Skin keratosis: photo, treatment, types and types. Keratopapilloma - what is it? Removal of keratopapilloma Seborrheic keratosis ICD code 10

Skin diseases are rightfully considered one of the most extensive groups of diseases in medicine. Their list includes both mild diseases that respond well to treatment, as well as more serious ones, for example, keratopapilloma. In the International Classification of Diseases 10 (ICD), keratopapilloma code D23 is other benign skin neoplasms.

By itself, this disease may not bring inconvenience and pain, but in many cases it causes the development of skin cancer. That is why specialist supervision is necessary from the very moment symptoms are detected. What is it - keratopapilloma, how to quickly identify its symptoms and is it possible to get rid of this diagnosis forever?

Definition

First you need to figure out what it is - keratopapilloma, and how to recognize it in time. Keratopapilloma is a benign neoplasm, one of the varieties of papillomas. This neoplasm often has a convex shape and is attached to the skin with a thin stalk (depending on the type). It differs from ordinary papillomas by the keratinization of the surface and the presence of peeling.

Sizes vary from quite small to large (up to the size of a hazelnut). The number of neoplasms also varies, from 1-2 to several hundred. Most often, keratopapillomas are localized on the face, neck, armpits, groin and lower back. There are also cases of keratopapilloma of the auricle in medical practice.

Reasons for the development of the disease

Patients with this diagnosis are people aged 35 years and older. Such statistics is explained by age-related changes occurring in the body of each person. Among the main causes of the disease:

• genetic predisposition (if one of the parents had keratopapillomas, in most cases the children will also suffer from this disease);
• age-related disruptions in the digestive and hormonal systems (this becomes an impetus to the growth of the skin layer);
• monotonous diet (lack of vitamins and microelements reduces immunity and leads to malfunction of individual organs);
• violations in the work of the sebaceous glands (the skin becomes dry, keratinization begins);
• the influence of UV rays;
• constant wearing of tight, uncomfortable clothing.

Clinical picture

The initial stages of keratopapilloma disease (ICD 10-D23) are accompanied by the appearance of small spots on the skin. Their color can be different: yellowish, light or dark brown. Over time, these spots increasingly begin to rise above the surface of the skin and become covered with a dense crust or roughness.

Lack of treatment leads to the fact that dozens of neoplasms grow in place of 1-2 neoplasms, covering vast areas of the skin. Many people with this diagnosis do not report pain or discomfort. In other words, keratopapilloma in some cases is considered by people only as a visual defect. Unpleasant manifestations occur when neoplasms are located at the points of contact with clothing. When rubbed with tissue, keratopapillomas begin to crack, bleed, cause itching and pain. In some cases, a benign tumor causes an inflammatory process or degenerates into an oncological skin disease.

What is it - keratopapilloma: types of disease

The appearance of the neoplasm, the development and course of the disease largely depends on the type of pathological site. With this in mind, the course of treatment of keratopapilloma is also being built. Types of neoplasms:

• Follicular keratopapilloma. This neoplasm often looks like a nodule with a small indentation in the center. It is localized in most cases on the face, in the mouth area. Individual nodules of this type are located quite close to each other.
• Senile. This type of disease is manifested by small spots on the skin that differ in color. Neoplasms do not rise above the surface of the skin, but over time they increase, acquire a loose structure.
• Horny. Most often, this type of keratopapilloma is located on the skin of the face. A distinctive feature is a very dense horny surface resembling a horn.
• Seborrheic. Visually, seborrheic keratopapilloma looks like a wart. It is clearly visible on the skin, rises above its surface. It differs from a common wart by its dark color and the presence of scales on the surface. In appearance and photo, this type of keratopapilloma is not easy to distinguish from other types of neoplasms. Patients with this diagnosis complain of itching and discomfort in the affected area.
• Angiokeratoma. This type of disease affects the smallest blood vessels and is presented as a burgundy or brown spot on the skin.
• Sunny. Such a diagnosis is accompanied by small spots on the skin, which after a while become covered with a dense crust and harden. Spots are prone to growth and more often than other types of keratopapilloma become the cause of oncology.

