlike, with which it should not be confused, seborrheic keratosis does not develop into a malignant pathology.

Epidemiology

Seborrheic keratoses are very common on the face and trunk in persons who have reached advanced middle age, without gender preference (i.e., in both men and women equally). The dermatological disorder occurs primarily in the Caucasian race, while the Oriental and black races are rarely affected.

Reasons

Etiopathological studies are still the basis for studying this disease. The only connection that scientists were able to prove was familiarity: Seborrheic keratosis appears to be genetically transmitted in an autosomal dominant manner.

There is no doubt, however, that the growth, and therefore the development, of seborrheic keratoses is enhanced by hormonal changes or irritation, although it is not the trigger: for this reason menopause, a time of high hormonal modulation, coincides with an increase in seborrheic keratoses.

Finally, some studies also suggest the possible involvement of ultraviolet radiation in the etiology of the disease, as seborrheic keratosis has been noted to occur in people who have exposed their skin to sun exposure. However, since the disorder occurs even in people who have not been overexposed to ultraviolet radiation, the debate about the influence of sun exposure in the etiology of seborrheic keratoses is still open. Therefore, further and more in-depth research is needed in this area.

Clinical manifestations

Typically, seborrheic keratoses begin as yellowish papules that turn brown and flake off over time. In truth, the color of the lesions can vary from hazel to brown or blue depending on the subtype of seborrheic keratosis that affects the patient. Additionally, although the lesions are more common on the face and torso, depending on the subtype of seborrheic keratosis a person suffers from, they can also occur in other parts of the body. (see paragraph “classification”).

Papules can be of different sizes, depending on the subject and depending on the area affected by the keratosis: in general, there are spots with a diameter of 1 millimeter to 1 centimeter, but there have been cases where the papules were even larger.

Often, seborrheic keratoses barely adhere to the skin and create the appearance of easily detachable tissue. It is precisely because of the barely adjacent feature with which seborrheic keratoses form on the skin that they are often destroyed, partially or completely, after injury.

Given the similarity with, seborrheic keratosis is called seborrheic warts, senile warts: Seborrheic lesions are not contagious and not transmitted and, as already mentioned, cannot develop into malignant tumors.

Symptoms

The lesions typical of this skin disease are usually asymptomatic and do not cause any discomfort. However, in some cases, the lesions may become irritated or cause itching and/or bleeding.

Classification

There are different subtypes of seborrheic keratosis:

• Seborrheic acanthotic keratosis: This is the most common form of this disease and presents with diffuse light brown to dark brown pigmentation with pseudo-corneal cysts that tend to take on a yellowish color.
• Acropostic ​seborrheic keratosis: Affects mainly the legs, lesions are multiple.
• Hyperkeratotic seborrheic keratosis: A keratotic manifestation that tends to flake continuously.
• Pigmented seborrheic keratosis or melanoacanthema: this form is manifested by multiple pigmentations, melanocytes are present in large numbers.
• Painful (irritated) seborrheic keratosis: the manifestation of seborrheic keratosis is accompanied by irritation and other possible skin changes. Bleeding and redness of the damaged areas occurs. Typically, the infiltration of melanophages in the above-mentioned areas gives the spots a bluish color, sometimes causing diagnostic doubts (difficult to distinguish from).
• Black papular dermatosis ( seborrheic keratosis on dark skin): Regarding this, it is not yet clear whether it can be considered a variant of seborrheic keratosis. It appears as small, multiple hyperpigmented spots.

Diagnostics

A dermatologist must properly diagnose the disorder by analyzing each individual seborrheic wart to avoid misunderstandings: the signs left behind by seborrheic keratoses actually resemble those of much more serious skin diseases (squamous carcinoma, spinocellular carcinoma, and basal cell carcinoma).

If the diagnosis of seborrheic keratosis is made correctly, removal of the warts will be futile (unless the disorder is a serious aesthetic problem in the eyes of the affected subject). Through dermatoscopy, a specialist can make the correct diagnosis and differentiate seborrheic keratosis from other skin diseases. Of course, the physician will also need to determine what type of seborrheic keratosis the patient has.

Treatment

As already mentioned, treatment by removing seborrheic warts is not necessary except for aesthetic reasons. In fact, the lesions are usually asymptomatic and cause no discomfort to patients. However, if seborrheic keratoses show unregulated and excessive growth, the disorder can have significant aesthetic consequences.

In this case, diathermocoagulation, cryotherapy, laser therapy, curettage or electrocoagulation are possible solutions to eliminate seborrheic keratosis. At the same time, these therapeutic approaches may be used if the lesions become irritating, causing itching, pain and/or bleeding.

