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Like any other organ, our skin is susceptible to various diseases, which is caused by the influence of negative chemical, bacterial, mechanical and other factors. Keratosis of the skin is one of the unpleasant diseases, expressed in thickening, keratinization of the skin, which, as the affected area increases, causes discomfort and a lot of unpleasant and painful sensations, including itching, cracks and their bleeding, erosion and ulceration. What are the causes of the development of the disease and methods of its treatment?

Keratosis of the skin and the reasons for its development?
Keratoses are understood as skin diseases of a non-inflammatory nature, which are associated with excessive keratinization against the background of a delay in the exfoliation process. The cause of the appearance of keratosis of the skin can be genetic factors (heredity), as well as the influence of external factors (radiation, mechanical, chemical influences). In addition, the development of this disease can be facilitated by diseases of an infectious nature, disruptions in the functioning of the nervous and endocrine systems, as well as the presence of malignant tumors of internal organs. Hence, in practice, two groups of keratoses are distinguished: acquired and hereditary.

Acquired keratoses of the skin.
Acquired keratoses include:

• Symptomatic, which is caused by dysfunction of the endocrine and nervous systems.
• Paraoncological keratosis of the palms and soles is provoked by the presence of cancer.
• Occupational keratosis - occurs upon contact with mechanical, physical and chemical factors.
• Keratosis can also occur as a result of an infectious disease of a venereal nature (syphilis, gonorrhea), against the background of a deficiency of the most important vitamins E, A, C.

In addition, this disease may be one of the symptoms of certain types of dermatosis.

Keratoses of the skin are hereditary.
Hereditary forms of keratosis are represented primarily by ichthyosis, follicular keratosis (lichen pilaris, Kirle's disease), keratoderma of the palms and soles, Mibelli porokeratosis, as well as congenital polykeratoses. These forms can be focal (keratoderma, porokeratosis, cutaneous horn) and universal (ichthyosis, ichthyosiform erythroderma, etc.). It is important to say that each form of the disease has its own characteristics of skin damage and its own treatment methods.

Symptoms of keratosis.
The disease manifests itself in the form of keratinization of hair follicles, peeling of the skin, lumpy skin and thickening of the skin on the palms and soles, which is accompanied by unpleasant pain, bleeding, and erosive lesions.

Ichthyosis.
Translated it means “fish scales”. To treat this disease, general and local methods of therapy are used. General therapy is of a general strengthening nature, expressed in the administration of fish oil, calcium, vitamin A, iron, and other vitamins and microelements. Since neuroendocrine disorders play a special role in the pathogenesis of the disease, their timely diagnosis and prescription of optimal treatment is of paramount importance. In such cases, taking Thyroidin with parallel administration of insulin often helps. The use of heat also has a positive effect in treating this disease. Exposure to heat dilates blood vessels, restores the process of sweating and helps reduce dry skin, stimulates the vasomotor and muscle-hair reflex. Dry air (55-60°) and long warm baths (38-39°) with the addition of baking soda also have an effect. After such baths, patients are wrapped in a warm blanket and given hot tea or raspberry infusion for two hours. Moreover, it is important to combine treatment with water procedures with massage, and such therapy should continue for quite a long time after improvement or recovery. Patients with ichthyosis benefit greatly from sulfur baths; a similar service is available in many resort areas.

Local therapy for ichthyosis involves lubricating the affected skin with fat in combination with salicylic acid (2%); it is advisable to carry out a similar procedure an hour after taking a therapeutic bath. If the skin is excessively dry, the biorevitalization procedure is effective. When forms of the disease are too pronounced, more intense exfoliation is used (sulfur-salicylic, salicylic-tar ointments, etc.). It is also effective to use ointments that contain a predominance of vitamin A. During cold periods of the year, the condition of patients with ichthyosis is significantly worsened due to increased dry skin, so it is recommended to temporarily go to a place with a warmer climate.

Congenital ichthyosiform Broca's erythroderma.
The treatment of this disease is similar to the treatment of ichthyosis, however, the duration and temperature of warm and dry air baths are significantly less, which is due to a more pronounced manifestation of inflammatory phenomena (often up to blisters). As a local treatment, weak solutions of salicylic ointment (1%) are used, and for feelings of tightness and burning, indifferent ointments and fats are recommended.

Follicular keratosis.
This form of the disease manifests itself in the form of keratinization of skin areas at the mouth of the hair follicles. Externally, the disease resembles light rashes on the skin. Follicular keratosis is divided into papular, atrophying, and vegetative. One of the diseases of keratosis pilaris is lichen pilaris, characterized by the appearance of numerous small nodules and pink color. The nodules are usually covered with hard and rough scales. In the center of the emerging nodules there are twisted hairs. The favorite place for pilaris is the skin of the back, abdomen, and flexion areas of the limbs. In most cases, the disease occurs in children and adolescents, has a chronic course, and in winter the disease worsens.

Kirle's disease is another common type of hereditary keratosis pilaris. The disease is characterized by the appearance of gray follicular papules on the skin of the body, limbs or face. As they grow, crusts form on the surface of the papules. Due to fusion, the papules form wart-like growths.

Keratoderma of the palms and soles.
A feature of this type of disease is the appearance of symmetrical yellow (brown) horny layers with a purple border on the palms and heels. The first manifestation of this disease is usually recorded in childhood, but over the years it only progresses. The surface of the keratinized layers becomes covered with painful cracks that bleed. The disease can spread to the backs of the hands, feet, knees and elbows.

Porokeratosis of Mibelli.
A manifestation of this type of disease is the formation of conical dense nodules of a grayish tint on the skin. Over time, the nodules form a ring-shaped plaque on the skin, which can reach a diameter of up to four centimeters. The peculiarity of the plaque is the presence of a recess in the center and a horny ridge along the edges. The disease is very difficult to treat; diathermocoagulation, freezing, electrolysis, surgical removal of large formations, and radiotherapy are used in therapy.

Hereditary palmoplantar symmetrical keratoma.
This disease has another name - “Meleda Island disease”. In the treatment of this disease, both general and local treatment is used. Vitamin A, restorative agents, magnesium salts, etc. are prescribed for long-term oral administration. In local therapy, long hot baths, washing with soapy water, and (10%) salicylic ointments in the form of a compress are used immediately after the bath. In particularly severe cases, surgical intervention with excision of the affected skin areas followed by skin plastic surgery is indicated. However, despite this, the disease can recur. Therefore, patients need to completely limit themselves from any pressure on the skin of the palms or feet. If the patient is involved in sedentary work, it may be necessary to change it.

Congenital polykeratoses.
From the name it is clear that such diseases have symptoms of various forms of keratosis. In this case, the disease causes damage to the nervous system, bone tissue and some other pathologies, including changes in nails, teeth and hair.

Seborrheic keratosis.
The disease is represented by multiple rashes of oval horny growths on the face, neck and other areas, which can be brown, flesh-colored or black. This type of keratosis is considered the most common benign neoplasm among older people. It is eliminated surgically with subsequent histological examination only if the patient experiences discomfort, an increase in formation, itching or bleeding. Otherwise, the course of the disease is under the supervision of specialists.

Actinic keratosis.
The disease is characterized by keratinization of the skin of the face, neck and décolleté. The inconvenience of this type of keratosis is purely aesthetic. The development is caused by prolonged exposure to sunlight, which causes the skin to lose firmness and elasticity, age and thicken. Outwardly, these are ordinary skin irregularities that feel like sandpaper to the touch. Actinic keratosis often develops into skin cancer, so it requires regular monitoring by a dermatologist.