Diagnostic methods

To prescribe an effective course of therapy, the doctor needs to conduct a thorough diagnosis with the identification of the type of keratopapilloma according to the ICD 10 code, its causes and features of the course. For this, several methods are used in medicine at once:

• Visual - an experienced dermatologist during the initial examination and, taking into account the patient's complaints, can preliminarily make a diagnosis and prescribe the additional studies necessary in this case.
• Siascopy is a procedure during which a hardware scan of neoplasms is performed for the purpose of studying (due to this, it is possible to establish a type of benign formation).

• Dermatoscopy - during the study, a device is used that works on the principle of a microscope.
• Ultrasound examination (ultrasound).
• Biopsy - a histological examination of tissues is necessary if there is a suspicion of the presence of malignant cells.

Methods for the treatment of keratopapilloma

How to get rid of the problem? Patients who have received such a diagnosis from a doctor are wondering what it is - keratopapilloma and how to treat the disease. To date, medicine offers a number of ways to quickly and effectively get rid of the manifestations of keratopapilloma. Among them:

• the use of medicines (not suitable for all cases);
• classical surgery;
• laser treatment;
• cryodestruction (exposure to liquid nitrogen);
• radio wave treatment;
• electrocoagulation (use of electric current).

The choice in favor of one or another method of therapy is made only after a thorough diagnosis. This is explained as follows: all of the above treatment options are only suitable in the absence of malignant cells. Keratopapilloma according to the ICD code refers to benign diseases. Skin cancers are treated with a laser, traditional surgical methods and radio waves. Other influences (liquid nitrogen, current) can cause rapid growth of malignant cells.

drug therapy

Drug treatment of keratopapilloma - what is it? Taking medications is prescribed by doctors, taking into account the general condition of patients, the causes and stage of development of the disease.

• Cytostatics. These drugs are prescribed in cases where there is a high risk of the transition of a benign neoplasm to a malignant one. Typical representatives of this group: "Methotrexate", "Prospidin", "Cyclophosphamide", used for local injections.
• Antitumor antibiotics.
• Local anti-inflammatory. In cases where the skin around the keratopapilloma has redness and inflammation, anti-inflammatory drugs of local action are prescribed. Diclofenac gel showed good efficiency.
• Hormonal. Such medicines allow you to cope with swelling, itching and burning. Used locally. These drugs should only be used under medical supervision.
• Mummifying and cauterizing. With seborrheic keratopapilloma, local preparations based on concentrated acids are often prescribed. One of them is Solcoderm.

Surgical method

This method of treatment is considered one of the oldest and consists in removing keratopapilloma with a scalpel. Among the undoubted advantages of this method:

• universality (suitable for the treatment of benign and malignant tumors);
• efficiency - after removal of the neoplasm, the problem disappears;
• affordable price - of all the options offered, surgical removal is considered the cheapest.

Among the shortcomings, one can name the complete dependence of the result on the professionalism of surgeons, since the human factor plays a big role here.

Laser treatment

This method of exposure can be included in the list of the most modern sparing methods for the treatment of keratopapilloma (ICD 10-D23). It consists in the use of a laser beam that acts directly on the affected area of ​​the skin and does not affect healthy surrounding tissues. Depending on the characteristics of the disease, a beam of different intensity can be used. During exposure to a laser beam, neoplasm cells do not disintegrate, however, their DNA chain is broken, which leads to a stop in the growth and development of keratopapilloma. The duration of removal of keratopapilloma can vary from 2 to 10 minutes. The number of sessions depends on the complexity of the disease and the size of the affected area. To eliminate small keratopapillomas, 1 procedure is enough.

Cryodestruction

A distinctive feature of this method of treatment is the impact on the affected area with low temperatures (up to -180 degrees). Freezing can be done in two ways:

• using a special device - a cryodestructor;
• using a cotton pad with liquid nitrogen.