After seborrheic keratosis removal, the skin usually appears lighter than the surrounding skin. This hypopigmented area may remain hypopigmented throughout the patient's life. However, treatment results in permanent removal of the lesion, as it will no longer appear in the area where it was removed. However, this does not prevent the appearance of new seborrheic keratoses in other untreated areas of the body.

Prevention

There are currently no specific methods for preventing this pathology. It is recommended to limit exposure to the sun, avoid heavy tanning, follow the rules of a healthy lifestyle, avoid drinking alcohol and cigarettes, and maintain good hygiene.

To summarize

To consolidate the material, see the table below...

Disease	Seborrheic keratosis or seborrheic wart.
Clinical aspects	The disease is not contagious, non-infectious, benign. Appears as raised dark brownish spots; The surface of the papules is rough, characterized by scales and uneven crusts. Typically, the diameter of the spots varies from 1 mm to 1 cm. Sometimes the skin disease is associated with an irritating itching sensation.
Prevalence	Seborrheic keratoses occur in subjects who have reached advanced middle age, with no gender preference; The dermatological disorder occurs primarily in the Caucasian population, while it is rare in Oriental and black people.
Affected areas	Often the face and torso.
Differences from	Seborrheic keratosis is not a malignant form of cancer and does not result from exposure to ultraviolet rays, like the actinic form.
Reasons	The reasons are not clear. It is probably genetically transmitted in an autosomal dominant manner. Increased by hormonal changes and immunosuppression (weak immunity).
Damage	Purely aesthetic
Classification	Seborrheic acanthotic keratosis; Acropostic seborrheic keratosis; Hyperkeratotic seborrheic keratosis; Seborrheic keratosis pigmentosa; Irritant seborrheic keratosis; Seborrheic keratosis on dark skin.
Possible treatments to eliminate seborrheic keratoses.	diathermocoagulation; cryotherapy; laser therapy; curettage (scraping with a curette); electrocoagulation.

Interesting

Both adults and children are susceptible keratosis , which manifests itself in thickening of the epidermis. Skin disease can be caused by a number of external factors, and methods of treatment are individual in each case. It is important to accurately determine the form of the pathology in order to understand its cause and prescribe appropriate treatment.

What is it

Under keratosis imply a whole group of dermatological pathologies that are not viral in nature.

Under the influence of certain factors, the following changes begin to occur in a person:

• skin becomes dry:
• Single and multiple neoplasms appear in open areas:
• itching appears.

Acquired plantar keratosis: photo

Sometimes keratomas are found on the soles of the feet, scalp, and genital area. The size and shape of neoplasms can be very diverse, their boundaries are outlined. Their color is usually pink, yellowish or brown, and the surface is rough with a thin film.

At an early stage, the disease does not cause serious concern, only the appearance is spoiled. As the keratoma grows, a person experiences more and more unpleasant symptoms.

Senile keratosis of the skin: photo

If you try to remove the tumor, blood will be released. Over time, the film becomes denser and becomes covered with cracks, the new growths rise more and more above the surface of the skin and acquire black or light inclusions.

ICD-10 code

L 57.0– actinic keratosis.

L 11.0– acquired follicular keratosis.

L 85.1– acquired palmoplantar keratosis.

L 85.2– pinpoint appearance of palmoplantar keratosis.

L 82- seborrheic form.

L 87.0– follicular and parafollicular keratoses.

Causes

It is not known exactly why keratosis of the skin appears.

In any case, it is not contagious and occurs as a result of exposure to certain factors:

• old age;
• genetic predisposition;
• large amounts of fat consumed;
• poor metabolism;
• lack of vitamins;
• prolonged exposure to UV rays;
• nervous system disorders;
• taking certain medications;
• disorders of the endocrine and immune systems;
• mechanical damage;
• contact with chemicals.

The following groups of people are most susceptible to this disease:

1. People with weakened immune systems.
2. Elderly men and women.
3. Light-skinned people with red hair.
4. Residents of hot countries.

Experts have discovered the connection between cancer and keratosis. After all, neoplasms on the skin are benign and sometimes malignant in nature. It is possible to distinguish a keratoma from cancer only with the help of histological examination.

The presence of multiple foci of the disease may indicate oncological pathologies of internal organs. According to statistics, among 9 thousand people with keratoma, 10 percent are diagnosed with various types of skin cancer.

Species

Depending on the symptoms, keratosis is divided into the following types:

1. Symptomatic. It occurs against the background of other diseases, under the influence of negative environmental factors.
2. Hereditary. It is formed due to a genetic predisposition and appears immediately after birth or in childhood.
3. Acquired. The exact reasons are not fully understood.