Senile keratosis of the skin.
The disease mainly develops in older people (as the name suggests). In fact, this is a precancerous disease, which in rare cases develops into skin cancer. It looks like dry or greasy flat plaques of yellow-brown color, reaching 1-2 cm in diameter. Such keratinized layers are similar in appearance to warts and appear, as a rule, on open areas of the skin (face, neck or hands). The disease can persist for many years and is practically undisturbed; in rare cases, slight itching is observed. However, there are cases when the plaques become inflamed and begin to bleed with the further appearance of erosion. The latter is an alarm bell that may indicate the onset of malignancy. In this situation, you should not hesitate to visit a doctor. After a thorough examination and necessary tests, appropriate treatment is prescribed.

Keratoacanthoma.
Keratoacanthoma is a fast-growing benign tumor with spontaneous involution (reverse development). Outwardly, it resembles a flesh-colored dome, in the middle of which there is a plug of horny substance. Usually occurs in areas exposed to sunlight (face, hands). In addition to solar radiation, the development of keratoacanthoma can be caused by mechanical damage and viruses. The tumor disappears after a few weeks or months, but there is always a tiny chance of it degenerating into squamous cell skin cancer, so you should never delay a visit to a specialist.

Treatment of keratosis of the skin.
Keratosis of the skin should be treated by an experienced dermatologist. If formations appear, you must immediately contact a specialist to avoid the development of a malignant tumor. Keratoses are characterized by long-term treatment with a special diet (with a predominance of vitamins and fats), and the application of external medicinal ointments.

To treat keratosis, various methods are used, similar to the treatment of skin cancer (surgical, laser, cryotherapy, radiation, medication). In each specific case, when drawing up the optimal treatment regimen, the prognosis for the development of education, localization, and general health of the patient are taken into account.

Skin formations that do not have a predisposition to degeneration or malignancy are treated based on cosmetic indications.

Keratosis is a skin disease that is largely genetic in nature, but can occur due to a number of external factors. Both adults and children are susceptible to the disease. Treatment methods for large and small patients are different. How to prevent the development of complications of the disease, for what reasons keratosis occurs, symptoms and treatment of pathology - the reader will find information on these and other issues in our article.

What is keratosis?

Keratosis includes a whole group of dermatological diseases, the most characteristic manifestation of which is thickening of the epidermis. The pathology does not have a viral nature of origin, but rather is a consequence of a certain set of provoking factors. These include:

Relationship with oncology

Surely many have heard about such a disease as keratosis. What it is, however, not everyone knows. In fact, pathology leads to the appearance of keratomas on human skin - benign neoplasms (single or multiple). Today, the opinions of specialists about the disease and the causes of its occurrence are ambiguous; doctors are divided into two camps. Some argue that the reasons leading to the onset of the disease are purely genetic. Others do not exclude the involvement of the factors mentioned above in the occurrence of pathology. Accordingly, answers to questions about how to treat keratosis will also vary.

One way or another, there is a relationship between keratosis and skin cancer. Keratoma is benign in nature, however, there are often cases when cancer cells develop in its structures. The neoplasms are hardly distinguishable from each other, so it is visually difficult to determine the type of pathology (cancer or keratosis). What this is can only be determined by histological examination. The procedure is used in almost all cases when making a diagnosis.

Multiple foci of keratosis may indicate the presence of cancer in the internal organs. There are certain statistics according to which, among 9 thousand patients with keratoma examined, 900 people were diagnosed with various forms of skin cancer.

Classification

The disease “keratosis” is divided into groups according to various symptoms. For example, according to the nature of origin, they distinguish:

• Symptomatic keratosis - pathology occurs against the background of other diseases, as well as under the influence of unfavorable environmental factors;
• Hereditary keratosis is a pathology that is formed for genetic reasons and manifests itself, as a rule, at an early age or immediately after birth;
• Acquired keratosis is a disease whose causes are not completely clear.

Depending on how keratomas appear on the body, they are distinguished:

• Localized keratosis - the disease affects a specific area (area) of the skin;
• Diffuse keratosis - the disease covers the entire body or very large areas of the skin.

Also distinguished:

• in which foci of the disease (horn plugs) form at the hair follicle;
• Actinic keratoses are uneven, rough patches on the skin that gradually develop into scaly lesions ranging in color from normal skin tone to red-brown;
• It is a nodular formation covered with dark-colored horny scales.

Types of seborrheic keratosis

Seborrheic keratosis is also divided into several forms:

Other forms of keratosis

Medical practice is also known:

• keratotic papilloma,
• cutaneous horn,
• clonal keratosis.

Keratotic papilloma is a form of pathology that manifests itself in small formations consisting of single cysts with inclusions of horn cells;

Cutaneous horn is a form of keratosis that is considered quite rare. The pathology manifests itself as formations of horn cells of a conditionally cylindrical shape protruding above the surface of the skin. The disease mainly affects older people. Tumors, which can vary in size, are classified into two subtypes:

• Primary - there is not enough information on the type of this pathology; it can appear spontaneously, without any apparent reason;
• Secondary - pathology occurs against the background of an inflammatory process in other skin formations. It is this form of cutaneous horn that can degenerate into a malignant formation under the influence of viruses or microtraumas;

Clonal keratosis. What it is? This type of pathology is similar to epithelioma and refers to a special form of the disease, which is characterized by plaques in addition, nests are located in the epithelial layer of the tumor. The formations themselves consist of keratinocytes - pigmented cells. Clonal keratosis mainly appears on the lower extremities and mainly in older people.

Main symptoms

The most obvious signs of keratosis are neoplasms (single or multiple) that appear on open areas of the skin - the back, chest, forearm. Sometimes the disease can affect the neck, scalp, back of the hand, and genital area. There are rare cases when pathology appears on the soles of the feet. The size of a benign tumor can vary from several mm to several cm. The formation most often takes on a round shape, its boundaries are clearly defined. It is possible that the patient may experience itching at the site of the tumor.

New growths usually have a pink or yellow tint, however, they can be dark brown or black. The surface of the tumor is rough, covered with a thin film, which, when removed or damaged, releases blood. Gradually the film becomes thicker and may become covered with cracks. As the crust thickens, the edges of the tumor change and take on an irregular shape. In this case, the neoplasm becomes too convex, with black or light inclusions.

Risk group and complications

The following group of people is more susceptible to the disease:

In the treatment of keratosis, early screening is important, therefore, before making a diagnosis, the following is carried out:

• general examination of the patient;
• taken biomaterial.

Keratosis is a disease whose treatment is performed sequentially and takes a long period of time. Advanced stages of the disease can cause various complications:

• Degeneration of benign formations into cancer;
• The pathology causes a malfunction of the endocrine system, as well as nerve trunks and endings;
• Pathology can lead to tooth loss;
• Often appears against the background of keratosis

Treatment methods

As a rule, the most effective methods for treating keratosis are surgical. But only in the case when the manifestation of pathology is represented by individual elements in open areas of the body. Conservative treatment methods provide little effect, although often in order to stop the progression of the pathology, the patient is prescribed large doses of ascorbic acid.

It must be said that this measure leads to positive dynamics in treatment. Therapy is carried out in courses lasting up to two months. Between stages of treatment it is necessary to take breaks of several weeks to give the body a rest. Course therapy helps to prevent new foci of the disease called “keratosis” from appearing in the future. Treatment with folk remedies is a purely additional measure to the above two.

