Question

Identify and describe a common geriatric skin disorder that commonly affects the skin, neck, or face.

Then answer these questions about that disorder:

1. Have you seen this rash and/or lesion on your geriatric patients?
2. What treatment did you prescribe?
3. What other differential diagnosis may be considered with this rash?

Answer 1

1.Seborrheic keratosis

slightly raised, wart-like macules with distant edges.light brown to black in color,

Mostly on upper body; causes discomfort and itching.

Yes ,I have seen this condition in my geriatric posting

2. Treatment - usually treatment is not required , adviced the patient not to rub , scratch as it causes bleeding .

Several options are available for removing a seborrheic keratosis:

Freezing with liquid nitrogen (cryosurgery). Cryosurgery can be an effective way to remove a seborrheic keratosis. It doesn't always work on raised, thicker growths, and it may result in discoloration of treated skin.

Scraping the skin's surface (curettage). First your doctor will numb the area and then use a scalpel blade to remove the growth. Sometimes scraping is used along with cryosurgery to treat thinner or flat growths. It may also be used with electrocautery.

Burning with an electric current (electrocautery). First your doctor will numb the area and then destroy the growth with electrocautery. This method can be used alone or with scraping, especially when removing thicker lesions. This procedure can leave scars if it's not done properly, and it may take slightly longer than other removal methods.

Vaporizing the growth with a laser (ablation). Different types of laser treatments are available.

Applying a solution of hydrogen peroxide. If you have a raised growth, your doctor may prescribe a solution of 40% hydrogen peroxide (Eskata), which is applied to the skin. The drug has been proved to be effective in removing seborrheic keratoses, but it may irritate the skin. This solution must be handled with care, as it can cause eye damage.

3. Differential diagnosis include :-

- Warts

- actinic keratosis

- pigmented growth like nevi

- lesions with irregular notched border ,resemble malignant melanomas.