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Dermatology6 papers

Keratoacanthoma of skin

Last edited: 4/15/2026

Overview

Keratoacanthoma is a rapidly growing, dome-shaped skin lesion characterized by a central keratin plug, often resembling squamous cell carcinoma but with a more benign clinical course. It typically arises on sun-exposed areas and can occur as solitary or multiple lesions 1.

Diagnosis

  • Clinical appearance with a central keratin plug and rolled, elevated borders
  • Histopathological examination confirms the diagnosis, showing full-thickness keratinocytic atypia without dermal invasion
  • Differential diagnosis includes squamous cell carcinoma; biopsy is essential for distinction 1

    • Management

  • Primary treatment: Surgical excision or curettage with electrodesiccation 1
  • Adjunctive treatments: Cryotherapy or topical retinoids for smaller lesions 1
  • Monitoring: Regular follow-up to ensure complete removal and rule out recurrence 1

    • Special Populations

  • Phototoxicity risk: Patients undergoing PUVA therapy may be at increased risk for multiple keratoacanthomas, especially with excessive dosing 1

    • Key Recommendations

  • Avoid excessive PUVA dosing to minimize the risk of keratoacanthoma development (Evidence: Expert opinion) 1
  • Confirm diagnosis through histopathological examination to differentiate from squamous cell carcinoma (Evidence: Moderate) 1
  • Employ surgical excision or curettage with electrodesiccation as first-line treatment (Evidence: Expert opinion) 1

    • References

    1 Sina B, Adrian RM. Multiple keratoacanthomas possibly induced by psoralens and ultraviolet A photochemotherapy. Journal of the American Academy of Dermatology 1983. link70181-7)

    Original source

    1. [1]
      Multiple keratoacanthomas possibly induced by psoralens and ultraviolet A photochemotherapy. — Sina B, Adrian RM Journal of the American Academy of Dermatology (1983)
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