Manifestations of keratosis are removed using various manipulations:

• Laser or radio wave radiation;
• Cryodestruction is a treatment method based on the effect of liquid nitrogen on the affected areas of the skin. This procedure is used primarily in cases of multiple keratomas;
• Chemical peeling - used for the procedure (in its pure form or a solution in various proportions);
• Electrocoagulation is a technique that uses electric current in the treatment of affected areas of the body;
• Curettage is a curettage procedure using a special metal instrument (curette).

Children are susceptible to the disease just like adults. In most cases, young patients are diagnosed with keratosis pilaris, which occurs in the area of ​​the hair follicle. The cause of the development of the painful condition may be the cold season; lack of vitamins in the body; diseases of the gastrointestinal tract; daily stress at school or in the family. A nodular rash that resembles “goose bumps” manifests itself in keratosis pilaris in children. A photo of a similar manifestation of the disease is shown in the illustration below.

The diagnosis is established on the basis of examination; additional research of biological material can be carried out. Often conservative treatment is aimed only at eliminating a cosmetic defect. The main goal of therapy is to moisturize the skin and exfoliate dead skin cells using special creams and ointments.

Prevention

It is important to remember that if any pathological conditions occur, you should not self-medicate. You should immediately seek advice from a specialist and find out what disorders have occurred in the body.

You should consult a doctor if:

• the neoplasm has changed shape, size, color within a short period of time,
• the neoplasm is inflamed or injured,
• non-healing or bleeding areas appear on the skin,
• Soreness or persistent itching is felt at the site of the keratoma.

To prevent pathology you should:

Tumors do not disappear on their own; they only progress over time.

Traditional medicine recipes for keratosis

As noted earlier, alternative medicine can only become an additional measure to conservative (surgical) therapy and only after the correct diagnosis has been established. Treatment of keratosis at home involves the use of various ointments and compresses based on potatoes, propolis, and yeast. For example, propolis is applied to the affected areas of the skin (it is necessary to apply the product in a thin layer) for several days. Then they give the skin a rest, and after some time they perform a similar procedure again. The course of treatment consists of several cycles.

The use of raw potatoes is considered effective in the fight against keratosis. The fruit is grated on a fine grater, placed in several layers of gauze and applied to the affected areas of the skin for 40-60 minutes. The procedure is repeated using fresh potatoes.

Live yeast is often used for compresses. The product is applied to problem areas for several hours, then washed abundantly with water. The course of treatment is repeated for five days.

Physiotherapy can also become an integral part in getting rid of the manifestations of the disease. However, the most important thing in treating the disease is daily skin care.

Main symptoms:

Keratosis is a group of skin pathologies of non-inflammatory etiology, characterized by keratinization of the entire surface of the skin or individual areas. It has many forms and diverse clinical manifestations. Keratosis of the skin can occur in people of any age group.

Causes

The causes of keratosis are endogenous and exogenous factors, depending on the form of the disease.

Common reasons include:

• exposure to ultraviolet radiation is the most common cause of keratosis of the facial skin;
• damage by aggressive chemicals;
• injuries;
• insect bites that produce toxins;
• skin infection for various reasons;
• inflammatory processes of the skin, exposure to bacteria, fungi, viruses;
• somatic diseases, especially inflammation of the digestive system, nervous diseases, pathologies of the heart and blood vessels;
• metabolic disorder;
• decreased immune status;
• hematopoietic disorder;
• endocrine disorders;
• benign and malignant neoplasms, especially blood and skin;
• allergic reactions;
• hormonal changes;
• old age;
• heredity (, Mibelli poroquetosis, Miescher-Lutz elastosis).

Keratosis in a child can develop as a result of intrauterine. There are frequent cases of pathology developing against the background of other skin diseases, for example (allergic reactions associated with genetic disorders).

Classification

Conventionally, pathology is divided into several types.

By degree of distribution:

1. Diffuse - almost the entire surface of the skin is affected.
2. Localized (focal) - specific areas of the body are affected.

By origin:

1. Congenital - the prerequisites for the disease are laid in intrauterine development.
2. Acquired - occurs at any age under the influence of external or internal factors.
3. Symptomatic - one of the manifestations of dermatosis.

By localization:

1. Keratosis of the cervix.
2. Follicular () - blockage of the hair follicle by epidermal scales.
3. Keratosis of the facial skin.
4. The scalp.
5. Plantar keratosis.
6. Keratosis of the vulva.
7. Keratosis of the feet.

For development reasons:

1. Solar keratosis (actinic) is a reaction to excessive exposure to sunlight. In older people, senile keratosis, a precancerous condition, may occur.
2. Actinic keratosis or seborrheic - “senile warts”, basal cell.
3. Pilar keratosis (pilaris) is inherited, the most common (50–80% of all skin pathologies in adolescents, 40% in adults).
4. Lichenoid keratosis - develops as a result of infection of skin formations that resemble when inflamed.
5. Professional - associated with constant skin contact with aggressive environments.
6. - occurs when protein metabolism is disrupted due to gene mutation.

The classification is conditional. As such, there is no classification of keratosis due to the variety of manifestations and causes.

Symptoms

Provoking factors in the development of clinical manifestations may be:

• use of oral contraceptives;
• unhealthy food;
• lack of personal hygiene;
• cold weather.

General symptoms:

• pigmented skin;
• keratinization;
• the appearance of various formations or thickenings;
• available ;
• bleeding

The nature of skin formations and symptoms vary depending on the form of the disease and location.

With palmoplantar keratosis, keratinization, deep cracks, and blisters appear on the heels. Roughness of the skin on the hands and feet occurs in 100% of cases, a change in the shade of the dermis from amber to brown - in 90%, increased sweating of the soles and palms - in 70%, painful cracks - in 60% of cases. Keratosis of the feet can occur when wearing uncomfortable shoes or an unsuccessful pedicure.

The first symptom of keratosis of the scalp is dry skin and hair, deterioration of hair condition (brittleness, dullness, split ends). Next, keratinization appears in the area of ​​the hair follicles, irregularities and tubercles are felt on the head, which can bleed if damaged.

As the disease progresses, hair begins to fall out in individual areas or over the entire surface at once. At the site of baldness, hair does not grow back, which is due to the death of the hair follicles.

The seborrheic form is characterized by the appearance of hyperpigmented spots that transform into plaques with clearly defined boundaries, covered with crusts. Plaques can occur anywhere on the body, plural or singular. The color of the formation varies, from flesh-colored to black. When subjected to mechanical damage (rubbing, squeezing), warts bleed.

Symptoms of the follicular form usually appear at an early age. The first manifestation is dryness of the dermis. Next, nodules with hairs on top appear, which are located symmetrically on the skin. A peculiarity in children is keratosis on the face, usually without any unpleasant sensations other than aesthetic ones. Often these manifestations disappear during adolescence due to hormonal changes.

Skin damage in the solar (actinic) form of the pathology occurs in open areas with direct exposure to ultraviolet radiation. At risk are older people, those who spend a long time in the sun, people with fair skin, HIV-infected people, and those with age spots.

The senile form is characterized by the formation of multiple fused hard scales on open areas of the body. Round or oval lesions up to one centimeter in size are difficult and painful to remove. At risk are men, people with skin photosensitivity types I – III, who are exposed to ultraviolet radiation for a long time.

