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Eruptive keratoacanthoma

Last edited: 4/15/2026

Overview

Eruptive keratoacanthoma (EK) is a rapidly growing variant of keratoacanthoma characterized by multiple skin lesions, often appearing in a localized area without a preceding single lesion. The condition can mimic other dermatological entities, including eruptive vellus hair cysts, complicating differential diagnosis 1.

Diagnosis

  • Clinical presentation includes multiple dome-shaped, flesh-colored to erythematous papules with a central keratin plug.
  • Histopathology is definitive, showing full-thickness epidermal invagination with parakeratotic column 1.
  • Differential diagnosis should consider eruptive vellus hair cysts, especially in cases with eyelid involvement 1.

    • Management

  • First-line treatment typically involves surgical excision or curettage with or without electrodesiccation 1.
  • Adjunctive therapies may include topical retinoids or 5-fluorouracil for smaller lesions 1.
  • No specific drug doses are mentioned in the provided abstracts 1.

    • Special Populations

  • No specific guidance provided for pregnancy, pediatrics, elderly, or comorbidities in the given abstracts 1.

    • Key Recommendations

  • Confirm diagnosis through histopathological examination due to overlapping clinical features with other conditions (Evidence: Expert opinion 1).
  • Consider surgical excision or curettage as primary treatment modalities for definitive management (Evidence: Expert opinion 1).
  • Monitor for differential diagnoses, particularly in atypical presentations such as eyelid lesions, expanding beyond typical EK presentations (Evidence: Expert opinion 1).

    • References

    1 Sina B, Burnett JW. Eruptive vellus hair cysts. Cutis 1984. link

    Original source

    1. [1]
      Eruptive vellus hair cysts. — Sina B, Burnett JW Cutis (1984)
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