Which description best fits seborrheic keratosis?

• A. Greasy, scaly, verrucous flat papules or plaques with a stuck-on appearance
• B. Pearl-like translucent papules with telangiectasias
• C. Blue-black pigmented macules with irregular borders
• D. Small, fluid-filled vesicles on an erythematous base

Answer: (A)

Seborrheic keratosis is a benign epidermal tumor that presents as greasy, scaly, verrucous flat papules or plaques with a stuck-on, waxy surface. That stuck-on appearance is the hallmark and helps distinguish SK from other lesions. The lesions are usually well defined, can range in color from tan to dark brown or black, and most commonly appear in middle age or older individuals. They’re typically asymptomatic, though they can become irritated if rubbed. In the provided descriptions, the greasy, scaly, flat papules or plaques with a stuck-on look fit seborrheic keratosis best. The other options describe different conditions: a pearly, translucent papule with telangiectasias suggests basal cell carcinoma; blue-black pigmented macules with irregular borders suggest melanoma; and small vesicles on an erythematous base describe a vesicular eruption such as herpes or varicella.