According to the degree of localization, there are two types of disease:

1. Localized. Affects certain areas of the skin.
2. Diffuse. Covers a large area of ​​skin.

The most common types of keratosis are the following:

Only an experienced dermatologist can determine this or that type of keratosis.

Treatment

Before treating keratosis, you should undergo the necessary examination and tests.

Diagnostic procedures include:

1. Anamnesis collection.
2. A thorough physical examination.
3. Carrying out a biopsy (sampling a small piece of a tumor for microscopic examination).

Therapeutic measures are aimed at reducing the number of keratomas, softening and exfoliating them. For this purpose, external means are used:

Vitamin and mineral complexes, immunomodulators and drugs to improve blood flow are taken internally. It is forbidden to use scrubs, peels, or rub the skin with a hard washcloth.

Various ointments and compresses with yeast, aloe, castor oil, propolis or potatoes are used as alternative medicine. However, folk recipes can only be used as an additional method of therapy.

Video:

Solar This type of keratosis is treated in the same way as other forms. The doctor selects a therapeutic method individually for each patient. These could be:

1. Cryotherapy. Freezing affected cells.
2. Laser exposure. Laser burning of pathological tissues.
3. Dermabrasion. Layer-by-layer sanding of leather.
4. Radio wave therapy. Vaporization of the tumor under local anesthesia.
5. Electrocoagulation. Excision using an electric scalpel.

Before and after treatment: photos

Surgical intervention involves the use of a curette to scrape out the affected tissue. A visible scar may form at the site of the keratosis, so keratosis of the facial skin, which can also be treated with surgery, is eliminated in other ways. The prognosis is favorable in most cases.

If keratosis is observed in a child, the famous TV doctor Komarovsky offers the following treatment:

1. It is necessary to take baths with sea salt.
2. It is necessary to use moisturizing creams and ointments.
3. It is recommended to follow a diet.

A well-known pediatrician believes that rough skin that does not bother the child in any way does not require radical treatment. Sometimes they go away on their own with age.

Video:

When keratomas form, you should not resort to self-medication. As a preventive measure, it is recommended to periodically undergo examination by a dermatologist, be exposed to sunlight only during the permitted time, and moisturize the skin more often.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Keratoma is a general collective name for several types of benign skin tumors formed from the superficial cells of the epidermis. That is, several types of neoplasms with a common origin are combined into one name “keratoma”. In principle, the term “keratoma” is clinically and morphologically inaccurate, since it does not reflect the specific characteristics of each type of benign tumor formed from cells of the superficial layer of the epidermis ( keratinocytes).

The term "keratoma" is formed from two parts: the first is "keratos", which is the Greek name for the cells of the superficial stratum corneum of the skin (keratinizing epithelium), and the second is the suffix "-oma", which denotes a tumor. That is, the direct translation of the word “keratoma” is a tumor of the cells of the keratinizing epithelium of the skin. It can be said that the term “keratoma” is equivalent in meaning to the concepts “fibroids”, “lipomas” and other similar general names for large groups of benign tumors originating from the same type of cells and including several specific types of neoplasms.

Keratoma - brief characteristics and localization

Any keratoma, regardless of the type, is formed from epithelial cells of the skin, which is the outer layer and is in direct contact with the environment. This epithelium is multilayered keratinizing in structure, and the cells that form it are called keratinocytes. Stratified keratinizing epithelium consists of several layers of cells lying on top of each other. Moreover, the cells of the outer layer located on the surface gradually die off, turning into horny scales, which peel off and are removed from the surface of the skin when washed.

When the scales peel off, new epithelial cells rise in their place from deeper layers, which themselves, after some time, begin to die and turn into scales. Thus, a process of constant renewal of skin epithelial cells occurs - the superficial ones die and peel off, and their place is taken by others that were previously in the underlying layer. The basement membrane of the epithelium, in turn, continually forms new epithelial cells, which gradually move toward the surface to eventually become scaled and slough off.

Normally, the rate of formation of new cells on the basement membrane and peeling off of horny scales is balanced. That is, only the number of cells that is necessary to replace those that have turned into horny scales is formed again. If the processes of exfoliation of scales and the formation of new epithelial cells are not balanced, this leads to the development of various skin diseases. This is how keratomas—benign tumors made from keratinocytes—are formed.

Keratoma is formed from unchanged skin epithelial cells prone to excessive keratinization. That is, the tumor consists of a large number of ordinary keratinocytes - exactly the same cells that form normal layers of the epithelium. Since keratomas are formed from normal cells, they are benign tumors.