In the first case, the doctor brings the cryodestructor as close as possible to the affected area of ​​the skin. In a short time, the tissue is frozen, and the contents of the cells are destroyed. When using a conventional cotton pad with liquid nitrogen, it is applied strictly to the area of ​​​​keratopapilloma and removed after 3 minutes. After some time, the neoplasm exfoliates on its own, and the skin in this place is restored. This method of treatment is considered one of the most effective. There are several reasons for this:

• speed of treatment - in most cases, 1-2 sessions are enough to remove keratopapillomas;
• efficiency;
• absence of cosmetic skin defects after treatment.

Radio wave therapy

This is another way to treat keratopapilloma, which can be classified as advanced. From many other methods of exposure, it differs in safety for healthy tissues, because it is not a scalpel or current that is used here, but radio waves.

Undoubted advantages:

• universality - treatment with radio waves is indicated for the diagnosis of benign and malignant neoplasms (including keratopapilloma of the auricle);
• sparing effect - healthy tissues are not involved, so there are no scars and scars after the procedure;
• the ability to process all types of tissues (even mucous);
• painlessness - when treating with radio waves, anesthesia is not required.

This option is not suitable for all patients, since there are some contraindications (pregnancy and lactation, herpes infection, menstruation, allergic reactions, pustular and inflammatory formations).

Electrocoagulation

This type of treatment is based on the use of electrical current of variable or constant frequency. During the procedure, a metal electrode acts on neoplasms, and therefore a burn occurs, which is very limited in area. In other words, they affect only keratopapilloma and closely spaced blood vessels. Due to this, the neoplasm is removed, and bleeding does not occur (vessels are cauterized).

Doctors consider this treatment as one of the most effective:

• in this way, all types of neoplasms can be treated;
• the effect is achieved in 1 session;
• an anesthetic is not required to remove small keratopapillomas;
• The price of the procedure is quite affordable.

Of the shortcomings, the appearance of scars after removal should be indicated (occurs when the skin of large areas is damaged).

Treatment with folk methods

In addition to the medication course and the removal of keratopapillomas, there is another method of treatment - the use of folk remedies. They can give some effect only if the keratopapilloma has appeared recently. Older neoplasms are not amenable to such treatment. It is important to understand that before using folk remedies, it is necessary to undergo a diagnosis. How dangerous is keratopapilloma? What it is - not everyone knows. This is a benign neoplasm that can turn into a malignant stage. Time spent on self-treatment makes it difficult to get rid of the disease.

• Aloe. Aloe leaves are cut, placed in the freezer for 3 days. After that, the leaf is thawed to room temperature, cut and the pulp is applied to the affected area overnight. The course of treatment is at least 3 weeks.
• Raw potatoes. Potatoes are peeled and rubbed on a fine grater. The resulting mass is applied to the hearth, covered with a bandage and a film on top. Wash off after 40 minutes.
• Ointment based on bay leaf. To prepare the product, you will need 2 juniper and 10 bay leaves, 100 grams of butter and 10 drops of fir oil. The leaves must be carefully crushed and mixed with oils, mix. Smear the affected areas should be daily. These ingredients help against neoplasms of various types.
• Unripe walnuts. You will need 1 part unripe walnuts and 6 parts warm vegetable oil. The liquid is infused in a thermos for about a day and used for daily lubrication of keratopapillomas. Apply 2 weeks.

We considered a disease called "keratopapilloma". What it is and how to treat it is no longer a mystery. Knowing everything about this pathology, people with such a diagnosis will be prepared for therapy. At the same time, information will be useful to those who are at risk.

Seborrheic keratosis - includes a whole group of diseases of the skin, which are united by a single factor - thickening of the stratum corneum of the skin. It is noteworthy that the main risk group is made up of people over forty years of age. Currently, the causes of such a pathology have not been fully elucidated, and clinicians identify a rather narrow range of predisposing factors that are based on chemical and mechanical damage to the skin.

The clinical picture will be slightly different depending on the form in which the disease proceeds. The most specific symptom is the formation of spots on any part of the body, except for the palms and feet.

