Verruca Seborroica - Wat Zijn Seborroïsche Wratten en Hoe Worden Ze Behandeld?

Hámszemölcs

Jóindulatú hámeredetű daganatok közül nagyon gyakori az öregkori hámszemölcs, az ún. verruca seborrhoica, amely nem tévesztendő össze a vírusos szemölccsel. Ezek a jóindulatú elváltozások 50 éves kor után jelennek meg és kezdenek terjedni, elsősorban a törzsön, nyakon, kezeken, alkarok feszítő felszínén.

Méretük néhány milliméterestől az akár 5 centiméteresig terjedhet. Egyesével, de gyakrabban nagyobb számban fordulnak elő.

Laposan előemelkedő, éles szélű növedékek, színük a sárgásbarnától a sötétbarna, fekete színig terjed. Gyakran viszket.

Jelentőségük a melanomától való elkülönítésben van, ezért érdemes megmutatni őket bőrgyógyásznak, de soha nem válnak rosszindulatúvá, orvosi szempontból kezelést nem igényelnek.

General Characteristics of Warts

Warts are small raised bumps on the surface of the skin. Most are flesh-colored, although some come in various shades of white, pink, yellow, or brown.

Some warts contain tiny black dots. These are blood vessels that have grown rapidly and irregularly into a wart and have thrombosed (clotted). This is most often seen when a wart is cut away or reduced by abrasion.

Warts normally emerge from the top layer of skin in cylindrical columns. On thick skin, the columns can fuse and become packed tightly, creating a mosaic-like pattern on the surface.

Types of Wart

There are many types of warts with different shapes, sizes, and appearances. They vary not only by their location but also by the type of HPV that caused them.

Common Warts (Verruca Vulgaris)

Per their name, common warts (verruca vulgaris) are the most frequent type affecting three out of every four people sometime in their lives. They are recognized by their raised, rough, pebble-textured surface.

Common warts can occur anywhere on the body but are most often seen:

• On the fingers
• Near the nails
• On the backs of the hands

Plantar Warts (Verruca Plantaris)

Flat Warts (Verruca Plana)

Flat warts appear in clusters of a few dozen to a hundred. Their location tends to vary by age and a person's biological sex, such as:

• On the legs of adult females
• In the beard area of adult males
• On the face of children

Filiform Warts (Verruca Filiformis)

Filiform warts (verruca filiformis) are an unusual-looking type of wart, forming long, thread-like, or spiky columns that protrude from the skin.

Filiform warts most often appear on the face, especially:

• Around the eyes
• On or around the nose
• Around the mouth

Genital Warts (Condyloma Acuminata)

Genital warts (condyloma acuminata) can appear on or around your genitals or anus. They can be raised or flat and vary in size. When they form in groups, they may resemble cauliflower.

Genital warts are usually painless, but in some people, they cause itching, burning pain, and bleeding.

HPV and Cancer

Most genital warts are caused by HPV types 6 and 11. HPV 16 is associated with a high risk of genital cancer.

Age Warts (Verruca Seborrhoica)

Age warts (verruca seborrhoica) are rough, raised, and light to dark brown in color. They initially start as yellowish skin discoloration and will develop over time into raised warts.

How Warts Are Treated

Most warts resolve within weeks or months without treatment, although some may take many years to fully clear. However, because warts can be uncomfortable or unsightly, most people opt to remove them.

Many warts can be treated with simple over-the-counter remedies. Those that don't clear up with home treatment may require prescription drugs or in-office therapies.

Home Remedies

A popular home remedy for wart removal is the duct tape method. For this procedure, you would put a piece of duct tape on the wart and leave it for six days. You would then remove the tape, soak the wart in water, and pare it down with an emery board.

If that doesn't get rid of it, you can wait 24 hours and try again. This may need to be repeated several times depending on the size and location of the wart.

Although studies have shown mixed results with the duct tape method, it is considered a safe home remedy for adults and children with few side effects.

Over-the-Counter (OTC) Wart Medications

Salicylic acid is a common and effective over-the-counter (OTC) wart removal treatment. It can be found in several forms, including oils, drops, and infused adhesive pads or strips.

Salicylic acid is applied to a wart and allowed to dry. Some practitioners recommend paring back the wart with a pumice stone or emery board before application. Soaking the wart in water before applying the acid and covering the area with a bandage will also aid with the absorption.

Some of the more popular salicylic acid-based wart removers include:

• Compound W
• Dr. Scholl's Clear Away
• DuoFilm
• Wart-Off

Another OTC option is an at-home freeze kit, also known as home cryotherapy . These products use a mixture of propane mixed in dimethyl ether delivered under pressure to freeze and destroy wart tissues. You simply point the precision applicator at the wart and spray.

What is the Evidence?

Duque, MI, Jordan, JR, Fleischer, AB, Williford, PM, Feldman, SR, Teuschler, H. “Frequency of seborrheic keratosis biopsies in the United States: a benchmark of skin lesion care quality and cost effectiveness”. Dermatol Surg. vol. 29. 2003. pp. 796-801. (This study reports on the costs and quality of care in the treatment of SK in the United States.)

Gill, D, Dorevitch, A, Marks, R. “The prevalence of seborrheic keratoses in people aged 15 to 30 years: is the term senile keratosis redundant”. Arch Dermatol. vol. 136. 2000. pp. 759-62. (This study reports a considerably high prevalence of SK in young patients.)

Hafner, C, Toll, A, Fernandez-Casado, A, Earl, J, Marques, M, Acquadro, F. “Multiple oncogenic mutations and clonal relationship in spatially distinct benign human epidermal tumors”. Proc Natl Acad Sci U S A. vol. 107. 2010. pp. 20780-5. (This study identified a high rate of oncogenic mutations (FGFR3, PIK3CA, RAS, etc.) in SK in the absence of senescence, genetic instability and malignancy. Some SK in patients wth multifocal lesions appear to be clonally related despite their spatial distance.)

Hafner, C, Vogt, T. “Seborrheic keratosis”. J Dtsch Dermatol Ges. vol. 6. 2008. pp. 664-77. (A review article on SK.)

Hafner, C, Vogt, T, Landthaler, M, Musebeck, J. “Somatic FGFR3 and PIK3CA mutations are present in familial seborrhoeic keratoses”. Br J Dermatol. vol. 159. 2008. pp. 214-7. (SK in patients with early familial occurrence reveal the same mutational spectrum as sporadic SK.)

Logie, A, Dunois-Larde, C, Rosty, C, Levrel, O, Blanche, M, Ribeiro, A. “Activating mutations of the tyrosine kinase receptor FGFR3 are associated with benign skin tumors in mice and humans”. Hum Mol Genet. vol. 14. 2005. pp. 1153-60. (This study identified FGFR3 mutations in SK for the first time. The functional relevance of the mutations were shown in a transgenic mouse model.)