History and exam

Key diagnostic factors

common

lesions appear "stuck-on"

This is the hallmark feature. Lesions can display a variety of colors and shapes, but usually they have their "pasted-on" or "stuck-on" appearance in common.

localization on torso or face

Most frequently found on the back and chest and then on the temple, scalp, and neck. However, they can occur on any part of the body, except on mucous membranes.

yellow or light- to dark-brown-colored lesions

Lesions can display a variety of colors.

slightly raised, flat surface lesions

Is a key diagnostic factor.

wart-like texture

Is a key diagnostic factor.

multiple lesions

May occur as a single lesion, but usually multiple lesions with the same clinical characteristics are found on the same patient.

painless

Lesions are painless, although they can itch and be irritated by clothing and friction.

itching (prurigo)

Lesions can cause intense itching.

Other diagnostic factors

common

round yellow-white horn pearls in the surface of lesions

Is a diagnostic factor.

Risk factors

strong

age over 50 years

From 80% to 100% of people over the age of 50 years are affected.[1][2][3][4] They are uncommon in people under 30 years.

Fitzpatrick skin type I or II

White skin increases the risk of seborrheic keratoses compared with brown or black skin.

family history

Familial predisposition is suspected with maybe an autosomal-dominant inheritance.[2][12]

sun/UV exposure

Seborrheic keratosis often appears on areas of the body that have been exposed to UV radiation over a long period.

weak

Fitzpatrick skin type IV, V, or VI (dermatosis papulosa nigra)

A variant of seborrheic keratosis (dermatosis papulosa nigra) sometimes develops in people with brown and black skin (Fitzpatrick skin type V and VI). Multiple small (1 to 2 mm in diameter), dark brown or black soft papules usually start to appear in adolescence and are found on the face, neck, and chest.

female sex (dermatosis papulosa nigra)

A variant of seborrheic keratosis (dermatosis papulosa nigra) is more common in women than men. Multiple small (1 to 2 mm in diameter), dark brown or black soft papules usually start to appear in adolescence and are found on the face, neck, and chest.

pregnancy

Development of seborrheic keratoses may be triggered by pregnancy.

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