Hello,
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     46 year old male
•     Known case of seborrheic keratosis
•     Worry related to presence of lesion on scrotum

Seborrheic keratosis (seborrheic warts) are warty, flesh-colored, brown, or black growths that can appear anywhere on the skin. So it can appear on scrotum too. It is not a cancer or skin infection so no need worry much about it.

These harmless growths are very common in middle-aged and older people. Some people have scores of lesions. Although these growths can appear anywhere, they most often appear on the torso and the temples.

Seborrheic keratosis is round or oval and varies in size from less than ¼ inch (0.5 centimeters) to several inches. They appear to be stuck on the skin and usually have a warty and waxy or scaly surface. These growths develop slowly. They are not cancerous and do not become so.

Treatment is not needed unless the keratosis become irritated or itchy or is cosmetically undesirable. They are best removed by freezing them with liquid nitrogen (cryotherapy) or by using an electric needle (electrolysis).

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Regards,

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Hello again,

Deciding final treatment is a complex decision and taken after considering detail history, reaction to previous treatment, history of allergy, examination findings, treatment facility available, doctors experience in specific procedure, investigation and specific issues with patient.

Keloids present a therapeutic challenge whenever skin is involved with any disease or trauma. The best treatment of Keloid is prevention in patients with a known predisposition. This includes preventing unnecessary trauma or surgery (including ear piercing, elective mole removal), whenever possible. Any skin problems in predisposed individuals (e.g., acne, infections) should be treated as early as possible to minimize areas of inflammation.

Cryotherapy itself indicated in keloid removal but you are developing keloid with this too.

Considering above facts following management issues can be considered in your case:
- Try electrolysis for small lesions of seborrheic keratosis: but keloid formation can not be predicted.
- Leave seborrheic keratosis without treatment if it is not causing much problem, as keloid after treatment can be much disfiguring than seborrheic keratosis itself. (I know it is distressing for you)

Hope this answer your query.

Wish you good health.

Regards,

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