Seborrheic keratosis

The Use of Ablative Nonfractional CO2 Laser for the Treatment of Periocular Lesions: A Retrospective Study

Background: In the eyelid region numerous lesions can develop, spanning from cosmetic imperfections to benign tumors and extending to inflammatory and precancerous lesions. Aim: This study aimed to treat benign periocular lesions with a CO2 laser and assess the effectiveness, the number of sessions required for resolution, and any potential side effects after the procedure. Materials and Methods: All patients were treated with a nonfractional ablative CO2 laser. The last evaluation and follow-up visit took place 2 months after the previous operation, with the clinical goal being the complete removal of the lesion. Before the first session and immediately afterward, clinical photographic documentation was completed, and it was done again 2 months after the final session. Patients were rated on a 4-point scale: none, mild, moderate, or severe. Results: A total of 715 patients were registered with different palpebral pathologies, all of whom showed good to excellent results with either no or mild adverse reactions. Conclusions: CO2 laser is effective and well tolerated to treat periocular lesions, despite the sensitivity of this region.

Revolutionizing Seborrheic Keratosis Treatment: A Case Report of Successful Topical Treatment of Basal Cell Papilloma Using Siddha Medicine

Seborrheic keratosis (SK), also known as seborrheic warts or basal cell papilloma, is a common benign epidermal tumor typically seen in middle-aged and older adults. SK is one of the most frequently encountered skin lesions by primary care physicians and dermatologists in outpatient settings. Traditionally, cryosurgery and electrocautery have been the primary treatment options for SK. While both approaches are effective, these methods can result in unwanted side effects that may affect the cosmetic appearance of patients and can be quite costly, deterring some individuals from seeking treatment. Siddha external medicine provides a viable, cost-effective, and well-tolerated alternative. A 73-year-old female patient presented with black papules featuring fissures and ridges on a verrucous surface. The lesions, with a waxy "stuck-on" appearance, were located on the prominence of the concha of her left ear, measuring 1.5 cm in length and 6 mm in thickness. Though asymptomatic, the lesions raised significant cosmetic concerns. The diagnosis was confirmed through a thorough clinical evaluation. The Siddha formulation Pachaieruvai was applied externally for seven consecutive days. After one week of treatment, a significant reduction in both lesion thickness and pigmentation was observed. At the follow-up appointment, one week after the last treatment, the SK lesions were completely eradicated. No adverse symptoms or recurrence were noted. This research highlights the effectiveness of the Siddha approach to managing SK. Based on the findings, Siddha medicine proves to be an effective treatment for SK.

Assessment of clinical and pathological characteristics of inverted follicular keratosis - five years comprehensive review

Inverted Follicular Keratosis (IFK) is a uncommon benign tumor, that presents a diagnostic challenge because of its varied clinical and histological appearance. This study aimed to dissect the clinical and pathological features of IFK in patients who have been presented to a tertiary care hospital for five years. Through a cross-sectional analysis, the medical records of 56 patients diagnosed with IFK for four years were meticulously reviewed. The study focused on demographic data, lesion characteristics, pathological findings, and treatment outcomes. The cohort included 56 patients with a mean age of 50.71 ± 19.76 years who were predominantly male (73.2%), with lesions most commonly located on their face (57.1%). The lesions varied in size from 0.3 to 3 cm, with an average size of 1.01 cm. The majority were papular, followed by nodular, plaque, verrucous, and ulcer types, in descending order of frequency. A significant portion of patients (95%) had solitary lesions, predominantly of short duration (less than 3 months). Surgical excision was the primary treatment modality. Pathologically, 50% of lesions exhibited both exo- and endophytic characteristics, with a notable presence of squamous eddies (80%), parakeratosis (79%), and hyperkeratosis (41.1%). Other findings included dyskeratotic cells (62.5%) and a predominance of lymphocytic inflammation when present. A notable association was found between the presence of keratin plugs and lesion location, but no significant correlation was observed between lesion duration and pathological features. This study highlights the clinical and pathological diversity of IFK, with a predominance in males and middle-aged individuals. The findings emphasize the importance of recognizing the variable presentation of IFK to ensure accurate diagnosis and effective management. Surgical excision remains the treatment of choice, reflecting the benign nature of the condition. Further research is warranted to explore the underlying mechanisms and potential for non-surgical treatment options.

