Alles wat u moet weten over Seborrhoische Wratten (Verruca Seborrhoica)

Steelwratjes (fibromen) en ouderdomswratten

Ouderdomswratten zijn rond of ovaal en duidelijk begrensd. De kleur kan variëren van licht tot zwart. De ouderdomswratten gaan er naarmate je ouder wordt vaak bloemkoolachtig uitzien. De wratjes kunnen op het gehele lichaam voorkomen, maar bevinden zich vooral in het gezicht en de romp. De oorzaak van ouderdomswratten is niet bekend, bij grote ouderdomswratten vermoeden onderzoekers dat erfelijkheid een rol speelt.

Fibromen (ook wel skin tags, wild vlees of steelwratjes genoemd) zijn langwerpige gezwelletjes die eveneens overal op de huid kunnen voorkomen. Ook de kleur van een fibroom kan variëren van licht tot donker.

Fibromen in de hals

Systemic Implications and Complications

In rare cases and especially in elderly people, SK may show a sudden appearance and the growth of numerous lesions in association with a malignant tumor of internal organs. This has been referred to as Leser-Trelat syndrome. About one-third of these patients have concomitant acanthosis nigricans, and nearly half of the patients report pruritus.

The most frequent underlying malignancies are adenocarcinomas of the stomach and colon, but other malignant tumors may be found as well. Disappearance of the multiple SK after successful therapy of the cancer has been reported, as well as reappearance after tumor relapse. In general, the Leser-Trelat syndrome is observed in advanced stages of the cancer and therefore has an unfavorable prognosis with a median survival of 11 months.

It is assumed that this rare paraneoplastic syndrome is caused by soluble growth factors secreted by the tumor. In all cases with a sudden appearance of numerous SK a Leser-Trelat syndrome should be taken into account and cancer of internal organs should be excluded.

Who is at Risk for Developing this Disease?

The incidence of SK rises with age. According to several epidemiologic studies, SK can be found in 50% to 100% of patients aged 50 or older. A British study found SK in 82% of men and 62% of women over age 70. The prevalence of SK among younger people is lower. However, SK can already be found in young people aged 15 to 30 years. An Australian study reported a prevalence of SK of 24% in this group.

SKs are benign clonal tumors. In the last years it has become evident that somatic mutations are associated with SK. These point mutations mainly affect the FGFR3 (fibroblast factor growth factor 3) and PIK3CA (alpha catalytic subunit of the phosphatidylinositol 3-kinase) genes and lead to activation of the RAS/MAPK and PI3K/AKT signaling pathways. Interestingly, the same FGFR3 and PIK3CA mutations have been identified in malignant tumors and are thought to be oncogenic, albeit SK bear no malignant potential.

In germline, the identical FGFR3 mutations cause severe skeletal dysplasia syndromes such as thanatophoric dysplasia. In a comprehensive study, 70% of SK revealed FGFR3 mutations and 50% PIK3CA mutations. Many lesions had both an FGFR3 and PIK3CA mutation simultaneously. Furthermore, activating mutations in KRAS, HRAS, AKT and EGFR genes have been found, but at a lower frequency than FGFR3 and PIK3CA.

Foto's

(Ouderdoms-)wratten en fibromen zijn onschuldige huidgezwellen die cosmetisch storend kunnen zijn, zeker in de hals en in het gezicht. Gelukkig zijn ze goed en snel te verwijderen.

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