However, keratomas are prone to degeneration into Cancer. According to statistics, malignancy of keratomas occurs in 8–20% of cases, depending on the type of tumor, the general condition of the human body, as well as the presence of negative factors contributing to the formation of cancer cells. It is precisely because of the relatively high probability of keratomas degenerating into malignant tumors that these neoplasms are classified as precancer. However, you should not be afraid of this, because in most cases keratomas do not become malignant.

Since keratomas are formed from skin epithelial cells, these tumors are localized only in different areas of the skin. Keratomas can form on the face, neck, torso, arms, and upper legs. Moreover, the most rare localization of these neoplasms is the lower extremities, and most often keratoma appears on areas of the skin exposed to sunlight, such as the face, neck, arms, chest, etc. One or more keratomas may appear at the same time.

At the initial stage, any keratoma looks like a slightly protruding spot above the skin, colored gray or coffee-colored. The surface of the keratome usually peels off, which is due to the formation and peeling of a large number of horny scales. As it develops, the area of ​​the keratoma increases, and the spot begins to protrude more strongly above the surface of the skin. On sufficiently large keratomas, a dense crust of horny scales forms, which can be torn off accidentally or intentionally. When a keratoma is injured, it can bleed and hurt, causing discomfort to the person. Otherwise, these tumors, as a rule, represent only a cosmetic problem and do not bother the person in any way.

Skin keratoma

Since the keratoma is formed from unchanged cells of the keratinizing epithelium, which is found only in the structure of the skin, the only possible localization of these benign tumors is the skin. In other words, keratomas can only form on the skin. In this aspect, keratomas are an example of benign tumors with a determinate (conditional) localization - that is, they can form only on the skin and nowhere else.

Accordingly, the term “skin keratoma” is incorrect, since it contains an excessive specification, which fully reflects the situation described by the well-known saying “butter oil”. After all, any keratoma can only be on the skin.

Keratoma on the face

Keratoma on the face forms quite often and is usually single. Keratomas of any kind can form on the face, as well as on other parts of the body. Moreover, their course is no different from tumor formations localized in other areas of the skin, for example, on the back, leg, etc. Therefore, it is inappropriate to consider keratomas on the face separately from the same tumor formations in other parts of the body, because there are no fundamental differences between them.

Multiple keratomas

The term “multiple keratomas” usually means the presence of more than 3 formations on a small area of ​​skin (approximately 5 X 5 cm). Multiple keratomas, like single ones, can be dangerous or non-dangerous, which depends on the period of time during which they appeared, as well as on the rate of increase in their size.

As a rule, several keratomas appear on the skin of different parts of the body over a relatively short period of time (a few months), and this phenomenon is considered normal. If over several years a person has formed a large number of keratomas, then this is also a variant of the age norm. In such cases, it is not recommended to remove the tumors; you should simply regularly (1-2 times every six months) undergo a preventive examination by a dermatologist who can monitor the growth and condition of the keratoma.

If within a short period of time (1 - 3 months) a person develops multiple keratomas in one or several areas of the body, then this is considered a dangerous condition, since it may be a sign of cancer in the internal organs. Otherwise, multiple keratomas are no different from single ones, since they are characterized by the same clinical course, approaches to therapy and possible causative factors.

Photo keratoma

Since there are several types of keratomas that differ in appearance from each other, we present their photographs in separate sections.

Senile (seborrheic, age-related) keratoma - photo

These photographs show various clinical variants of seborrheic keratomas.

Follicular keratoma - photo

This photograph shows a follicular keratoma.

Solar (actinic) keratoma – photo

These photographs show various variants of solar keratoma.

Cutaneous horn - photo

These photographs show cutaneous horns of various shapes and sizes.

Types of keratomas

Currently, doctors and scientists use a classification of keratomas based on the nature of the causative factor that provoked the skin tumor. According to the most common classification, the following types of keratomas are distinguished:

• Senile keratoma, which is also called age-related, senile or seborrheic;
• Solar keratome, which is also called actinic;
• Follicular keratoma;
• Cutaneous horn, also called keratoma keratoma.

Since each of these types of keratomas is characterized by the presence of specific structural features, we will describe them separately.

Senile keratoma (seborrheic, age-related, senile keratoma)

To designate this type of formation, in addition to the name “senile”, the terms seborrheic, age-related or senile keratoma are also used, which, accordingly, are synonyms. Three variants of tumor names, such as senile, senile and age-related, reflect the fact that these keratomas are formed in older people (after 40 - 50 years). And the term “seborrheic keratoma” reflects the fact that excess sebum production plays a large role in the process of tumor formation. In addition to the listed options for the names of keratomas, the terms “seborrheic keratosis” or “senile keratosis” are often used.

