Patient Preferences and Comparative Outcomes Regarding Cryosurgery versus Electrodesiccation in the Removal of Truncal Seborrheic Keratoses.

Background: Seborrheic keratoses (SKs) are one of the most common benign epithelial tumors seen by dermatologists. Many people elect to have these lesions removed, most commonly by way of cryosurgery or electrodesiccation. Objective: We sought to evaluate the comparative efficacy and patient preferences regarding cryosurgery and electrodesiccation for the treatment of truncal SK lesions. Methods: In this randomized, blinded clinical trial, 33 eligible subjects with two similar truncal SKs were assigned to receive treatment with cryosurgery and electrodesiccation applied to separate lesions. Patients rated their pain and preference at the time of treatment and follow up at two and eight weeks. Physicians rated the color, texture, and efficacy of lesion removal at eight weeks. Results: Patients did not have a treatment preference (p=0.10) and there was no significant difference in pain when comparing cryosurgery to electrodesiccation (p=0.43). Both treatment modalities were similar in terms of efficacy (p=0.50). Skin texture was rated similarly (p=0.64); however, lesions treated with cryosurgery were nominally less likely to have posttreatment hyperpigmentation compared to lesions treated with electrodesiccation (odds ratio: 0.35, 95% confidence interval: 0.12-1.002; p=0.0504). Conclusion: Cryosurgery and electrodesiccation are both effective treatment modalities for truncal SKs. While cosmetic outcomes were similar, cryosurgery resulted in less postinflammatory hyperpigmentation.