Keratoacanthoma

Sometimes, {the} cells in {the} skin can form small lesions that require treatment. Keratoacanthoma is a clinical condition where skin cells grow into a small tumour which is often localised and does not spread to any other part of {the} body. In this article, we shall briefly review keratoacanthoma and how it is treated.

What is a keratoacanthoma?

Keratoacanthoma is a skin tumour that appears like a small boil on {the} surface of {the} skin. Once it appears, it starts to grow rather rapidly and can reach a significant size within a matter of weeks. Its appearance is a rather typical and several a times, untreated keratoacanthoma is will eventually disappear though they would leave a scar. A keratoacanthoma can take up to 4 to 6 months for complete resolution.

What causes a keratoacanthoma?

The primary reason for {the} development of a keratoacanthoma is exposure of {the} skin to ultraviolet rays of {the} sun. A rare few cases have been linked to {the} human papilloma virus.

Types of keratoacanthoma

There are various types of keratoacanthoma. While a detailed discussion is out of {the} scope of this article, it is worthwhile remembering that keratoacanthomas might be a solitary lesion (called solitary keratoacanthoma), might be multiple (called multiple keratoacanthoma) or maybe a rather large (known as giant keratoacanthoma). Sometimes, multiple lesions might arise in different parts {the} body and this is known as generalised eruptive keratoacanthoma. Similarly, multiple lesions might also arise in one part of {the} body and this is known as keratoacanthoma centrifugum marginatum.

How is keratoacanthoma diagnosed?

Diagnosis can be easily made from history and clinical examination. Keratoacanthomas have a characteristic appearance upon inspection. However, frequently just a clinical diagnosis is insufficient and confirmation is required through additional tests. A skin biopsy is helpful and this will reveal {the} presence of small fragments of keratin which is a part of normal skin tissue. Other additional findings will also be demonstrated which can help confirm {the} diagnosis.

Treatment options

There are different treatment options available in managing keratoacanthoma. The choice of treatment depends upon where exactly {the} tumour is located. When {the} tumour is located on {the} trunk, arms and legs, simple procedures such as curettage and electrodesiccation are sufficient.

If {the} lesions occur on {the} face, a special surgical procedure known as Mohs surgery is performed. Here, {the} entire keratoacanthoma is removed along with {the} surrounding skin margins in order to prevent it from recurring.

In {the} event that multiple keratoacanthomas develop on {the} skin, surgical options might not be appropriate and using drugs such as isotretinoin are useful. Steroids and other special medication such as methotrexate and bleomycin have been used with a degree of success. Treatment is best offered by expert dermatologists who have managed patients would keratoacanthomas in {the} past. The input of a plastic surgeon might be required.

Unfortunately, patients who suffer a keratoacanthoma can experience recurrences despite adequate medical and surgical therapies.

Conclusion

A keratoacanthoma is a low-grade skin tumour that can be localised or spread all across {the} body. Treatments are variable and depend upon {the} site and number of {the} tumours. Long-term outcomes are good though recurrence rates are high.