In people under 40–50 years of age, seborrheic keratoma is most often single and, as a rule, localized in open areas of the body, such as the face, arms, neck, chest, etc. In the older age group (in people 50 years and older), this The type of keratomas is almost always multiple, and they are localized in closed areas of the body, such as the back, abdomen, legs, etc.

Seborrheic keratoma at the initial stage is a spot that rises slightly above the skin, colored brown, gray, dark brown or black. The shape of the spot can be oval or round, and the size ranges from medium lentils to large beans. As the spot grows, it may increase slightly in size and rise significantly above the surface of the skin. When the keratoma finally grows, it protrudes strongly above the skin and looks like something foreign, as if glued.

Numerous scales are visible on the surface of the formation, which in some cases can form a continuous crust. The scales are loose, greasy to the touch and easily removed from the surface of the keratoma, since they are not strongly fused to its tissues. Under the removed scales, protrusions of various sizes are visible, similar to the papillae of the tongue. Usually these protrusions are well demarcated from the rest of the keratoma tissue, they look like peculiar inclusions, painted in a slightly different shade, but the same color as the rest of the formation, as a result of which it is not difficult to identify them.

Senile keratomas grow slowly throughout a person's life and never disappear on their own. As the formation grows, they can change shape, color and degree of elevation above the surface of the skin. When localized in close proximity to physiological openings (eyes, vagina, entrance to the urethra in men, etc.), keratomas are often subject to trauma, as a result of which in 20% or more cases they become malignant and give rise to basal cell carcinoma or squamous cell carcinoma of the skin.

The risk of malignant degeneration of senile keratomas ranges from 8 to 35%, which is determined by the presence of additional factors promoting tumor growth. Thus, the risk of malignancy by keratomas increases with their regular injury, improper treatment, as well as exposure to ultraviolet and radioactive radiation, etc.

Depending on the histological structure, senile keratomas are divided into the following forms:
1. Spotted form;
2. Nodular form;
3. Plaque form;
4. Keratoma similar to Bowen's disease;
5. Transitional form between keratoma and cutaneous horn.

These forms of keratomas represent five successive stages of tumor development, which are listed in the order of their transformation into each other. That is, the spotted form is the earliest stage of keratoma development, and the transitional form to the cutaneous horn is, accordingly, the last.

Spotted keratoma It is a round or oval-shaped spot ranging in size from 3 to 7 mm with fuzzy edges. When localized on the body, the spot is colored brownish-brown, and on the face – light brown or pinkish-yellow. The spots may feel smooth or rough to the touch. In the area of ​​the keratoma, the skin is thin, susceptible to atrophy, as a result of which it is easy to gather into folds and wrinkles.

Nodular keratoma has dimensions up to 10 mm, clearly defined edges and is colored dark gray or dirty yellow. The formation is raised above the surface and covered with horny scales. If you remove the scales, the reddish surface of the keratome will be underneath them.

Plaque keratoma It is an irregularly shaped disc 5–10 mm in diameter with clear edges, painted gray. The color of the plaque is due to a dense layer of horny scales that can be scraped off from the surface of the keratoma. If the scales are removed, the bleeding surface will be visible underneath them.

Keratoma similar to Bowen's precancer , is several plaques merged into one with a total diameter of 10 - 15 mm. The edges of the common plaque are uneven, jagged, but clearly defined. The edges of the keratoma are copper or pinkish in color, and the center is various shades of brown or gray. The number of scales on the surface of the keratoma is insignificant. As the formation progresses and grows, its central part atrophies and sinks. Such a keratoma is only superficially similar to Bowen's precancer, but its distinguishing feature is the almost zero possibility of degeneration into cancer.

Transitional form from keratoma to cutaneous horn It is an ordinary plaque, at one end of which a keratinized elevation is formed, resembling a horn. This elevation is dense to the touch, consists of a cluster of horny scales and is colored brown. The size of such a horny growth on the surface of the skin is usually small - from 10 to 15 mm, and over time it becomes malignant, turning into spinocellular skin cancer.

Solar (actinic) keratoma

Solar (actinic) keratoma is a type of tumor provoked by the negative effects of ultraviolet radiation on the skin. That is, as the name implies, solar keratoma is formed due to prolonged exposure to the sun. The total dose of solar radiation received throughout life plays a role in the development of keratoma. That is, the more and more often a person was exposed to the scorching sun, the higher his likelihood of forming solar keratomas.

Typically, this form of the disease manifests itself with the simultaneous formation of multiple keratomas on the surface of the skin in areas most exposed to sunlight, for example, the face, lips, ears, neck, forearms, hands and lower legs. Keratomas are located on thin, atrophied skin.