Establishing the correct diagnosis will not be a problem for an experienced dermatologist, which is why the diagnosis is based only on a thorough physical examination, which is carried out personally by the clinician.

The treatment of seborrheic keratosis in the vast majority of cases is performed by minimally invasive surgical operations, but sometimes alternative medicine can be used.

The international classification of diseases has singled out a separate value for such a benign skin pathology. The ICD-10 code is L82.

Etiology

Previously, it was believed that the disease is one of the symptoms or occurs due to prolonged exposure to direct sunlight. However, after lengthy clinical studies, experts from the field of dermatology decided that such theories are not related to seborrheic keratosis, in particular because the pathology is diagnosed in the vast majority of cases in people over the age of forty.

However, predisposing sources are considered to be:

• repeated mechanical damage to the skin;
• chemical influence of aerosols;
• the course of chronic diseases in humans from the endocrine system;
• a wide range of autoimmune processes;
• uncontrolled intake of certain medications, in particular hormonal substances containing estrogen.

It is generally accepted that genetic predisposition plays an important role in the development of such an ailment. Diagnosing this type of seborrhea in one of the close relatives by about 40% increases the risk of developing a similar pathology in the offspring.

Classification

The choice of tactics for the treatment of seborrheic keratosis is directly dictated by the stage of progression of such a disease. Thus, the following stages of flow are distinguished, slowly replacing each other:

• spot- this is the initial degree, in which, in addition to yellowish-brown spots, no other clinical manifestations are observed. Often, the treatment of the disease at this stage is not carried out, since the disease does not cause discomfort to the patient. In the vast majority of cases, the first spots begin to form between the ages of fifty and sixty;
• papular form- the affected area of ​​\u200b\u200bthe skin begins to change color, and a nodule or papule rises above its surface. Neoplasms may differ in volume and number;
• keratotic form- the formation of a senile wart is observed or. If you accidentally damage the neoplasm, slight bleeding will begin;
• keratinization- in this case, the formation of a skin horn occurs. Most often, it is at this stage of the course that patients seek qualified help from a dermatologist.

According to its histological structure, the disease is divided into:

• flat keratosis- consists of unchanged pathological cells;
• irritated seborrheic keratosis- differs in that the neoplasm is impregnated with an accumulation of lymphocytes;
• reticular or adenoid- includes a network of cystic formations from the stratum corneum of the epithelium;
• clear cell melanoma- acts as the rarest variety of such a disease. In the composition, the presence of horny cysts, melanocytes and keratinocytes is noted;
• lichenoid keratosis- differs in that in appearance it resembles rashes that appear on the background or;
• clonal seborrheic keratosis- in such cases, the tumor includes both small and large pigmented keratinocyte cells;
• keratotic papilloma- consists of particles of the epidermis of single horny cystic neoplasms;
• follicular inverted keratosis- a benign tumor histogenetically associated with the squamous epithelial lining of the funnel of the hair follicle.

Symptoms

Seborrheic keratosis of the skin is completely asymptomatic, in the sense that it does not worsen the patient's well-being, does not bring pain and does not have pronounced symptoms.

However, the disease has such clinical signs:

• the formation of single or multiple spots. A favorite place of localization is the skin on the back or chest, on the shoulders or on the face. Several times less often, neoplasms affect the neck and scalp, as well as the back surface of the forearm and the genital area;
• keratomas in shape resemble a circle or oval;
• neoplasms vary in size from a few millimeters to six centimeters;
• have clear boundaries with healthy skin;
• as they progress, they rise above the surface of the skin;
• often accompanied by itching;
• spots and nodules have a wide range of colors ranging from pink to black;
• peeling of the skin in the affected areas;
• warts are covered with a thin film, which is easily removed, but bleeds at the same time;
• the acquisition of a pointed shape, which makes the papule rise above healthy skin by about one millimeter;
• keratinization of the skin involved in the pathological process.

