Skin Lesions: Are They Moles or Seborrheic Keratosis?

Inquiry Consultation

Hello Dr.
Wu: I have a mole on the sole of my right foot, and last year and early this year, I discovered two additional black spots.
One of them is clearly a mole, while the other is less distinct, approximately 0.1 cm in size, appearing as a rough, gray-black patch.
I noticed that I could scrape off some of its surface with a metal ruler, but I couldn't completely remove it.
Earlier this year, I visited a dermatologist who examined the moles on the sole of my right foot using a dermatoscope and confirmed that two of them are clearly melanocytic nevi.
However, regarding the 0.1 cm gray-black patch, the doctor mentioned that it is likely also a nevus but could not be completely certain.
In any case, it is not a viral wart or a corn and poses no health risk.
Recently, I learned that many of the unidentified black spots I found on my skin are actually seborrheic keratosis.
I have the following questions for you, Dr.
Wu:
Q1.
Can seborrheic keratosis occur on the skin of the soles of the feet? The doctor I consulted earlier was also not entirely sure if the black spot was a mole; he only stated that it is not a skin disease and is harmless, which makes me wonder if the black spot could also be a seborrheic keratosis.
Q2.
Following up on the previous question, if seborrheic keratosis can occur on the skin of the soles of the feet, can the friction and irritation from walking lead to adverse changes in the seborrheic keratosis on the soles?
Thank you, Dr.
Wu.

Axiang, 40~49 year old female. Ask Date: 2023/08/25

Dr. Wu Yuxin reply Dermatology

Q1.
Less likely.
Q2.
The chances are slim.

Reply Date: 2023/08/25

More Info

When it comes to skin lesions, distinguishing between moles (nevi) and seborrheic keratosis can be quite challenging, especially when the lesions appear on less common areas like the soles of the feet. In your case, you have observed multiple dark spots, including a prominent mole and a less distinct gray-black lesion.

Understanding Skin Lesions
Seborrheic Keratosis is a common, benign skin growth that often appears as a brown, black, or light tan lesion. They can have a scaly, wart-like appearance and are typically raised above the skin surface. While they are most commonly found on the trunk, face, neck, and scalp, they can occasionally appear on the soles of the feet, although this is less common.
Moles, on the other hand, are clusters of pigmented cells that can vary in color from brown to black. They can be flat or raised and may change over time. The fact that a dermatologist confirmed some of your spots as moles suggests that they are likely benign, especially since they have been assessed with a dermatoscope.

Addressing Your Questions
Q1: Can seborrheic keratosis occur on the soles of the feet?
Yes, seborrheic keratosis can occur on the soles of the feet, although it is not as common as on other parts of the body. The appearance of these lesions can sometimes be mistaken for other conditions, such as plantar warts or other types of keratosis. If the lesion is rough, scaly, and has a stuck-on appearance, it may indeed be seborrheic keratosis.

Q2: Can friction from walking cause changes in seborrheic keratosis?
Friction and irritation can potentially lead to changes in any skin lesion, including seborrheic keratosis. While these lesions are benign, constant irritation from walking or pressure can cause them to become inflamed or change in appearance. If you notice any changes such as increased size, color change, or bleeding, it is crucial to consult a dermatologist for further evaluation.

Recommendations
1. Monitoring: Keep an eye on the lesions. If you notice any changes in size, shape, color, or if they become painful or bleed, seek medical advice promptly.

2. Avoid Irritation: If you suspect that friction from footwear is causing issues, consider wearing more comfortable shoes or using protective pads to minimize irritation.

3. Dermatological Evaluation: Since you have already consulted a dermatologist, it may be beneficial to have a follow-up appointment to discuss your concerns about the gray-black lesion. If there is any uncertainty, a biopsy can provide a definitive diagnosis.

4. Skin Care: Maintain good skin hygiene and moisturize the area to keep the skin healthy. Avoid harsh scrubs or treatments that could irritate the lesions.

5. Education: Understanding the nature of your skin lesions can help alleviate anxiety. Knowing that seborrheic keratosis is benign and common can provide peace of mind.

In conclusion, while seborrheic keratosis can occur on the soles of the feet, it is essential to monitor any lesions closely and consult with a dermatologist for any concerns. Regular skin checks and awareness of changes in your skin can help ensure that any potential issues are addressed early.

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