At the initial stage, solar keratomas are small, painful spots or round-shaped blisters, the size of which ranges from a pinhead to several centimeters. Such keratomas are painted in the color of normal skin or in various shades of red and gray-black. If the formation has the same color as the surrounding skin, then it is difficult to identify them during examination, but it is easy to do this by palpation. When you touch the surface of the solar keratome, your fingers feel a rough and very dense formation, slightly protruding above the skin. In addition, solar keratomas appear well when creams containing 5-fluorouracil are applied to them.

Solar keratomas are divided into the following forms depending on their clinical manifestations:

• Erythematous form;
• Keratotic (papular) form;
• Warty (papillomatous) form;
• Horny form;
• Pigment form;
• Proliferative form.

Erythematous form Solar keratosis is characterized by the appearance of lesions of various shapes on the skin, in which there are a large number of hard and dry scales. The lesions are clearly defined and delimited from the surrounding skin by a red rim. At the time of appearance, the size of the lesion is several millimeters, but as the tumor progresses, it increases to 10–20 mm.

Keratotic form is formed due to the thickening of the layer of horny scales covering the surface of the erythematous keratoma. At the same time, the redness goes away, and the surface of the lesion becomes covered with horny scales, giving it a yellowish dirty-brown or gray-black color. If the scales are scraped off, you will find red, thin, cracked skin underneath.

Warty form Solar keratosis is characterized by “cauliflower-like” growths on the surface of the keratosis, which is covered with scales, giving it a dirty gray color with a yellowish tint.

Horny form solar keratomas are characterized by the formation of a dense growth on the skin, similar to a horn. This horn is formed by a large number of tightly compressed scales. Most often, the cutaneous horn is formed from the keratotic form of solar keratosis and is predominantly localized on the skin of the forehead or ears.

Pigment form Solar keratoses are brown spots covered with horny scales, giving their surface a strong roughness. As a rule, keratomas are located on the back or the back of the hands.

Proliferative form Solar keratoma is an oval plaque that rises above the surface of the skin, colored red and covered with flaking scales. The edges of the plaque are blurred, and the size can reach 3–4 cm in diameter. Solar keratomas of this form are most often localized on the skin of the lips, but can also affect the conjunctiva of the eye.

Follicular keratoma (keratosis)

Follicular keratoma is a rare type of tumor that originates from the epithelial cells lining the hair canal, from which the hair emerges from the follicle to the surface of the skin. This keratoma is extremely rare, and according to some data, the tumor is more often formed in women, and according to others, on the contrary, in men.

Follicular keratoma looks like a dense nodule of regular round shape, protruding above the surface of the skin and colored gray or pinkish. As it grows, it can increase in size up to 20 mm. Follicular keratomas are usually localized above the upper lip, on the scalp or on the forehead near the hairline.

Cutaneous horn (horny keratoma)

The cutaneous horn (horny keratoma) is a dense protruding formation with a characteristic elongated shape, which is why it received the name “horn”. This keratoma is formed by dense horny scales, fused together into one dense mass.

It is currently believed that cutaneous horn is not an independent and separate form of benign tumors of the epidermis, but represents a special variant of the course of solar or senile keratoma. That is, cutaneous horn can have different origins and course, but the same clinical manifestations. Actually, it was precisely the same type of clinical manifestations that made it possible to combine all possible variants of the origin of the cutaneous horn into one type of keratoma.

Most often, a cutaneous horn develops against the background of an existing senile keratome and somewhat less frequently with a solar keratome. In order for a skin horn to form from a solar or senile keratoma, it is necessary to constantly influence the formation of additional factors that will form a predisposition. Such factors include microtraumas, sunburn, chronic infectious diseases, etc. This means that if an existing solar or senile keratoma is continually traumatized, exposed to sunlight, or becomes infected, it is highly likely to form a cutaneous horn.

The cutaneous horn looks like an elongated protruding formation on the skin of a conical or cylindrical shape. It constantly grows in length, and therefore can reach significant sizes - in isolated cases up to 30 cm. In rare cases, the horn grows not in length, but in width, and in this case it looks like a large, wide formation attached to the surface of the skin with a thin stalk .

The surface of the formation can be smooth or rough, dotted with numerous irregularities and grooves, and the color is dark with a predominance of yellowish-brown or brown colors. To the touch, the skin horn has a dense consistency. At the base of the horn on the skin there may be local inflammation, which looks like a narrow red rim surrounding the formation.

The cutaneous horn forms somewhat more often in women and is usually single. It is extremely rare for two or more cutaneous horns to form on the skin of one person. Usually the formation is localized on the face, ears and scalp. Since malignancy of the cutaneous horn occurs quite often, it is classified as a precancerous disease.