It is also worth noting the signs in which it is necessary to seek medical help from a dermatologist. They should include:

• severe discomfort caused by papules or nodules - while neoplasms begin to interfere with normal daily activities;
• severe bleeding;
• accession of the inflammatory process;
• significant growth - the volume of spots or nodes change upwards every day, which is noticeable even to the naked eye;
• localization of education in a conspicuous place, which causes not only physical, but also emotional discomfort;
• multiple keratomas, the number of which is constantly increasing;
• attachment of pain.

All of the above manifestations are characteristic of both sexes.

Diagnostics

Due to the fact that the disease has pronounced symptoms, very often there are no problems with establishing the correct diagnosis.

The basis of diagnostics is the following activities:

• study by the clinician of the patient's medical history and life history - to establish the most characteristic cause of seborrheic keratosis in a particular patient;
• the implementation of a thorough physical examination - to assess the condition of the skin or hairline, which will help determine the number of pathological foci;
• a detailed survey of the patient - to determine the presence of unpleasant sensations, as well as in the presence of pronounced symptoms to establish the first time of occurrence and the severity of the symptoms. This will enable the doctor to determine the extent of the pathological process.

Laboratory and instrumental diagnostics is based on a biopsy, in which a small particle of the neoplasm is taken and subsequent microscopic studies are performed. This is necessary for:

• confirmation of the course of a benign process;
• identification of infrequent situations of malignancy with keratomas;
• definition of the type of disease.

Only after studying the results of all tests and examinations, the dermatologist will decide on how to treat seborrheic keratosis on an individual basis for each patient.

Treatment

The tactics of therapy will differ depending on at what stage of the course the diagnosis was made. For example, before warts or nodules form on the skin, specific therapy is not carried out. The only medical method is the intake of ascorbic acid. This will help to avoid further progression of the disease and completely eliminate the initial stages of the pathology.

In other cases, the treatment of seborrheic keratosis is aimed at removing neoplasms and is carried out by implementing the following procedures:

• laser therapy- lies in the fact that pathological tissues are burned out by laser radiation and simply evaporate. After that, a small seal remains at the site of the operation, which eventually resolves on its own;
• radio wave therapy- similarly to the previous event, it is based on the evaporation of the neoplasm, but is performed under local anesthesia;
• burning with liquid nitrogen- differs in that the keratoma is burned out by cold, after which it dies. A small blister remains at the site of intervention, but it self-opens, and healthy skin grows in its place;
• electrocoagulation- involves excision with an electric scalpel, after which a suture is applied to the site of the wart.

In rare cases, such methods of therapy are used:

• applications using an ointment containing fluorouracil, solcoderm and other medicinal substances;
• curettage;
• folk medicine.

In the latter case, treatment is carried out with the help of:

• lotion from a thin piece of aloe, which is applied to the problematic part of the body;
• compress based on propolis;
• applications from gruel of raw potatoes;
• lotions of onion peel and vinegar.

It should be noted that therapy at home should be carried out only after prior consultation and approval of the attending physician.

Prevention and prognosis

Since the causes of the development of the disease are unknown, preventive measures will be based on general rules:

• maintaining a healthy lifestyle;
• careful skin care;
• minimizing the influence of irritating factors;
• taking medication strictly according to the doctor's prescription;
• timely treatment of endocrine pathologies.

Also, do not forget that several times a year it is recommended to undergo a complete preventive examination in a medical institution with a visit to all specialists.

Seborrheic keratosis is a disease that can be cured without much effort. The prognosis in the vast majority of cases is favorable. Nevertheless, in 9% of situations, keratoma malignancy occurs.

Is everything correct in the article from a medical point of view?

Answer only if you have proven medical knowledge

The most frequent occurrence of seborrheic keratosis is observed in individuals in whose families there were similar cases of the disease in relatives, which is the basis for the assumption of a genetic predisposition. It is realized as a result of age-related aging of the skin and can be provoked by various external and internal factors:

The degree of danger of seborrheic keratosis

Although the disease is considered a benign tumor, there is a definite connection between it and aggressive types of skin cancer:

Symptoms of the disease

The main symptoms of seborrheic keratosis are single or multiple elements, localized mainly on the back and anterior surface of the chest, less often on the scalp, on the neck, face, back of the hand, back of the forearm, in the area of ​​the external genitalia. Very rarely, keratomas appear on the palms and soles of the feet. Tumors often have a round or oval shape with a diameter of 2 mm to 6 cm, clear boundaries and rise above the surface of the skin, often accompanied by itching.

