Seborrheic keratoses (seb-o-REE-ik ker-uh-TOE-sEEs) are very
common benign lesions found on middle-aged and elderly people. These lesions
are sometimes called, “age spots”, but I like to refer to them as “wisdom
spots”. They are not very common on people younger than 30 years of age, but
once they develop, new lesions will appear throughout one’s life. I sometimes
joke with my patients that they will collect them with each new birthday. And
yes, anyone lucky enough to live a long life will get them; it’s part of life.
It’s part of the aging process of the skin. They are distinct from actinic keratoses, which are considered to be a premalignant skin lesion.
Seborrheic keratoses (SKs) can be tan-colored, brown, flat or even raised, like warty growths with a greasy texture. They can be found anywhere on the body, except for the palms and soles. They are most common on the face, chest, and back. They tend to occur more commonly on sun-exposed areas compared to non-sun exposed areas. Sometimes if they're deeply pigmented or traumatized they may be mistaken for melanoma. Some of my patients confuse these warty looking growths for “moles”, but moles are actually made up of melanocytes. Seborrheic keratoses are made up of keratinocytes, not melanocytes and thus are not true moles. They generally are asymptomatic (without symptoms) but sometimes they can be very itchy. When traumatized, they can actually be sore. These lesions are benign and generally do not need treatment, except for cosmetic purposes or when they are inflamed and/or itchy.
Some people have many small keratoses on the cheeks. This pattern of clustering of small keratoses on the cheeks is called, “dermatosis papulosa nigra” (see image below).
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