Cause of keratoma

The exact causes of keratomas, like other tumors, have not currently been identified, but it has been established for certain that the development of these tumors is associated with exposure to sunlight on human skin. This does not mean that a few months after exposure to the sun, for example, at sea, keratomas will begin to appear and grow in a person. However, the sun can repeatedly negatively affect the skin throughout life, which ultimately leads to various changes in its overall structure and individual cells, which become predisposing factors for the formation of keratomas. In other words, slowly but steadily over decades, the sun's rays cause changes in the structure and functioning mechanisms of the cells of the surface layer of the skin, which ultimately becomes the basis for the formation of tumors from them. That is, skin cells damaged by solar radiation give rise to keratoma.

Scientists were able to find out that the decisive factor in the formation of keratomas is not a single dose of solar treatment received by a person during one or several days of exposure to direct sunlight. On the contrary, the decisive role is played by the total dose of solar radiation received by a person throughout his life. That is, if a person was exposed to the open rays of the sun for one hour every day for 20 years, then his risk of developing keratomas is higher than that of someone who, for the same 20 years, spent only 2 weeks a year on the beach, exposing his skin to the sun.

Since it is the total dose of solar radiation received by a person throughout his life that is important for the formation of keratomas, it is recommended to avoid intense sunbathing for more than 15 to 45 minutes a day and working in open areas under the scorching sun without thick clothing that covers as much skin as possible. This means that to prevent keratomas and skin cancer, it is recommended that when working in the open sun (for example, in a field, lifeguards on the beach, etc.), you should dress to cover your arms, neck, shoulders, legs, and forehead.

Are keratomas dangerous?

Keratomas are both dangerous and safe. This means that in general, keratomas are safe neoplasms because they are benign, but at certain moments they can become dangerous due to malignancy and their transformation into a cancerous tumor. That is, until the process of malignancy and degeneration into cancer begins in the keratome, it is safe.

Based on the fact that the keratoma itself is a safe formation, and becomes dangerous only with malignant degeneration, it is very important to monitor the condition of the tumor and record possible signs of its transformation into cancer. Currently, the signs of malignancy of keratomas are the following changes in it:

• The keratoma began to grow rapidly;
• The keratoma began to bleed without injury;
• The keratoma began to itch.

This means that if these signs are detected, you should consult a doctor as soon as possible and remove the suspicious keratoma.

In addition, the danger of keratoma lies in the fact that in appearance some forms are similar to skin cancer, as a result of which even experienced doctors cannot always distinguish one formation from another. In such situations, it is recommended to remove the suspicious tumor as soon as possible and send it for histological examination. If the results of histology reveal that the formation was indeed a cancerous tumor, then for a complete recovery you should undergo a course of chemotherapy.

Finally, the indirect danger of keratomas is that with the simultaneous appearance of a large number of such tumors on the skin, there is a high probability of developing cancer in any internal organ. In such a situation, it is necessary to consult a doctor and undergo a detailed examination, which will detect a growing cancerous tumor and remove it at an early stage.

Treatment of keratosis

General principles of treatment of keratomas (senile, seborrheic, follicular, cutaneous horn)

Currently, the only way to treat keratomas is to remove them using various methods. However, keratomas do not always require mandatory removal; moreover, in most cases, people live with them into old age and die for completely different reasons. That is, you can cure a keratoma only by removing it, but this is not always necessary. In other words, these tumors do not need to be treated in all cases. The only type of keratomas that must be removed is the cutaneous horn.

If there are keratomas, doctors recommend not removing all existing tumors, but visiting a dermatologist 1-2 times every six months so that he can monitor the dynamics and condition of the formations, and if they are suspected of malignant degeneration, quickly remove them. Thus, it is recommended to remove only keratomas that are suspected of malignant degeneration into skin cancer.

In addition, at the request of patients, doctors remove keratomas, which create a visible cosmetic defect that disrupts a person’s normal life and causes discomfort. That is, if the keratoma does not show signs of malignancy and from the doctor’s point of view it can be left, but at the same time the person does not like its presence in principle, then it is quite possible to remove the formation at the request of the patient.

Keratoma removal methods

Currently, the following techniques can be used to remove keratomas:

• Kerat removal with laser;
• Cryodestruction (removal of keratosis with liquid nitrogen);
• Electrocoagulation (removal of keratomas with electric current);
• Radio wave removal of keratomas;
• Surgical removal of keratomas;
• Destruction by acids (removal of keratomas by acids) or cytostatics.

The choice of method for removing keratoma is made individually in each specific case, based on the size, type and shape of the formation, as well as available tools and equipment.