The color of neoplasms can be pink, yellow, dark cherry, dark brown, black. The surface structure is often similar to many small scaly warts, covered with a thin, easily removable crust that bleeds with minor mechanical damage. Over time, black dotted inclusions appear in it, it gradually thickens, reaching 1-2 cm. It is covered with a network of cracks.

Although the entire formation has a soft texture, the crust becomes more dense, the edges acquire irregular, sometimes jagged outlines. Occasionally, keratomas become spiky or dome-shaped, 1 mm in size, with a smooth surface and black or whitish grains of keratin.

Classification and characteristics of various forms

Seborrheic keratosis for practical purposes is divided into forms:

Seborrheic keratosis, irritated

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Converters

1. Flat, having the form of a slightly raised above the skin surface and sharply pigmented flat formation.
2. Reticular, or adenoid - thin, interconnected in the form of a looped network, strands of epithelial pigmented cells. The network often includes cysts from the stratum corneum.
3. Clear cell melanoacanthoma is a rare form of seborrheic keratosis with a warty, rounded surface. It contains horny cysts and consists of keratinocytes, which are the basis of the epidermis, and pigment-containing cells - melanocytes. Melanoacanthomas occur mainly on the lower extremities. They look like flat, moist plaques that clearly merge into the normal surrounding epidermis.
4. Lichenoid keratosis, which looks like a tumor with inflammatory changes. These elements are similar to mycosis fungoides, discoid erythematosis in systemic lupus erythematosus, or lichen planus.
5. Benign squamous, or keratotic papilloma of small size, consisting of elements of the epidermis and single cystic formations of horny cells.
6. Cutaneous horn is a relatively rare form of keratosis. It is more common in older people and is a cylindrical mass of horny cells protruding above the surface of the skin. It can reach large sizes. The tumor occurs in 2 forms - primary, poorly understood and arising without apparent causes, and secondary, which is formed as a result of an inflammatory process in other skin tumor-like formations. The secondary horn is dangerous by degeneration into skin cancer under the influence of microtraumas, viral infection, hyperinsolation, etc.

Seborrheic keratosis: symptoms of the disease, pathogenesis and treatment features

Features of the disease

Seborrheic keratosis is the most common type of this disease. As a rule, the disease manifests itself and develops in people over 40 years old, and more often even 50–60 years old, for which it was called senile warts or senile keratosis. According to studies, 88% of patients over 64 years of age have at least one focus of seborrheic keratosis, in persons younger than 40 years, in 25% of cases there is at least one focus.

Neoplasms develop in the upper layer of the skin, have a variety of shapes and sizes. Most often, skin growths are small - 0.2-6 cm, the color is flesh, black or brown. The spot protrudes above the level of the skin. Initially, the plaque has a shape close to oval, but with development it becomes uneven. The surface of the wart is covered with rough crusty formations and peels off. Appear as single keratomas. as well as multiple.

Warts are quite sensitive: with a slight mechanical injury, and sometimes with a simple touch, the keratoma begins to bleed. If the keratoma is damaged, you need to consult a doctor - the probability of infection is very high.

The ICD-10 disease code is L82.

By itself, seborrheic keratosis is not particularly dangerous. Even itching does not always appear. However, with the formation of warts on the face, neck, open areas of the body, the disease causes severe psychological discomfort. In addition, keratomas can "mask" the manifestations of skin cancer.

Seborrheic keratosis tends to progress. The formations grow, become darker, the surface becomes more and more rough over time. Keratonic plugs appear. With a strongly convex shape, warts cause inconvenience: they are easily damaged when removing clothes, unsuccessful movement, and so on.

