Keratosis is the growth of keratin on the skin or on mucous membranes stemming from keratinocytes, the prominent cell type in the epidermis. Seborrheic keratosis is a common non cancerous skin growth. People tend to get more of them when they get older. The growths look waxy, scaly and slightly raised usually brown black or light tan colour. It is not clear what causes this. It may be genetic and of course normal skin ageing plays a role as is over exposure to sun. It may be worth removing if it is hard to distinguish from skin cancer or the patient doesn’t like it and is self conscious particularly if it is in a prominent place or it might cause problems like itching or irritation with clothing or jewellery rubbing against it. There are several ways of removing seborrheic keratosis. Cryosurgery where the lesion is frozen by a liquid nitrogen spray and then falls off after a few days may be performed, ablation with laser or electrosurgery or electrocautery where the growth is cauterised under local anaesthetic is an option as is curettage and some patients may require one or the other or both.
Actinic keratosis also known as solar keratosis looks like rough or crusty patches of skin. They may be red, light or dark tan and have rough textures that develops from years of exposure to the sun. It is most commonly found on face lips, ears, back of hands, forearms, scalp or neck. It enlarges slowly and usually causes no signs or symptoms and these patches can take years to develop usually first appearing in people over 40. Actinic keratosis can lead to skin cancer called squamous cell carcinoma however if treated early almost all actinic keratosis can be cleared up or removed before before they develop into skin cancer.
Different types of surgery can be used to treat squamous cell skin cancers.
Excision: cutting out the tumour along with a small margin of normal skin or electrodessication and curettage however this procedure is not recommended for larger tumours
Mohs surgery is especially useful for squamous cell cancers that pose a higher risk of coming back such as tumours larger than 2 cm. Mohs surgery might also be done after an excision if it didn’t remove all the cancer. This approach is typically more complex and time consuming than other types of surgery. Otherwise cryosurgery or laser surgery may be performed.
Radiation can also be used to treat cancers that have come back after surgery but is not recommended after surgery.