Diagnostics

The clinical picture of the disease is pronounced, so an experienced specialist can make a diagnosis based on a visual examination. To clarify the form of pathology and differentiation, a microscopic examination is carried out. Modern devices have great capabilities and provide information sufficient for a clear understanding of the disease.

The main method for the final diagnosis is a histological examination of a biopsy specimen, which makes it possible to establish the type of skin formation, stage, nature of the pathological process, and obtain other accurate indicators based on which adequate treatment is selected.

Treatment

You can get rid of keratosis with the help of comprehensive treatment after identifying the cause of the disease. The treatment is carried out by a dermatologist; you may need to consult a geneticist, endocrinologist, nutritionist, or oncologist.

The treatment complex includes:

• systemic therapy;
• diet therapy;
• symptomatic treatment;
• surgical intervention;
• local treatment;
• traditional methods.

Vitamins (A, D), fish oil, calcium and iron supplements are prescribed, and, if necessary, painkillers. The specific treatment regimen is selected individually, taking into account the causes and manifestations.

For topical use, creams, sprays, and gels based on sodium chlorite are used with a moisturizing and anti-inflammatory effect.

If you have hyperkeratosis of the feet, you should consult a podiatrist. For keratosis of the foot, treatment is aimed at careful care and hygiene procedures. First, you should soften the stratum corneum using salt baths or softening cosmetic products. The hard layer is then removed and then sanded.

A competent podiatrist carefully removes the rough layer to reveal healthy skin. To remove corns and rough skin, using a sugar cone is effective - a pedicure milling machine with a garnet-coated cutter can be used both at home and in beauty salons. Hardware procedures are hygienic and effective.

To treat keratosis at home, caring emollient oils (lavender, rosemary, pine oil), hand and foot baths, special lotions, and gels are used. It is especially effective to use herbal baths in the morning and evening hours before abrasive procedures, after which a medicinal ointment or oil is applied. Compresses are made from herbs with anti-inflammatory and healing effects (chamomile, sage, aloe, etc.). The main goal is to soften the formation and carefully remove it.

The healing properties of tar soap in the fight against skin diseases have been known since ancient times. Tar soap removes excess sebum, preventing clogging of pores, reduces sweating, dries out inflammation on the skin, fights dandruff, and makes hair stronger and thicker. Due to the content of tannins and oils in soap, it has an anti-inflammatory, antibacterial, and moisturizing effect. Skin and hair look well-groomed after using soap.

It is recommended to eat a diet that excludes canned foods, spicy, fatty, pickled foods, baked goods, sweet carbonated drinks, alcohol and those foods to which the patient may develop an allergic reaction. It is recommended to consume large amounts of vitamins contained in fresh fruits and vegetables, seafood, and cereals.

Gentle surgical and cosmetic techniques are used to remove growths:

1. Cryotherapy is indicated for large lesions; the technology involves the effect of liquid nitrogen on the formation. After freezing, the plaques undergo necrosis and are removed. A possible complication of cryotherapy is.
2. Laser therapy - laser removal. The manipulation involves the impact of a laser beam on pathological lesions. This is the most effective method of combating keratotic formations, characterized by painlessness, speed, and absence of consequences.
3. Diathermocoagulation - removal of lesions with electric current is performed under anesthesia. There is a high risk of scarring and pigmented spots.
4. Phototherapy is the treatment of keratotic lesions with a special agent that increases the sensitivity of the epidermis to light waves of a certain length. The plaques are then exposed to light rays without damaging healthy tissue. After the procedure, you should not stay in the sun for 48 hours.
5. Plasmolifting - plasma injections to stimulate local immunity and skin regeneration.
6. Biorevitalization - injections of hyaluronic acid improve the condition of the skin, rejuvenate it, and increase its ability to regenerate.

For minor lesions, chemical peeling (glycolic, lactic, glycolic-salicylic) helps - the use of acids for a chemical effect on warts.

Solar keratosis is treated using curettage, a surgical technique in which localized affected areas are scraped out using a curette. Curettage is not used to remove actinic lesions on the face, since the manipulation may leave a scar.

For ichthyosis skin lesions (“fish scales”), warm alkaline baths (up to 39 degrees) help, after which the patient is wrapped in a blanket for two hours and given hot herbal tea to drink. Heat dilates blood vessels, promotes sweating, exfoliation, moisturizing the skin, and stimulates the muscle and vasomotor reflex.

An hour after the bath, the body is lubricated with salicylic acid in combination with oil or fat. Combining baths with massage is effective. The treatment is long-term.

Forecasts

The outcome of the disease depends on the type and extent of the keratotic process. In general, the prognosis is favorable with timely treatment and compliance with medical recommendations. In the absence of proper treatment, the development of microbial, malignant neoplasms, tooth loss, hyperpigmentation, disruption of the endocrine system, and development are possible.

The most unfavorable prognosis is considered to be the senile form of keratosis. Plaques do not disappear on their own, as, for example, with the follicular form. This is a precancerous condition: in the absence of treatment, irrational therapy, and constant trauma to the lesions, degeneration into. Malignancy occurs in 2–5% of cases.

Ichthyosis can be complicated by metabolic disorders, folliculitis, progression of chronic diseases, and the addition of new systemic diseases. If ichthyosis is detected in the fetus, it is recommended to terminate the pregnancy.

The risk group includes people with fair skin, a family history, those living in a sunny, hot climate, those who have undergone radiation and chemotherapy, and those who are HIV-infected.

Prevention

Keratotic skin lesions are a complex problem that is difficult to eliminate. In order not to encounter the disease, it is recommended:

• avoid prolonged exposure to the sun, especially for people at risk, do not be in the sun from 10 a.m. to 4 p.m.;
• do not sunbathe in the sun or in a solarium, especially if the patient has solar keratosis;
• use sunscreen, wear glasses with UV filters, sick people - wear natural, light clothing with long sleeves, comfortable shoes;
• take care of the immune system, strengthen it, eat rationally;
• do not overcool;
• maintain hygiene;
• avoid injury to the skin.

People suffering from dermatoses should undergo regular medical examinations with a dermatologist and preventive treatment, and eliminate irritating and provoking factors.

The exact causes of the disease have not yet been established. The main one is regular exposure to ultraviolet radiation. It affects the dermis, epidermal layers, blood vessels, sebaceous glands, and melonocytes.

Gradually, under the influence of sunlight, the disturbances increase, reaching the peak of the disease.

The following factors contribute to the development of pathology:

• genetic predisposition;
• weakened immune system;
• influence on the skin of chemicals (resinous substances, oil, sand, etc.);
• past infections;
• age-related changes (the disease most often affects people over 50 years of age).

Due to weak immunity, AIDS carriers, people with problems with the nervous and endocrine systems, as well as patients who have undergone chemotherapy or complex operations are more prone to the appearance of keratosis.

Some types of keratoses often affect young people. This usually applies to red-haired or fair-haired people with gray, blue or green eyes. Research shows that by the age of 40, 60% of the population has at least one element of keratosis.

Over the age of 80, everyone has some type of this pathology.

Types and signs of keratosis

A person may not pay attention to the signs of the initial stage of the disease. It can manifest itself as unnoticeable roughness on any part of the body (cheeks, bridge of the nose, forearms, scalp, ears, etc.). At first the formation is solid, small in size, red or brown in color. The skin around the affected area may peel off, itching begins, and hair loss may also be observed at the site of the keratoma.

