INTRODUCTION
Seborrheic keratoses (SKs) are common age-related skin lesions that affect an estimated 83 million Americans.1 These growths can cause irritation, cosmetic concerns, and fear of malignancy. Furthermore, SKs can mimic melanomas or be located adjacent to a melanoma or squamous cell carcinoma (collision tumor).2
The accurate diagnosis of this benign condition can usually be accomplished clinically, aided with the use of dermoscopy. Nonetheless, reassurance alone does not solve the bothersome nature of these age-related growths, which can be unsightly or irritated by clothing or jewelry.1 Patients often seek removal of SKs. Current therapies for SK eradication, frequently liquid nitrogen cryotherapy or curettage, can be painful, require significant healing time, and may not be covered by medical insurance. Several topical therapies show promise in removing SKs. One topical treatment, 40% hydrogen peroxide (Eskata®), was approved by the Food and Drug Administration (FDA) for the treatment of raised SKs by a healthcare provider. Although Eskata was effective in most cases and well received by patients, the market among providers proved smaller than expected, and it is no longer available. In this study, we sought to determine an effective topical treatment to improve the appearance of these lesions using a novel topical mixture.
The accurate diagnosis of this benign condition can usually be accomplished clinically, aided with the use of dermoscopy. Nonetheless, reassurance alone does not solve the bothersome nature of these age-related growths, which can be unsightly or irritated by clothing or jewelry.1 Patients often seek removal of SKs. Current therapies for SK eradication, frequently liquid nitrogen cryotherapy or curettage, can be painful, require significant healing time, and may not be covered by medical insurance. Several topical therapies show promise in removing SKs. One topical treatment, 40% hydrogen peroxide (Eskata®), was approved by the Food and Drug Administration (FDA) for the treatment of raised SKs by a healthcare provider. Although Eskata was effective in most cases and well received by patients, the market among providers proved smaller than expected, and it is no longer available. In this study, we sought to determine an effective topical treatment to improve the appearance of these lesions using a novel topical mixture.
MATERIALS AND METHODS
This research study was approved by the Phelps Health Institutional Review Board, Rolla, Missouri (FWA 00009095). Patients with SKs who were willing to try a novel topical mixture of plant extracts and other ingredients were recruited for the study and consented to participate.
Selection of Ingredients Based on the known growth-inhibiting characteristic of walnut trees,3 we crushed green walnut hulls (GWH) and rubbed the GWH juice on a seborrheic keratosis, which cleared. This single success was not reproducible. Some lesions showed significant size reduction within a week, but most showed no change. We sought antioxidants to add to the GWH extract and tested four antioxidants known to have antitumor effects: N-acetyl cysteine, resveratrol, pomegranate extract, and green tea extract.4-7
Selection of Ingredients Based on the known growth-inhibiting characteristic of walnut trees,3 we crushed green walnut hulls (GWH) and rubbed the GWH juice on a seborrheic keratosis, which cleared. This single success was not reproducible. Some lesions showed significant size reduction within a week, but most showed no change. We sought antioxidants to add to the GWH extract and tested four antioxidants known to have antitumor effects: N-acetyl cysteine, resveratrol, pomegranate extract, and green tea extract.4-7
