General: benign epidermal proliferation


HPI: gradually-appearing lesions later in life, slow-growing, patient may have scratched it off but it recurs


Risk factors: middle-aged adults, family members with similar lesions (autosomal dominant inheritance)


Physical exam: small, elevated, tan, brown, or black "stuck on" papules/plaques with a greasy appearance and well-defined margins, sometimes scaling, pedunculated, verrucous


Differential: actinic keratoses, warts, nevi (dermal growths), melanomas and carcinomas


Histology: can perform excisional or deep shave biopsy to rule out melanoma or carcinoma; you will see hyperkeratosis and pseudocysts (keratin-filled invaginations of the epidermis)


Complications: can become inflamed and form a lichenoid keratosis, can form more lesions with age, *Leser-Trelat sign: rapid increase in size and # of seborrheic keratoses along with pruritus can be a sign of malignancy involving the stomach or certain reproductive organs*


Treatment: none needed unless troublesome for patient, in that case (1) cryotherapy, (2) curettage


References: AAD Basic Dermatology Curriculum, Dermatology by Bolognia et. al., Lookingbill and Mark's Principles of Dermatology, First Aid USMLE Step 1 2020, First Aid USMLE Step 2 CK