There is no unified classification of the varieties of this disease, because it has not been fully studied. According to etiology, the following types of keratosis are distinguished:

1. Congenital - appears at birth or at a younger age. Very rare.
2. Acquired - appears in adulthood, less often - in adolescence.
3. Symptomatic - occurs due to external factors.

According to the affected area, local (single areas of skin are affected) and diffuse (large areas of the skin are affected) keratosis.

There are also several types of clinical manifestations.

Follicular keratosis

The formation of horny plugs in the hair follicles is observed. These are dead cells that have separated from the skin. By forming nodules, they interfere with hair growth. Most often, keratosis pilaris appears on the abdomen, face, shoulders, buttocks, neck, and armpits. Such manifestations are characteristic of the cold season; closer to summer, symptoms may disappear. This type of pathology is also called pilar keratosis. If the nodule grows more than 3 mm, pain may occur.

Consumption of allergens can cause an exacerbation of the inflammatory process.

Seborrheic keratosis

This type of disease is characterized by plaque-like or nodular formations with a warty surface. The top of the keratomas is covered with a brown or black keratinized substance. As a rule, it occurs over the age of 50 years, therefore it is also called actinic keratosis.

The most common areas for the appearance of formations are the face, chest, neck, etc. It does not occur on the palms and soles. The development of this form of the disease proceeds slowly and usually becomes chronic. Actinic keratosis does not develop into a cancerous tumor, but a malignant tumor can masquerade as keratosis. In case of inflammation of the affected areas, bleeding and rapid growth of the formation, you should immediately consult a doctor.

Actinic keratosis

Appears on exposed areas of the body. At first it looks like uneven, rough skin. Over time, it develops into a scaly, flaky, compacted spot, ranging in color from skin color to brownish. Such formations may look like growths, rising above the skin. Mostly the face, neck, and chest are affected by keratinization. Such keratosis can transform into cancerous tumors, so it is necessary to be regularly monitored by a dermatologist.

Treatment of the disease

Treatment should be carried out by a dermatologist.

You need to visit a specialist after the first appearance of keratomas, since it is important to exclude the malignant nature of the formation. Treatment is long-term and complex, usually including a number of activities.

Conservative therapy

It is carried out with the aim of reducing the number of keratoses before moving on to radical methods of treatment.

Therapeutic agents reduce symptoms and alleviate the course of the disease, but do not cure completely.

To soften keratonic areas, applications using drugs with urea (content - from 12 to 30%) are used: Keratosan, Ureaderm, Ureatop, Akerat..

The following drugs are used in therapeutic treatment: Fluorouracil, Efudex cream, Diclofenac Gel 3%, Imiquimod. Special shampoos are used to treat keratosis of the scalp. Retinoids are taken internally, which help reduce the growth rate of formations, as well as vitamins of groups A, B and C. Additionally, courses of physiotherapy are prescribed.

Radical methods of treating keratosis

Since conservative therapy for keratosis does not guarantee a complete cure, it is often necessary to proceed to radical measures - direct removal of the formations. The use of drastic techniques is especially justified if there is a risk of keratosis degenerating into cancer.

The following radical methods of therapy exist:

1. Cryodestruction - freezing with liquid nitrogen.
2. Radio wave removal. The formation is excised using a radio knife under the influence of radio waves.
3. Electrocoagulation - the doctor performs cauterization using high-frequency electric current.
4. Laser destruction - a targeted effect of a carbon dioxide laser is applied to the keratoma.
5. Photodynamic therapy - methyl aminolevulinate is applied to the affected area with further exposure to a light wave of a certain length. All this leads to necrosis of the affected tissues.
6. Surgical removal - the skin is cleaned with a curette (special instrument).
7. Dermabrasion - removal using an abrasive brush.

Forecast and prevention of the disease

The prognosis of the disease depends on the time of initiation of treatment. However, in order to avoid relapses, it is necessary to follow certain recommendations.

The following measures can be taken as prevention:

• use moisturizing creams;
• eat well so that food provides the skin with all the necessary “building” elements;
• limit exposure to direct sunlight to reduce exposure to ultraviolet radiation;
• when in the sun, use sunscreens (ointments and creams) with a high SPF level;
• When working with chemicals, you must use appropriate skin protection.

Keratosis is a skin condition that requires constant monitoring. In addition to an aesthetic defect, sometimes formations can develop into malignant tumors. And to prevent this, it is necessary to undergo regular examinations and monitor changes in the skin.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Keratoma is a general collective name for several types of benign skin tumors formed from the superficial cells of the epidermis. That is, several types of neoplasms with a common origin are combined into one name “keratoma”. In principle, the term “keratoma” is clinically and morphologically inaccurate, since it does not reflect the specific characteristics of each type of benign tumor formed from cells of the superficial layer of the epidermis ( keratinocytes).

The term "keratoma" is formed from two parts: the first is "keratos", which is the Greek name for the cells of the superficial stratum corneum of the skin (keratinizing epithelium), and the second is the suffix "-oma", which denotes a tumor. That is, the direct translation of the word “keratoma” is a tumor of the cells of the keratinizing epithelium of the skin. It can be said that the term “keratoma” is equivalent in meaning to the concepts “fibroids”, “lipomas” and other similar general names for large groups of benign tumors originating from the same type of cells and including several specific types of neoplasms.

Keratoma - brief characteristics and localization

Any keratoma, regardless of the type, is formed from epithelial cells of the skin, which is the outer layer and is in direct contact with the environment. This epithelium is multilayered keratinizing in structure, and the cells that form it are called keratinocytes. Stratified keratinizing epithelium consists of several layers of cells lying on top of each other. Moreover, the cells of the outer layer located on the surface gradually die off, turning into horny scales, which peel off and are removed from the surface of the skin when washed.

When the scales peel off, new epithelial cells rise in their place from deeper layers, which themselves, after some time, begin to die and turn into scales. Thus, a process of constant renewal of skin epithelial cells occurs - the superficial ones die and peel off, and their place is taken by others that were previously in the underlying layer. The basement membrane of the epithelium, in turn, continually forms new epithelial cells, which gradually move toward the surface to eventually become scaled and slough off.

Normally, the rate of formation of new cells on the basement membrane and peeling of horny scales is balanced. That is, only the number of cells that is necessary to replace those that have turned into horny scales is formed again. If the processes of exfoliation of scales and the formation of new epithelial cells are not balanced, this leads to the development of various skin diseases. This is how keratomas—benign tumors made from keratinocytes—are formed.

Keratoma is formed from unchanged skin epithelial cells prone to excessive keratinization. That is, the tumor consists of a large number of ordinary keratinocytes - exactly the same cells that form normal layers of the epithelium. Since keratomas are formed from normal cells, they are benign tumors.

However, keratomas are prone to degeneration into cancer. According to statistics, malignancy of keratomas occurs in 8–20% of cases, depending on the type of tumor, the general condition of the human body, as well as the presence of negative factors contributing to the formation of cancer cells. It is precisely because of the relatively high probability of keratomas degenerating into malignant tumors that these neoplasms are classified as precancer. However, you should not be afraid of this, because in most cases keratomas do not become malignant.

Since keratomas are formed from skin epithelial cells, these tumors are localized only in different areas of the skin. Keratomas can form on the face, neck, torso, arms, and upper legs. Moreover, the most rare localization of these neoplasms is the lower extremities, and most often keratoma appears on areas of the skin exposed to sunlight, such as the face, neck, arms, chest, etc. One or more keratomas may appear at the same time.

