Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Evolving Strategies for Optimizing SK Treatments

J Drugs Dermatol; 2017 Nov; Ranasinghe, et al

The seborrheic keratosis (SK) is the most common benign skin tumor of middle-aged and elderly adults, affecting nearly 83 million individuals in the US alone, according to a recent review. Although these are benign lesions, many patients still undergo some form of treatment. Clinicians are frequently presented with a challenge when determining whether to remove an SK, and which treatment modality to use when doing so. The most commonly used method of removal is cryotherapy, however there are numerous other options that can be employed with varying degrees of efficacy. In this study, researchers highlight the use of topical keratolytics, vitamin D analogues, and lasers, to name a few. They also address potential side effects associated with these treatment options, as well as discuss patients’ preferences and concerns. They conclude with the most recent advances in topical treatments currently under clinical investigation, and offer treatment strategies aimed at maximizing patient satisfaction.


Ranasinghe GC, Friedman AJ. Managing seborrheic keratoses: Evolving strategies for optimizing patient outcomes. J Drugs Dermatol. 2017;16(11):1064-1068.


This article points out several important challenges faced in the treatment of seborrheic keratoses. When patient express desire to remove these lesions, dermatologists need to counsel these individuals as to the potential risks of therapeutic intervention. In my practice, I recently saw one young woman with a superficial seborrheic keratosis on the right cheek. We spoke about the options for treatment, including cryotherapy and electrodesiccation. While I told her that both therapies were effective, I also explained that there was a risk of pigmentary alteration with both interventions. We also spoke about therapies in development, including a topical application which could help to remove the lesion. The patient went home, but indicated she may wait for the topical therapy to be available to treat the lesion.

This experience indicated to me that there is the need for additional therapies, in addition to the ones we have now. These therapies may offer some benefits over our current armamentarium.

Jeffrey M. Weinberg, MD, FAAD
Assistant Clinical Professor of Dermatology, Columbia University College of Physicians and Surgeons, NYC
Director, Clinical Research Center/Dermatopharmacology, St. Luke's-Roosevelt Hospital Center, NYC
Acting Director, Division of Dermatology, Jamaica Hospital Medical Center, NYC