Photo Library Resource: SK and More
CLINICAL IMAGES
Stucco keratoses tpically present as multiple, flesh-colored, dry, well-circumscribed, scaly, flat-topped papules commonly seen on the lower legs and dorsum of the hands. The following photos are courtesy of Michael S. Kaminer, MD.
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DERMOSCOPIC IMAGES
The following photos are courtesy of Ashfag A. Marghoob, MD.
The presence of multiple milia-like cysts, comedo-like openings and gyri-sulci are considered diagnostic for seborrheic keratosis but only in the absence of dermoscopic features associated with skin cancer. For example, presence of blue-white veil, shiny white lines, or regression structures in a presumed SK should raise concern for malignancy.
Milia comedo blue white veil |
Milia blue white veil |
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Milia and comedo |
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Gyri Sulci |
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Hairpin vessels. Vessels with an acute bend (hairpin turn) resulting in half-looped and twisted vessels, often surrounded by a white halo. These vessels can also be observed in melanoma, squamous cell carcinoma, and basal cell carcinoma but in such cases the vessels will usually be in a pink background (pink halo). The presence of hairpin vessels with a white halo supports but does not make diagnosis of seborrheic keratosis.
Hairpin vessels

Advances in Seborrheic Keratosis
This journal supplement is intended for dermatologists, family practitioners, internists, registered nurses, nurse practitioners, physician assistants, and other clinicians who treat patients and practice medical and/ or aesthetic dermatology.
Supported by an educational grant from:
Aclaris Therapeutics, Inc.
Activity Information
Expired
Original Release Date: December 2018
Expiration Date: December 31, 2020
Estimated Time To Complete Activity: 1 hour
Expired
Participants should read the activity information, review the activity in its entirety, and complete the online post-test and evaluation. Upon completing this activity as designed and achieving a passing score on the post-test, you will be directed to a Web page that will allow you to receive your certificate of credit via e-mail or you may print it out at that time.
The online post-test and evaluation can be accessed at http://tinyurl.com/SebK2018.
Inquiries about continuing medical education (CME) accreditation may be directed to the University of Louisville Office of Continuing Medical Education & Professional Development (CME & PD) at cmepd@louisville.edu or (502) 852-5329.
Faculty
![]() | Joseph F. Fowler Jr, MD
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![]() | Michael S. Kaminer, MD |
Designation Statement
The University of Louisville School of Medicine designates this Enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Joint Provider Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Louisville School of Medicine and Global Academy for Medical Education. The University of Louisville School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Global Academy for Medical Education.
Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Continuing Nursing Education: The maximum number of hours awarded for this Continuing Nursing Education activity is 0.5 contact hours. Designated for 0.1 contact hours of pharmacotherapy credit for Advanced Practice Registered Nurses.
Educational Needs
Seborrheic keratoses (SKs) represent the most common benign tumor in humans and are among the most frequent reasons for visiting a dermatologist. SKs can mimic or mask cutaneous malignancy. Clinicians should be able to diagnose SKs efficiently and accurately to avoid missing melanoma or other cancers. Medical intervention is not required unless the diagnosis is uncertain or the SKs are symptomatic (eg, bleeding, irritation, or itching). Patients with benign lesions often express interest in treatment due to the emotional and social impact of SKs. Current destructive options can be associated with pain, scarring, and pigmentary abnormalities. The first topical therapy approved for use on SKs—hydrogen peroxide topical solution, 40% (HP40)—received US Food and Drug Administration approval about 1 year ago. Clinicians need to be aware of and sympathetic to patient concerns about SKs and treatments. They also benefit from being informed about the latest therapeutic options for removing SKs.
Learning Objectives
At the conclusion of this activity, participants should be better able to:
- Differentiate between benign seborrheic keratosis (SK) and other common skin lesions
- Recognize the potential emotional and social impact of SK lesions on patients
- Designatherapeuticapproachforindividual patients with SK lesions that maximizes outcomes while minimizing adverse events.
Disclosure Declarations
Individuals in a position to control the content of this educational activity are required to disclose: 1) the existence of any relevant financial relationship with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients with the exemption of non-profit or government organizations and non-health-care-related companies, within the past 12-months; and 2) the identification of a commercial product/device that is unlabeled for use or an investigational use of a product/device not yet approved.
Joseph F. Fowler Jr, MD, Speakers Bureau: Smart Practice, Regeneron; Grant/Contracted Research Support: Aclaris Therapeutics, Galderma Laboratories, Pfizer, Novartis, Lilly, Accuitis, Dermira, Ralexar, and Regeneron. He will discuss the investigational/unlabeled uses of A-101 40% solution; 5% potassium dobesilate cream; aqueous trichloroacetic acid (TCA) and formic acid combination; tazarotene 0.1% cream; A-443654; GSK690693.
Michael S. Kaminer, MD, Consultant: Cytrellis Biosystems, Zeltiq, Soliton, Exploramed, L’Oreal, Endo, Arctic Fox LLC.
CME/CE Reviewers: Courtney Schadt, MD, Assistant Professor, Division of Dermatology, University of Louisville School of Medicine, has no relevant financial relationships to disclose. Staff and Advisory Board Disclosures: The University of Louisville CME & PD Advisory Board and office staff have nothing to disclose with the following Board Member exceptions: Sathya Krishnasamy, MD-Kowa Pharmaceuticals; Ashlee Bergin, MD-Merck Pharmaceuticals; Michael Sowell, MD-Amgen, Impax Pharmaceuticals.
The PIM planners and managers have nothing to disclose.
Global Academy for Medical Education Staff:
Eileen McCaffrey; Sylvia H. Reitman, MBA, DipEd; and Ron Schaumburg have no relevant financial relationships to disclose.
This CME/CE supplement was developed from interviews with the faculty. Dr Fowler and Dr Kaminer acknowledge the editorial assistance of Global Academy for Medical Education and Eileen McCaffrey, medical writer, in the development of this supplement. Neither the editors of Dermatology News nor the Editorial Advisory Board nor the reporting staff contributed to its content. The ideas and opinions expressed in this supplement are those of the faculty and do not necessarily reflect the views of the supporter, Global Academy for Medical Education, the University of Louisville, Postgraduate Institute for Medicine, or the Publisher.
Copyright © 2018 Global Academy for Medical Education, LLC, and Frontline Medical Communications. All rights reserved. No part of this publication may be reproduced or transmitted in any form, by any means, without prior written permission of the Publisher.
Global Academy for Medical Education, LLC, Frontline Medical Communications, The University of Louisville, and Postgraduate Institute for Medicine will not assume responsibility for damages, loss, or claims of any kind arising from or related to the information contained in this publication, including claims related to the products, drugs, or services mentioned herein.