Overview
Keratoacanthoma (KA) is a common, rapidly growing, low-grade squamous cell carcinoma that typically presents as a dome-shaped nodule with a central keratin plug 1. While most KAs are benign and resolve spontaneously, a subset can exhibit aggressive behavior, invade locally, metastasize, or arise in the context of pre-existing skin conditions with malignant potential 1.Diagnosis
Rapidly growing, dome-shaped nodule with a central keratin plug 1.
Histopathological examination is crucial for definitive diagnosis and to rule out invasive squamous cell carcinoma 1.Management
Surgical excision is the primary treatment for most keratoacanthomas 1.
Other treatment modalities include intralesional chemotherapy, radiation therapy, and topical agents, particularly for larger or recurrent lesions 1.
For porokeratosis ptychotropica with suspected malignant transformation, topical lovastatin/cholesterol cream has shown promise 1.Key Recommendations
Surgical excision is the primary treatment for keratoacanthoma 1. (Evidence: Expert opinion)
Long-term surveillance is recommended for patients with porokeratosis ptychotropica due to the risk of malignant transformation 1. (Evidence: Expert opinion)References
1 Loh CH, Tan CL, Tan KB, Sudhoff H, Goon P. Malignant Transformation in Porokeratosis Ptychotropica: A Systematic Review. Acta dermato-venereologica 2024. link