At the initial stage, any keratoma looks like a slightly protruding spot above the skin, colored gray or coffee-colored. The surface of the keratome usually peels off, which is due to the formation and peeling of a large number of horny scales. As it develops, the area of ​​the keratoma increases, and the spot begins to protrude more strongly above the surface of the skin. On sufficiently large keratomas, a dense crust of horny scales forms, which can be torn off accidentally or intentionally. When a keratoma is injured, it can bleed and hurt, causing discomfort to the person. Otherwise, these tumors, as a rule, represent only a cosmetic problem and do not bother the person in any way.

Skin keratoma

Since the keratoma is formed from unchanged cells of the keratinizing epithelium, which is found only in the structure of the skin, the only possible localization of these benign tumors is the skin. In other words, keratomas can only form on the skin. In this aspect, keratomas are an example of benign tumors with a determinate (conditional) localization - that is, they can form only on the skin and nowhere else.

Accordingly, the term “skin keratoma” is incorrect, since it contains an excessive specification, which fully reflects the situation described by the well-known saying “butter oil”. After all, any keratoma can only be on the skin.

Keratoma on the face

Keratoma on the face forms quite often and is usually single. Keratomas of any kind can form on the face, as well as on other parts of the body. Moreover, their course is no different from tumor formations localized in other areas of the skin, for example, on the back, leg, etc. Therefore, it is inappropriate to consider keratomas on the face separately from the same tumor formations in other parts of the body, because there are no fundamental differences between them.

Multiple keratomas

The term “multiple keratomas” usually means the presence of more than 3 formations on a small area of ​​skin (approximately 5 X 5 cm). Multiple keratomas, like single ones, can be dangerous or non-dangerous, which depends on the period of time during which they appeared, as well as on the rate of increase in their size.

As a rule, several keratomas appear on the skin of different parts of the body over a relatively short period of time (a few months), and this phenomenon is considered normal. If over several years a person has formed a large number of keratomas, then this is also a variant of the age norm. In such cases, it is not recommended to remove the tumors; you should simply regularly (1-2 times every six months) undergo a preventive examination by a dermatologist who can monitor the growth and condition of the keratoma.

If, within a short period of time (1 - 3 months), a person develops multiple keratomas in one or several areas of the body, then this is considered a dangerous condition, since it may be a sign of cancer in the internal organs. Otherwise, multiple keratomas are no different from single ones, since they are characterized by the same clinical course, approaches to therapy and possible causative factors.

Photo keratoma

Since there are several types of keratomas that differ in appearance from each other, we present their photographs in separate sections.

Senile (seborrheic, age-related) keratoma - photo

These photographs show various clinical variants of seborrheic keratomas.

Follicular keratoma - photo

This photograph shows a follicular keratoma.

Solar (actinic) keratoma – photo

These photographs show various variants of solar keratoma.

Cutaneous horn - photo

These photographs show cutaneous horns of various shapes and sizes.

Types of keratomas

Currently, doctors and scientists use a classification of keratomas based on the nature of the causative factor that provoked the skin tumor. According to the most common classification, the following types of keratomas are distinguished:

• Senile keratoma, which is also called age-related, senile or seborrheic;
• Solar keratoma, which is also called actinic;
• Follicular keratoma;
• Cutaneous horn, also called keratoma keratoma.

Since each of these types of keratomas is characterized by the presence of specific structural features, we will describe them separately.

Senile keratoma (seborrheic, age-related, senile keratoma)

To designate this type of formation, in addition to the name “senile”, the terms seborrheic, age-related or senile keratoma are also used, which, accordingly, are synonyms. Three variants of tumor names, such as senile, senile and age-related, reflect the fact that these keratomas are formed in older people (after 40 - 50 years). And the term “seborrheic keratoma” reflects the fact that excess sebum production plays a large role in the process of tumor formation. In addition to the listed options for the names of keratomas, the terms “seborrheic keratosis” or “senile keratosis” are often used.

In people under 40–50 years of age, seborrheic keratoma is most often single and, as a rule, localized on open areas of the body, such as the face, arms, neck, chest, etc. In the older age group (in people 50 years and older), this The type of keratomas is almost always multiple, and they are localized in closed areas of the body, such as the back, abdomen, legs, etc.

Seborrheic keratoma at the initial stage is a spot that rises slightly above the skin, colored brown, gray, dark brown or black. The shape of the spot can be oval or round, and the size ranges from medium lentils to large beans. As the spot grows, it may increase slightly in size and rise significantly above the surface of the skin. When the keratoma finally grows, it protrudes strongly above the skin and looks like something foreign, as if glued.

Numerous scales are visible on the surface of the formation, which in some cases can form a continuous crust. The scales are loose, greasy to the touch and easily removed from the surface of the keratoma, since they are not strongly fused to its tissues. Under the removed scales, protrusions of various sizes are visible, similar to the papillae of the tongue. Usually these protrusions are well demarcated from the rest of the keratoma tissue, they look like peculiar inclusions, painted in a slightly different shade, but the same color as the rest of the formation, as a result of which it is not difficult to identify them.

Senile keratomas grow slowly throughout a person's life and never disappear on their own. As the formation grows, they can change shape, color and degree of elevation above the surface of the skin. When localized in close proximity to physiological openings (eyes, vagina, urethral opening in men, etc.), keratomas are often subject to trauma, as a result of which in 20% or more cases they become malignant and give rise to basal cell carcinoma or squamous cell carcinoma of the skin.

The risk of malignant degeneration of senile keratomas ranges from 8 to 35%, which is determined by the presence of additional factors promoting tumor growth. Thus, the risk of malignancy by keratomas increases with their regular injury, improper treatment, as well as exposure to ultraviolet and radioactive radiation, etc.

Depending on the histological structure, senile keratomas are divided into the following forms:
1. Spotted form;
2. Nodular form;
3. Plaque form;
4. Keratoma similar to Bowen's disease;
5. Transitional form between keratoma and cutaneous horn.

These forms of keratomas represent five successive stages of tumor development, which are listed in the order of their transformation into each other. That is, the spotted form is the earliest stage of keratoma development, and the transitional form to the cutaneous horn is, accordingly, the last.

Spotted keratoma It is a round or oval-shaped spot ranging in size from 3 to 7 mm with fuzzy edges. When localized on the body, the spot is colored brownish-brown, and on the face – light brown or pinkish-yellow. The spots may feel smooth or rough to the touch. In the area of ​​the keratoma, the skin is thin, susceptible to atrophy, as a result of which it is easy to gather into folds and wrinkles.

Nodular keratoma has dimensions up to 10 mm, clearly defined edges and is colored dark gray or dirty yellow. The formation is raised above the surface and covered with horny scales. If you remove the scales, the reddish surface of the keratome will be underneath them.

Plaque keratoma It is an irregularly shaped disc 5–10 mm in diameter with clear edges, painted gray. The color of the plaque is due to a dense layer of horny scales that can be scraped off from the surface of the keratoma. If the scales are removed, the bleeding surface will be visible underneath them.

Keratoma similar to Bowen's precancer , is several plaques merged into one with a total diameter of 10 - 15 mm. The edges of the common plaque are uneven, jagged, but clearly defined. The edges of the keratoma are copper or pinkish in color, and the center is various shades of brown or gray. The number of scales on the surface of the keratoma is insignificant. As the formation progresses and grows, its central part atrophies and sinks. Such a keratoma is only superficially similar to Bowen's precancer, but its distinguishing feature is the almost zero possibility of degeneration into cancer.

