Peer Reviewed

Dermclinic

How Would You Diagnose This Man’s Lesion?

David L. Kaplan, MD—Series Editor 

Author:
David L. Kaplan, MD—Series Editor

Citation:
Kaplan DL. How would you diagnose this man’s lesion? Consultant. 2018;58(2):65-66.

 

This 88-year-old man presented for evaluation of a lesion on his right pinna that had grown rapidly over the past several weeks. There was no history of trauma, and the patient absolutely insists that he does not want a biopsy or any surgical procedure.

Keratoacanthoma

Keratoacanthoma

 

 

 

 

 

Answer: Keratoacanthoma

Keratoacanthoma

Keratoacanthoma

Keratoacanthoma

Keratoacanthoma

The patient returned 8 weeks later, and the lesion on his ear had regressed spontaneously without any treatment.

Keratoacanthoma is a relatively common low-grade tumor that closely resembles squamous cell carcinoma (SCC). While some authors support classifying keratoacanthoma as a variant of invasive SCC, others believe that keratoacanthoma is a separate entity, based on certain clinical features.1,2

Keratoacanthoma is characterized by rapid growth over a few weeks to months, typically followed by spontaneous resolution over 4 to 6 months in most cases. 

Because keratoacanthoma may progress to invasive or metastatic carcinoma in rare cases, most authors recommend if not insist on surgical excision to prevent malignant transformation and for medicolegal reasons. 

David L. Kaplan, MD, is a clinical assistant professor of dermatology at the University of Missouri–Kansas City School of Medicine in Kansas City, Missouri, and at the University of Kansas School of Medicine in Kansas City, Kansas. He practices adult and pediatric dermatology in Overland Park, Kansas.

References:
  1. Griffiths RW. Keratoacanthoma observed. Br J Plast Surg. 2004;​57(6):485-501.
  2. Ramos LMA, Cardoso SV, Loyola AM, Rocha MA, Durighetto AF Jr. Keratoacanthoma of the inferior lip: review and report of case with spontaneous regression. J Appl Oral Sci. 2009;17(3):262-265.