Peculiarities of the course of seborrheic keratosis of extragenital localization among the female population

Abstract

Seborrheic keratosis (SK) remains the leader among benign skin pathologies. In the classical sense, extragenital foci of this dermatosis look like light or dark brown papules with dense hyperkeratotic or verrucous layers. Such a clinical picture is characteristic of the typical form of foci of skin lesions. The etiopathogenetic mechanisms of SK appearance are not sufficiently studied, because a large number of trigger factors are reported. Given the benign profile of these lesions, practitional doctors very often do not pay much attention to these foci. While for patients, their appearance and increase in size can cause the emergence of obsessive or anxiety states both due to the development of cancer-phobic states due to significant aesthetic discomfort.The objective: to determine the peculiarities of the course of seborrheic keratosis in women, taking into account anamnestic data on the effect of insolation on the skin and phenotypic criteria represented by the skin phototype, as well as to analyze the dermatological quality of life indicator in patients with keratosis depending on the location of neoplasms.Materials and methods. Based on the Educational and Scientific Medical Center «University Clinic» of Zaporizhzhia State Medical and Pharmaceutical University, 50 patients with foci of seborrheic keratosis, whose ages ranged from 27 to 80 years old, were examined. To verify the diagnosis, the following parameters were carried out: a clinical examination of neoplasms with an assessment of the phenotypic criterion – skin phototype according to Fitzpatrick, dermatoscopic and pathomorphological examination. The assessment of the impact of keratosis on the quality of life of patients was based on the calculation of the results of the DLQI (Dermatology Life Quality Index) questionnaire.Results. The studied sample is represented by the majority of representatives of the II phototype – 44 persons and a small number of the III phototype – 6 patients, which amounted to 88% and 12%, respectively. The most frequent localization of keratosis was the head – 18 (36%), torso – 11 (22%), extremities – 13 (26%), and neck – 8 (16%). This location on open areas of the body can be an additional confirmation of the effect of ultraviolet radiation on the occurrence of keratosis. According to the results of the questionnaire with the study of anamnestic data, more than half of the examined patients (58%) had skin burns after a long stay in the open sun. In addition, an insufficient level of use of photoprotective agents was determined. All these factors can be as triggers for the appearance of keratosis foci and negatively affect the self-esteem and aesthetic appeal of patients. Indeed, when efflorescences are located in visual areas of the body, the dominant factor is a decrease in the quality of life.Conclusions. Predominance of patients with II skin phototype (88%) and lack of photoprotection skills (48% never use sunscreen, 32% sometimes) are the most influential factors in determining insolation as one of the leading triggers of seborrheic keratoma formation. Localization of keratosis foci on open areas of the body to a greater extent negatively affects the quality of life of women, demonstrating higher DLQI index values – 7 points – versus 5 points in the women with the keratomas on the torso. Therefore, increasing the level of awareness among patients about sun exposure, the use of photoprotection and regular examination is a priority task for doctors of all levels.