Transitional form from keratoma to cutaneous horn It is an ordinary plaque, at one end of which a keratinized elevation is formed, resembling a horn. This elevation is dense to the touch, consists of a cluster of horny scales and is colored brown. The size of such a horny growth on the surface of the skin is usually small - from 10 to 15 mm, and over time it becomes malignant, turning into spinocellular skin cancer.

Solar (actinic) keratoma

Solar (actinic) keratoma is a type of tumor provoked by the negative effects of ultraviolet radiation on the skin. That is, as the name implies, solar keratoma is formed due to prolonged exposure to the sun. The total dose of solar radiation received throughout life plays a role in the development of keratoma. That is, the more and more often a person was exposed to the scorching sun, the higher his likelihood of forming solar keratomas.

Typically, this form of the disease manifests itself with the simultaneous formation of multiple keratomas on the surface of the skin in areas most exposed to sunlight, for example, the face, lips, ears, neck, forearms, hands and lower legs. Keratomas are located on thin, atrophied skin.

At the initial stage, solar keratomas are small, painful spots or round-shaped blisters, the size of which ranges from a pinhead to several centimeters. Such keratomas are painted in the color of normal skin or in various shades of red and gray-black. If the formation has the same color as the surrounding skin, then it is difficult to identify them during examination, but it is easy to do this by palpation. When you touch the surface of the solar keratome, your fingers feel a rough and very dense formation, slightly protruding above the skin. In addition, solar keratomas appear well when creams containing 5-fluorouracil are applied to them.

Solar keratomas are divided into the following forms depending on their clinical manifestations:

• Erythematous form;
• Keratotic (papular) form;
• Warty (papillomatous) form;
• Horny form;
• Pigment form;
• Proliferative form.

Erythematous form Solar keratosis is characterized by the appearance of lesions of various shapes on the skin, in which there are a large number of hard and dry scales. The lesions are clearly defined and delimited from the surrounding skin by a red rim. At the time of appearance, the size of the lesion is several millimeters, but as the tumor progresses, it increases to 10–20 mm.

Keratotic form is formed due to the thickening of the layer of horny scales covering the surface of the erythematous keratoma. At the same time, the redness goes away, and the surface of the lesion becomes covered with horny scales, giving it a yellowish dirty-brown or gray-black color. If the scales are scraped off, you will find red, thin, cracked skin underneath.

Warty form Solar keratosis is characterized by “cauliflower-like” growths on the surface of the keratosis, which is covered with scales, giving it a dirty gray color with a yellowish tint.

Horny form Solar keratomas are characterized by the formation of a dense growth on the skin, similar to a horn. This horn is formed by a large number of tightly compressed scales. Most often, the cutaneous horn is formed from the keratotic form of solar keratosis and is predominantly localized on the skin of the forehead or ears.

Pigment form Solar keratoses are brown spots covered with horny scales, giving their surface a strong roughness. As a rule, keratomas are located on the back or the back of the hands.

Proliferative form Solar keratoma is an oval plaque that rises above the surface of the skin, colored red and covered with flaking scales. The edges of the plaque are blurred, and the size can reach 3–4 cm in diameter. Solar keratomas of this form are most often localized on the skin of the lips, but can also affect the conjunctiva of the eye.

Follicular keratoma (keratosis)

Follicular keratoma is a rare type of tumor that originates from the epithelial cells lining the hair canal, from which the hair emerges from the follicle to the surface of the skin. This keratoma is extremely rare, and according to some data, the tumor is more often formed in women, and according to others, on the contrary, in men.

Follicular keratoma looks like a dense nodule of regular round shape, protruding above the surface of the skin and colored gray or pinkish. As it grows, it can increase in size up to 20 mm. Follicular keratomas are usually localized above the upper lip, on the scalp or on the forehead near the hairline.

Cutaneous horn (horny keratoma)

The cutaneous horn (horny keratoma) is a dense protruding formation with a characteristic elongated shape, which is why it received the name “horn”. This keratoma is formed by dense horny scales, fused together into one dense mass.

It is currently believed that cutaneous horn is not an independent and separate form of benign tumors of the epidermis, but represents a special variant of the course of solar or senile keratoma. That is, cutaneous horn can have different origins and course, but the same clinical manifestations. Actually, it was precisely the same type of clinical manifestations that made it possible to combine all possible variants of the origin of the cutaneous horn into one type of keratoma.

Most often, a cutaneous horn develops against the background of an existing senile keratome and somewhat less frequently with a solar keratome. In order for a skin horn to form from a solar or senile keratoma, it is necessary to constantly influence the formation of additional factors that will form a predisposition. Such factors include microtraumas, sunburn, chronic infectious diseases, etc. This means that if an existing solar or senile keratoma is continually traumatized, exposed to sunlight, or becomes infected, it is highly likely to form a cutaneous horn.

The cutaneous horn looks like an elongated protruding formation on the skin of a conical or cylindrical shape. It constantly grows in length, and therefore can reach significant sizes - in isolated cases up to 30 cm. In rare cases, the horn grows not in length, but in width, and in this case it looks like a large, wide formation attached to the surface of the skin with a thin stalk .

The surface of the formation can be smooth or rough, dotted with numerous irregularities and grooves, and the color is dark with a predominance of yellowish-brown or brown colors. To the touch, the skin horn has a dense consistency. At the base of the horn on the skin there may be local inflammation, which looks like a narrow red rim surrounding the formation.

The cutaneous horn forms somewhat more often in women and is usually single. It is extremely rare for two or more cutaneous horns to form on the skin of one person. Usually the formation is localized on the face, ears and scalp. Since malignancy of the cutaneous horn occurs quite often, it is classified as a precancerous disease.

Cause of keratoma

The exact causes of keratomas, like other tumors, have not currently been identified, but it has been established for certain that the development of these tumors is associated with exposure to sunlight on human skin. This does not mean that a few months after exposure to the sun, for example, at sea, keratomas will begin to appear and grow in a person. However, the sun can repeatedly negatively affect the skin throughout life, which ultimately leads to various changes in its overall structure and individual cells, which become predisposing factors for the formation of keratomas. In other words, slowly but steadily over decades, the sun's rays cause changes in the structure and functioning mechanisms of the cells of the surface layer of the skin, which ultimately becomes the basis for the formation of tumors from them. That is, skin cells damaged by solar radiation give rise to keratoma.

Scientists were able to find out that the decisive factor in the formation of keratomas is not a single dose of solar treatment received by a person during one or several days of exposure to direct sunlight. On the contrary, the decisive role is played by the total dose of solar radiation received by a person throughout his life. That is, if a person was exposed to the open rays of the sun for one hour every day for 20 years, then his risk of developing keratomas is higher than that of someone who, for the same 20 years, spent only 2 weeks a year on the beach, exposing his skin to the sun.

Since it is the total dose of solar radiation received by a person throughout his life that is important for the formation of keratomas, it is recommended to avoid intense sunbathing for more than 15 to 45 minutes a day and working in open areas under the scorching sun without thick clothing that covers as much skin as possible. This means that to prevent keratomas and skin cancer, it is recommended that when working in the open sun (for example, in a field, lifeguards on the beach, etc.), you should dress to cover your arms, neck, shoulders, legs, and forehead.

Are keratomas dangerous?

Keratomas are both dangerous and safe. This means that in general, keratomas are safe neoplasms because they are benign, but at certain moments they can become dangerous due to malignancy and their transformation into a cancerous tumor. That is, until the process of malignancy and degeneration into cancer begins in the keratome, it is safe.

