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Some years ago, sitting on the sofa with the kids watching the Simpsons, I saw appear on the screen the slim figure of Monty Burns. The decrepit owner of the nuclear power plant that employs Homer was, at that moment, naked. The Simpson kids commented on the unsightly spots that seemed to cover his body.
Whilst not explicitly stated in the script, those spots were most likely seborrhoeic keratoses. Aka "senile warts" or, more kindly, "wisdom warts". These are crusty, crumbly, raised brown spots that look like bits of dried mud stuck on the skin.
Patients in their 30s and 40s will often ask me to have a look at one of these with the concern that it might be a skin cancer, and of course anyone with a new skin spot of uncertain nature should have that spot looked at by a doctor with an interest in skin conditions, but most seborrhoeic keratoses are readily recogniseable to experienced doctors.
Treatment
Seborrhoeic keratoses are usually easy to treat via a number of different modalities. Freezing with liquid nitrogen, cautery with a Hyfrecator, and laser treatments, when expertly performed, will all damage the unwanted cells of the seborrhoeic keratosis without impacting on the normal skin cells underneath. Typically the seborrhoec keratosis will then darken, and over the following days it will dry out and eventually shed from the skin.
Urgent removal can often be effected with the Hyfrecator. After hyfrecation the seborrhoeic keratosis can be often abraded off the skin with gauze, leaving pink clean skin underneath. On the other hand, this process is inherently a little more traumatic, with a risk of damaging the skin, and so the gradual approach is preferred.
The freshly revealed skin underneath will be pink at first but almost always heals up without any mark. |
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