So, if a malignant degeneration of a keratoma is suspected, then it should be removed only by surgical, radio wave or laser methods. Other methods cannot be used to remove malignant tumors, since they are not effective and radical enough. As a result, their use makes it impossible to completely remove all tumor cells, which will trigger explosive cancer growth a few weeks after surgery.

All three of these methods for removing suspicious malignant keratomas are equally effective, but laser and radio wave are less traumatic compared to surgery. This means that after removing a keratoma using a laser or radio wave method, a rough and noticeable scar will not form, and tissue healing after surgery will occur very quickly. Therefore, if possible, it is recommended to prefer the laser or radio wave method of keratoma removal to the surgical method.

Methods of cryodestruction, electrocoagulation and acid destruction can be used to remove keratomas that are definitely not at the stage of malignant degeneration, but bother a person only as cosmetic defects or interfere with leading a normal lifestyle (for example, they are injured during movements, etc.).

Methods for removing keratomas with acids and cytostatics can be considered conservative, since when they are used, the neoplasm is destroyed due to the death of its cells, and not “cutting out” it with a scalpel, laser beam or radio wave radiation. Treatment of keratoses with acids or ointments with cytostatics is carried out in order to remove small but numerous neoplasms. As a rule, only solar keratomas are removed with the help of acids and cytostatics, since they are small in size and have a shallow depth of damage to skin tissue.

Laser removal of keratoma

Laser removal of keratoma is an effective method that allows you to completely destroy tumor cells, which guarantees the absence of relapses. Typically, laser removal of keratomas is performed in one session, during which the formation is either evaporated or “cut out” with a laser beam used as a thin scalpel. After laser removal of a keratoma, complete healing of the skin occurs within 1 – 2 weeks, after which an almost invisible scar remains on it.

Removing tumors with liquid nitrogen

Removal of keratoma with liquid nitrogen is carried out without anesthesia, as a result of which during the procedure a person may feel a slight tingling or burning sensation on the skin. The essence of the manipulation is to destroy the keratoma tissue with liquid nitrogen. After treating the tumor with liquid nitrogen, a crust-spot forms on the skin, under which tissue healing occurs. About a week after the operation, the crust disappears, and a pink spot remains on the skin, which within a month acquires the color of the normal surrounding skin, as a result of which it becomes invisible.

Unfortunately, when using liquid nitrogen, it is impossible to control the depth of tissue damage, as a result of which a common complication of cryodestruction of keratomas is a wound that is too large, healing with the formation of a noticeable and unsightly scar. In addition, when using the cryodestruction method, relapses of keratomas quite often occur due to the fact that not all tumor cells were destroyed.

Removal of keratoma by electrocoagulation

Removal of a keratoma by electrocoagulation is its “cauterization” with an electric current, which is completely similar to that for cervical erosion. During the manipulation, the keratoma is exposed to a high-frequency electric current, which heats the tumor tissue, actually burning it locally. After electrocoagulation of the keratoma, a crust is formed, under which the skin heals. After 1 - 1.5 weeks, the crust disappears and pink skin is exposed, which acquires a normal color after a month. The electrocoagulation method is excellent for removing small keratomas because it does not cause scarring and is quite effective.

Removal of keratoma using the radio wave method

Removing a keratoma using the radio wave method involves “cutting it out” using a radio knife. The essence of the operation is exactly the same as when removing a keratoma with a scalpel, but instead of a rough metal cutting object, thin and precise radio wave radiation is used, allowing bloodless and small incisions to be made. As a result of radio wave removal of the keratoma, the surrounding tissues are not damaged and therefore no scars are formed. The method can be used to remove any keratomas.

Surgical removal of keratoma

Surgical removal of a keratoma involves “cutting it out” with a scalpel under local anesthesia. This method is the simplest and most accessible, but at the same time very effective, therefore it can be used to remove any type of keratoma. The only drawback of the method is the formation of a postoperative scar and relatively long tissue healing.

Removal of tumors with acids and cytostatics

Removal of keratoma with acids and cytostatics involves treating the formations with external agents (creams, emulsions or solutions) containing substances as active components that can destroy tumor cells. Such substances are trichloroacetic and glycolic acids, as well as the cytostatics Podophyllin and 5-fluorouracil.

Treatment of kerat with acids is carried out only by a doctor, since it is very important to dose these substances correctly. Indeed, when using too high a dose of acids or when applying them to keratomas for a long period of time, a chemical burn is possible, which will lead to the formation of ugly scars.

The cytostatic solution Podophyllin and ointments containing 5-fluorouracil can be used for self-treatment of keratomas, since their use is relatively safe. So, 25% Podophyllin should be lubricated with keratomas once a day for 10 days. In this case, 4–8 hours after applying Podophyllin to the keratoma, it should be washed off with warm water and soap.