Based on the fact that the keratoma itself is a safe formation, and becomes dangerous only with malignant degeneration, it is very important to monitor the condition of the tumor and record possible signs of its transformation into cancer. Currently, the signs of malignancy of keratomas are the following changes in it:

• The keratoma began to grow rapidly;
• The keratoma began to bleed without injury;
• The keratoma began to itch.

This means that if these signs are detected, you should consult a doctor as soon as possible and remove the suspicious keratoma.

In addition, the danger of keratoma lies in the fact that in appearance some forms are similar to skin cancer, as a result of which even experienced doctors cannot always distinguish one formation from another. In such situations, it is recommended to remove the suspicious tumor as soon as possible and send it for histological examination. If the results of histology reveal that the formation was indeed a cancerous tumor, then for a complete recovery you should undergo a course of chemotherapy.

Finally, the indirect danger of keratomas is that with the simultaneous appearance of a large number of such tumors on the skin, there is a high probability of developing cancer in any internal organ. In such a situation, it is necessary to consult a doctor and undergo a detailed examination, which will detect a growing cancerous tumor and remove it at an early stage.

Treatment of keratosis

General principles of treatment of keratomas (senile, seborrheic, follicular, cutaneous horn)

Currently, the only way to treat keratomas is to remove them using various methods. However, keratomas do not always require mandatory removal; moreover, in most cases, people live with them into old age and die for completely different reasons. That is, you can cure a keratoma only by removing it, but this is not always necessary. In other words, these tumors do not need to be treated in all cases. The only type of keratomas that must be removed is the cutaneous horn.

If there are keratomas, doctors recommend not removing all existing tumors, but visiting a dermatologist 1-2 times every six months so that he can monitor the dynamics and condition of the formations, and if they are suspected of malignant degeneration, quickly remove them. Thus, it is recommended to remove only keratomas that are suspected of malignant degeneration into skin cancer.

In addition, at the request of patients, doctors remove keratomas, which create a visible cosmetic defect that disrupts a person’s normal life and causes discomfort. That is, if the keratoma does not show signs of malignancy and from the doctor’s point of view it can be left, but at the same time the person does not like its presence in principle, then it is quite possible to remove the formation at the request of the patient.

Keratoma removal methods

Currently, the following techniques can be used to remove keratomas:

• Kerat removal with laser;
• Cryodestruction (removal of keratosis with liquid nitrogen);
• Electrocoagulation (removal of keratomas with electric current);
• Radio wave removal of keratomas;
• Surgical removal of keratomas;
• Destruction by acids (removal of keratomas with acids) or cytostatics.

The choice of method for removing keratoma is made individually in each specific case, based on the size, type and shape of the formation, as well as available tools and equipment.

So, if a malignant degeneration of a keratoma is suspected, then it should be removed only by surgical, radio wave or laser methods. Other methods cannot be used to remove malignant tumors, since they are not effective and radical enough. As a result, their use makes it impossible to completely remove all tumor cells, which will trigger explosive cancer growth a few weeks after surgery.

All three of these methods for removing suspicious malignant keratomas are equally effective, but laser and radio wave are less traumatic compared to surgery. This means that after removing a keratoma using a laser or radio wave method, a rough and noticeable scar will not form, and tissue healing after surgery will occur very quickly. Therefore, if possible, it is recommended to prefer the laser or radio wave method of removing keratomas to the surgical one.

Methods of cryodestruction, electrocoagulation and acid destruction can be used to remove keratomas that are definitely not at the stage of malignant degeneration, but bother a person only as cosmetic defects or interfere with leading a normal lifestyle (for example, they are injured during movements, etc.).

Methods for removing keratomas with acids and cytostatics can be considered conservative, since when they are used, the neoplasm is destroyed due to the death of its cells, and not “cutting out” it with a scalpel, laser beam or radio wave radiation. Treatment of keratoses with acids or ointments with cytostatics is carried out in order to remove small but numerous neoplasms. As a rule, only solar keratomas are removed with the help of acids and cytostatics, since they are small in size and have a shallow depth of damage to skin tissue.

Laser removal of keratoma

Laser removal of keratoma is an effective method that allows you to completely destroy tumor cells, which guarantees the absence of relapses. Typically, laser removal of keratomas is performed in one session, during which the formation is either evaporated or “cut out” with a laser beam used as a thin scalpel. After laser removal of a keratoma, complete healing of the skin occurs within 1–2 weeks, after which an almost invisible scar remains on it.

Removing tumors with liquid nitrogen

Removal of keratoma with liquid nitrogen is carried out without anesthesia, as a result of which during the procedure a person may feel a slight tingling or burning sensation on the skin. The essence of the manipulation is to destroy the keratoma tissue with liquid nitrogen. After treating the tumor with liquid nitrogen, a crusty spot forms on the skin, under which tissue healing occurs. About a week after the operation, the crust disappears, and a pink spot remains on the skin, which within a month acquires the color of the normal surrounding skin, as a result of which it becomes invisible.

Unfortunately, when using liquid nitrogen, it is impossible to control the depth of tissue damage, as a result of which a common complication of cryodestruction of keratomas is a wound that is too large, healing with the formation of a noticeable and unsightly scar. In addition, when using the cryodestruction method, relapses of keratomas quite often occur due to the fact that not all tumor cells were destroyed.

Removal of keratoma by electrocoagulation

Removal of a keratoma by electrocoagulation is its “cauterization” with an electric current, which is completely similar to that for cervical erosion. During the manipulation, the keratoma is exposed to a high-frequency electric current, which heats the tumor tissue, actually burning it locally. After electrocoagulation of the keratoma, a crust is formed, under which the skin heals. After 1 - 1.5 weeks, the crust disappears and pink skin is exposed, which acquires a normal color after a month. The electrocoagulation method is excellent for removing small keratomas because it does not cause scarring and is quite effective.

Removal of keratoma using the radio wave method

Removing a keratoma using the radio wave method involves “cutting it out” using a radio knife. The essence of the operation is exactly the same as when removing a keratoma with a scalpel, but instead of a rough metal cutting object, thin and precise radio wave radiation is used, allowing bloodless and small incisions to be made. As a result of radio wave removal of the keratoma, the surrounding tissues are not damaged and therefore no scars are formed. The method can be used to remove any keratomas.

Surgical removal of keratoma

Surgical removal of a keratoma involves “cutting it out” with a scalpel under local anesthesia. This method is the simplest and most accessible, but at the same time very effective, therefore it can be used to remove any type of keratoma. The only drawback of the method is the formation of a postoperative scar and relatively long tissue healing.

Removal of tumors with acids and cytostatics

Removal of keratoma with acids and cytostatics involves treating the formations with external agents (creams, emulsions or solutions) containing substances as active components that can destroy tumor cells. Such substances are trichloroacetic and glycolic acids, as well as the cytostatics Podophyllin and 5-fluorouracil.

Treatment of kerat with acids is carried out only by a doctor, since it is very important to dose these substances correctly. Indeed, when using too high a dose of acids or when applying them to keratomas for a long period of time, a chemical burn is possible, which will lead to the formation of ugly scars.

The cytostatic solution Podophyllin and ointments containing 5-fluorouracil can be used for self-treatment of keratomas, since their use is relatively safe. So, 25% Podophyllin should be lubricated with keratomas once a day for 10 days. In this case, 4–8 hours after applying Podophyllin to the keratoma, it should be washed off with warm water and soap.