Keratoses (Solar and Seborrhoeic)

SEBORRHOEIC KERATOSES

Management

• Usually nil apart from reassurance

• Does not undergo malignant change

• Can be removed for cosmetic reasons

• Light cautery to small facial lesions

• May drop off spontaneously

• If diagnosis uncertain, remove for histopathology

Decolourisation or removal:

• liquid nitrogen (regular applications, e.g. every 3 wks) or

• concentrated phenol solution (with care), repeat in 3 wks or

• trichloracetic acid: apply to surface and instil with multiple small needle pricks (25 g). Repeat twice wkly for 2 wks.

SOLAR KERATOSES

Management

• Reduce exposure to sunlight

• Can disappear spontaneously

• Liquid nitrogen if superficial or

• 5-fluorouracil 5% cream daily or bd for 3–4 wks (2 wks for face)

• Surgical excision for suspicious and ulcerating lesions

• Biopsy if doubtful