Description of the disease seborrheic keratosis is given in this video:

Classification of seborrheic keratosis

• flat- plaques have a bright dark color, but slightly rise above the level of the skin. This is especially well heard during palpation - on this basis, flat keratosis is distinguished from actinic lentigo;
• reticular or adenoid. In addition to pigmented plaques, horny cysts appear on the surface. The formations form a kind of looped network;
• irritated- looks like flat plaques of the corresponding color. Histological examination reveals an accumulation of lymphocytes in the surface layer of the dermis;
• inflammatory- the neoplasm is accompanied by inflammation. As a rule, the most severe itching and peeling is observed;
• black papular- papules are smooth, dome-shaped, dark brown in color. Most often observed on the face in patients from 20 to 40 years. This is usually found in those with dark skin;
• "plaster"- a lot of light brown and gray spots of small size. The spots are flat and usually appear on the back of the hands and forearms, as well as the feet and ankles.

Seborrheic keratosis (photo)

Localization

Warts can appear on almost any part of the body: on the face, torso, limbs, scalp, even on the halos of the mammary glands. Never found on the palms, soles and mucous membranes. Black papular dermatosis is localized on the face.

As a rule, the localization of warts has no practical significance. The exception is the appearance of multiple foci, as it may be associated with acute leukemia, gastrointestinal cancer, and so on.

Causes

The mechanism by which seborrheic keratosis occurs is unknown. Its relationship with age is obvious: people over 75 have seborrheic keratosis without fail. Moreover, it can manifest itself both in the form of single formations and in the form of multiple spots.

The dependence of keratosis on solar radiation remains unconfirmed. As a rule, warts first appear on exposed areas of the body, but this is not enough to confirm the hypothesis of the negative effects of the sun. Also, the hypothesis of a viral etiology of the disease was not confirmed.

There is evidence of a genetic predisposition to keratosis: if the disease is observed in relatives, the probability of its occurrence in a patient is 100%.

However, the provoking factors today include:

• sunburn abuse;
• frequent damage to the skin of a mechanical nature;
• the action of household chemicals - aerosols;
• chronic diseases leading to malfunctions of the endocrine glands;
• abuse of fats of animal origin with a low content of vegetable fats in the diet;
• pregnancy;
• disorders in the immune system, as well as taking hormonal drugs, especially based on estrogen.

Seborrheic keratosis on the back

Benign hyperkeratotic skin neoplasms in dermatology are classified according to clinical manifestations and risk of malignancy. There are senile, seborrheic, horny, follicular, solar keratoma and angiokeratoma.
Senile (senile) keratoma. The most common form of pathology, characterized by the appearance of single or multiple brown spots from 1 to 6 cm in diameter, localized in open areas of the skin. Formations tend to grow peripherally with a change in structure. Over time, the spot becomes convex due to infiltration and proliferation of individual sections of the keratoma, loose, soft, sometimes a little painful to the touch. Later, the keratoma begins to peel off, follicular keratosis occurs inside the growing tumor with the formation of cysts of hair follicles. Injury to the neoplasm leads to bleeding, secondary infection, inflammation. Senile keratoma can self-resolve or transform into a cutaneous horn, and therefore there is a tendency to malignancy of the pathological process.
Seborrheic keratoma. Neoplasia, a distinctive feature of which is slow growth with the formation of multi-layered crusts in the absence of weeping. The pathological process begins with the appearance of yellowish spots up to 3 cm in diameter, localized on the chest, shoulders, back, and scalp. Over time, due to disruption of the sebaceous glands in the lesion, the spots become covered with loose cortical scales, which are easily separated from the surface of the neoplasm. Seborrheic keratomas rarely remain isolated from each other, they tend to cluster and grow peripherally. Together with them, they increase in size and the crusts, which begin to exfoliate, become covered with cracks. The thickness of the cortical scales reaches 1.5-2 td. The keratoma itself acquires a brown tint, its damage causes bleeding and pain. There was no tendency to spontaneous resolution or malignancy.
Horny keratoma (skin horn). A rare tumor-like neoplasm of horny cells. First, a hyperemic area appears on the skin, in the area of ​​​​which, due to the compaction of the epidermis, a hyperkeratotic convex tubercle is formed (up to 10 cm above the level of healthy skin), dense to the touch, with an uneven scaly surface and an inflammatory rim around the base. Most often, the cutaneous horn is a single neoplasm, but cases of multiple keratomas have also been described. Horny keratoma exists as an independent pathology or as a symptom accompanying other nosologies. It is localized on the face, in the area of ​​the red border of the lips and genitals. A distinctive feature of horny keratoma is its spontaneous malignancy.
Follicular keratoma is located around the hair follicles. The first manifestation of the pathology is a convex flesh-colored nodule with a diameter of not more than 1.5 cm with a rough surface. In the center of the formation, a cone-shaped depression, sometimes covered with a scale, is revealed. Keratoma is localized in the area of ​​hair follicles, most often on the face and scalp. Spontaneous malignancy is unlikely, but the tumor may recur even after radical resection.
Solar keratoma is a precancerous skin disease. The pathological process debuts with the appearance of many small, scaly, bright pink papules, which quickly transform into brown plaques with a wide inflammatory corolla along the periphery. The scales covering the plaques are whitish, dense, rough, but are easily removed from the keratoma when scraped. The solar keratoma is localized mainly on the face. It has a tendency to spontaneous malignancy or spontaneous resolution of the pathological process, followed by the appearance of a keratoma in the same place.