Identifying potential drug targets for seborrheic keratosis through druggable genome-wide Mendelian randomization and colocalization analysis

Seborrheic keratosis (SK) is the most prevalent benign epidermal tumor in adults, characterized by complex pathogenesis and diverse clinical subtypes. This study systematically evaluated the genetic susceptibility and identified novel therapeutic targets for SK. We applied two-sample Mendelian randomization (MR) using cis-eQTL data for druggable genes in blood and SK genome-wide association study (GWAS) data to identify causal genes. Sensitivity and colocalization analyses were performed to assess MR reliability and estimate the likelihood of shared causal variants between cis-eQTLs of druggable genes and SK. For additional validation, we conducted enrichment analysis, phenome-wide association analysis, and candidate drug prediction to further interpret our findings. The expression levels of 18 druggable genes were significantly associated with SK susceptibility (adjusted p-value [FDR] < 0.05), of which 8 were identified as risk factors for SK, while 10 significantly reduced SK predisposition. The susceptibility of SK was likely linked to a shared causal variant with two significant druggable genes, CASP8 (OR = 0.725, 95%CI: 0.622-0.844, PPH4 = 0.907) and TSSK6 (OR = 0.478, 95%CI: 0.327-0.696, PPH4 = 0.970). Functional analyses revealed CASP8 and TSSK6 may influence SK onset and progression through mechanisms cell differentiation and programmed apoptosis regulation. CASP8 and TSSK6 stand out as the most promising potential drug targets for reducing the susceptibility of SK. Our findings identify potential drug targets and provide valuable insights for future SK drug development.

Artificial Intelligence-Based Distinction of Actinic Keratosis and Seborrheic Keratosis

Actinic keratosis (AK) and seborrheic keratosis (SK) represent prevalent dermatological conditions with distinct clinical characteristics and potential health implications. This article investigates recent strides in dermatological diagnostics, centered on the development and application of artificial intelligence (AI) technology for discerning between AK and SK. The objective of this study is to develop and evaluate an artificial intelligence (AI) model capable of accurately distinguishing between stage one and stage two gastric carcinoma based on pathology slides. Employing a dataset of high-resolution images obtained from Kaggle.com, consisting of 1000 AK and 1000 SK images, a novel AI model was trained using cutting-edge deep learning methodologies. The dataset underwent meticulous partitioning into training, validation, and testing subsets to ensure robustness and generalizability. The AI model showcased exceptional proficiency in distinguishing AK from SK images, attaining notable levels of accuracy, precision, recall, specificity, F1-score, and area under the curve (AUC). Insights into the etiology and clinical ramifications of AK and SK were presented, emphasizing the critical significance of precise diagnosis and tailored therapeutic approaches. The integration of AI technology into dermatological practice holds considerable potential for enhancing diagnostic precision, refining treatment decisions, and elevating patient outcomes. This article underscores the transformative impact of AI in dermatology and the importance of collaborative efforts between clinicians, researchers, and technologists in advancing the realm of dermatological diagnosis and care.

Nevus Variations in the Jordanian Population: Effects of Age, Medical Conditions, Environment, Congenital, Inherited, and Genetic Factors

Background

Nevi is a common benign proliferation of melanin-producing cells. Many triggers can influence their transformation into either benign or malignant, thus it is important to understand these triggers and their incidence across different populations to take adequate prevention. Here, we aim to examine the different etiologies of nevi changes across the Jordanian population.

Methods

We carried out a cross-sectional observational study focusing on patients seeking dermatological consultation for normal nevi or nevi with minimal changes. Demographic and clinical variables were collected from the patient's case history. Nevi's characteristics were also recorded. A skilled dermatologist assessed nevi morphology and changes using the ABCDE criteria for potential signs of melanoma. Nevi biopsy samples were fixed in formalin and sent for histopathological analysis and were stained with hematoxylin and eosin (H&E).

Results

A total of 231 patients were enrolled, with a majority of females (85%) and a median age of 37. Past medical history was positive in 17% of the samples, with hypertension, endocrine diseases, and diabetes mellitus being the most common. The majority of patients (61%) had fewer than three nevi. Changes in nevus size, configuration, and color were reported in 10% of patients, with multiple changes observed in 36% of patients. Microscopic analysis revealed polypoidal intradermal melanocytic blue nevi as the most common histopathological finding (84%). Positive medical history and the number of nevi were significantly associated with nevi changes.

Conclusion

Our results report that the number of nevi, as well as medical history, is linked to changes in their appearance. Additionally, we provide a detailed account of the various types of observed changes and their occurrence rates.