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Seborrheic keratosis

Last reviewed: 10 Jul 2025
Last updated: 29 Jul 2025

Summary

Definition

History and exam

Key diagnostic factors

  • lesions appear "stuck-on"
  • localization on torso or face
  • yellow or light- to dark-brown-colored lesions
  • slightly raised, flat surface lesions
  • wart-like texture
  • multiple lesions
  • painless
  • itching (prurigo)
Full details

Other diagnostic factors

  • round yellow-white horn pearls in the surface of lesions
Full details

Risk factors

  • age over 50 years
  • Fitzpatrick skin type I or II
  • Fitzpatrick skin type IV, V, or VI (dermatosis papulosa nigra)
  • female sex (dermatosis papulosa nigra)
  • family history
  • sun/UV exposure
  • pregnancy
Full details

Diagnostic tests

Tests to consider

  • dermoscopy
  • biopsy and histopathologic examination
  • reflectance confocal microscopy (RCM)
Full details

Treatment algorithm

ACUTE

irritated or itching lesions

ONGOING

raised seborrheic keratosis

flat seborrheic keratosis

Contributors

Authors

Ralph Braun, MD

Professor

Clinic Utoquai

Zurich

Switzerland

Disclosures

RB declares that he has no competing interests.

Isabel Kolm-Djamei, MD

Consultant Dermatologist

Department of Pathology

Cantonal Hospital Lucerne

Lucerne

Switzerland

Disclosures

IKD declares that she has no competing interests.

Peer reviewers

Erin Warshaw, MD, MS

Associate Professor

Department of Dermatology

University of Minnesota

MN

Disclosures

EW declares that he has no competing interests.

References

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Key articles

Seaton E, Madan V. Benign keratinocytic acanthomas and proliferations. In: Barker J, Griffiths C, Bleiker T, eds. Rook's textbook of dermatology. 10th ed. Hoboken, NJ: John Wiley & Sons, Ltd; 2024.

Patterson JW. Chapter 32: Tumors of the epidermis. In: Patterson JW. Weedon's skin pathology. 6th ed. Philadelphia, PA: Elsevier; 2025: 877-936.

Barthelmann S, Butsch F, Lang BM, et al. Seborrheic keratosis. J Dtsch Dermatol Ges. 2023 Mar;21(3):265-77.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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