Precancerous skin lesions- benign diseases with a high risk of degeneration into squamous cell carcinoma. These include chronic dermatitis, keratosis, chronic cheilitis, senile or cicatricial atrophy of the skin, kraurosis. Among the nosological forms, more often we are talking about senile keratoma, keratoacanthoma, leukoplakia, skin horn. A number of diseases are obligate precancer: xeroderma pigmentosum, erythroplakia.

Code according to the international classification of diseases ICD-10:

• L57.0

actinic keratosis- a rough scaly lesion of the epidermis in areas of the body exposed to constant exposure to sunlight. Appears during the 3rd or 4th decade of life; in 10-20% of patients it becomes malignant. If the biopsy confirms the benign disease, treatment consists of excision or cryodestruction. Patients with multiple lesions are shown local chemotherapy (fluorouracil).

ICD-10. L57.0 Actinic [photochemical] keratosis

Keratoacanthoma- a benign epidermal tumor of the hair follicles in the form of single or multiple spherical nodes with a crater-shaped depression in the center, filled with keratinized epithelium. Localized on the head, neck and upper limbs. The tumor progresses rapidly within 2-8 weeks, followed by spontaneous destruction. Treatment is excision with histological examination.

Nevi(birthmarks) - hamartoma-like malformations of the skin, can develop both from the elements of the epidermis and the dermis itself (connective tissue, vascular elements or melanocytes). They are pigmented formations of the skin, usually protruding above the surface. Some nevi (especially melanocytic and dysplastic ones) may become malignant. Rarely, well-defined and uniformly colored nevi are reborn.

Acanthosis blackening- dermatosis, manifested more often by benign warty keratinizing growths of black skin folds, especially in the axillary areas, on the neck, in the inguinal and anal areas. May be hereditary (*100600, В) or acquired (as a result of endocrine disorders, malignant neoplasms, drug [nicotinic acid, diethylstilbestrol, oral contraceptives, GC]). The course is chronic. Treatment is etiotropic. A complete oncological examination is required. Synonyms: Acanthosis nigricans, pigment-papillary dystrophy of the skin, papillary-pigmentary dystrophy.

ICD-10. L83 Acanthosis nigricans

Pigmented xeroderma(see Xeroderma pigmentosa).
erythroplakia(Keira's disease) develops rarely, more often in older men on the glans penis or foreskin. Clinically, a limited, painless, bright red nodule is detected. Initially, the node has a velvety surface, and with progression (for a long time), papillomatous formations or ulcerations appear. Surgical treatment.

ICD-10. D23 Other benign neoplasms of skin