Treatment of Seborrheic Keratosis by High Frequency Focused Ultrasound – An Early Experience with 11 Consecutive Cases

Abstract

Purpose High intensity focused ultrasound operating at 20 MHz has been demonstrated as a safe and efficient treatment modality for a range of dermatological indications. The method is potentially also applicable to removal of seborrheic keratosis. Patients and Methods A total of 54 seborrheic keratoses in 11 volunteer subjects (8 women and 3 men, average age 51.5 ± 13.2 years) were treated in a single session with a medical 20 MHz high intensity focused ultrasound device developed for dermatological conditions. Handpieces with nominal focal depths of 0.8 mm below the skin surface were used to administer acoustic energy of 0.99–1.2 J/dose. An integrated dermoscope in the handpiece was used to monitor the treatment in real-time. Treatment efficacy and side-effects were assessed directly after treatment and at follow-up 4–15 weeks after treatment. Results The treatment showed positive results in 96.3% of the cases. About 68.5% of the cases were classified as complete response and 27.8% of the cases as partial response. Two cases (3.7%) did not respond to treatment and were classified as stable condition. No subjects experienced worsening of their condition, and no treatment received the classification of progressive condition. Side effects were primarily redness in the treatment area due to superficial telangiectasia, mild scarring, and persisting and slow-healing lichen planus-like keratosis. No adverse events were observed. Conclusion HIFU is concluded to be a safe and efficient skin treatment for seborrheic keratoses. It has advantages over conventional treatments that can lead to pain during treatment and scarring after healing.

Lead-Free HIFU Transducers

“…However, very similar devices operating from 3 to 10 MHz can be applied for subcutaneous treatments in cosmetology or treatment of shallow organs such as lymph nodes (Zawada and Bove 2017;Bove et al 2019). Use of the same overall design concept, but with a piezoelectric element designed for operating at frequencies of 10 to 25 MHz, can be directly applicable to a very wide range of dermatological indications including actinic keratosis and basal cell carcinoma (Serup et al 2020), seborrheic keratosis (Calik et al 2022), superficial vascular tumors (Calik et al 2021) and verruca vulgaris (Bove et al 2021). Similarly, comparable lead-free transducers operating at lower frequencies, for example, 500 kHz to 2 MHz, allow for deeper ultrasound penetration and larger focal zone sizes (Bove et al 2019).…”

Treatment of Condylomata Acuminata Using a New Non-Vapor-Generating Focused Ultrasound Method following Imiquimod 5% Cream

“…This device can be used to target features near the surface of the skin, and reproducibly deliver a clinically efficient thermal and mechanical insult with localized heating to approximately 60–65°C that will spontaneously kill cells and denaturate fibrous tissue. The system has earlier been demonstrated to provide safe and efficient treatment of other dermatological indications, including basal cell carcinoma and Kaposi sarcoma [ 9 ], actinic keratosis [ 9 , 10 ], seborrheic keratosis [ 11 ], superficial vascular tumors [ 12 ], and verruca vulgaris [ 13 ].…”

“…Results from prior treatments indicate that virus infected cells are removed directly in the wound crust, and that the healing process furthermore may induce a wider beneficial immune response in the directly adjacent/deeper nontreated tissue [ 9 , 13 ]. Sequelae have been very limited, and only sporadic cases with further fibrous change of an already damaged dermis have been observed [ 9 , 10 , 11 , 12 , 13 ].…”

Comparing the efficacy of plasma exeresis and cryotherapy for the treatment of seborrheic keratosis: A randomized controlled trial

“…The use of liquid nitrogen cryotherapy is among the commonly used procedures and previous studies have shown the effectiveness of this modality. [6][7][8] Plasma exeresis is a new minimally invasive technique that has recently gained attention in recent years. The plasma exeresis medical devices generate plasma energy by ionizing atmospheric gas between the device and the skin.…”

“…There are various options for the treatment of SKs including minor surgical techniques, topical, and laser‐based options. The use of liquid nitrogen cryotherapy is among the commonly used procedures and previous studies have shown the effectiveness of this modality 6–8 …”