Browse > Article

KERATOACANTHOMA ON FACIAL SKIN : CASE REPORT  

Kang, Hee-In (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym University)
Lee, Won-Hak (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym University)
Oh, Hae-Soo (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym University)
Kim, Dong-Suk (Department of Oral & Maxillofacial Surgery, College of Medicine, Hallym University)
Kim, Sang-Joong (Department of Oral & Maxillofacial Surgery, Daejeon Sun Hospital)
Publication Information
Maxillofacial Plastic and Reconstructive Surgery / v.27, no.6, 2005 , pp. 570-574 More about this Journal
Abstract
Keratoacanthoma is a benign, self-limited epithelial lesion that closely resembles Squamous cell carcinoma(SCC). Keratoacanthoma occur primarily exposed skin in male patients over 45 years of ages. although etiology is unknown, sunlight, genetic, and human papillomavirus factor have been considered. in clinical feature, rapid enlargement occurs over 4$\sim$8 weeks, resulting ultimately in a hemispheric, firm, elevated, asymptomatic nodule that contains a central plug of keratin. When fully developed, the keratoacanthoma contains a core of keratin surrounded by a concentric collar of raised skin. Over the next 4$\sim$8 weeks, static lesion persists. Then undergoes spontaneous regression over the next 6$\sim$8weeks period by expulsion of the keratin core with resorption of the mass. In histologic feature, Keratoacanthoma consists of hyperplastic squamous epithelium growing into the underlying connective tissue. The surface is covered by a thickened layer of parakeratin with central plugging. Epithelium cell shows dysplastic features and the margins the normal adjacent epithelium is elevated. The differential diagnosis includes SCC. Keratoacanthoma present as a exophytic lesion with horny keratin occupying a depression on the top of the lesion, persists static period and undergoes rapid growth compared with SCC. Keratoacanthoma is usually treated by surgical excision or curettage of the base, spontaneous regression does not occur in every case. A 60 years old male who present facial lesion visit our hospital and surgical excision was done. Biopsy result was keratoacanthoma. We report case with review of literatures.
Keywords
Keratoacanthoma; Squamous cell carcinoma; Spontaneous regression; Surgical excision;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Roth A.M : Solitary Keratoacanthoma of the conjunctiva. Am J Opththalmol 85 : 647, 1978   DOI
2 Kern WH, McCray MK : The histopathologic differentiation of keratoacanthoma and sqamous cell carcinoma of the skin. J Cutaneous pathol 7 : 318, 1980   DOI   ScienceOn
3 H. Clifton, Patterson : Facial keratoacanthoma. Am Academy Otolaryngology- Head and Neck Surgery, p17, 1982
4 Moon DC, Hyun MK, Kwon KS et al : Involucrin expression in Epidermal Tumors. Korean J Dermatol 27 : 145, 1989
5 Moschella SH, Hurley HJ : Dermatology, 3rd ed. philadelphia, WB. Snunders Co, 1992, p1728
6 Kopf AW, Bart RS : Giant keratoacanthoma. J Dermatol Surg Oncol 4 : 444, 1978   DOI   PUBMED
7 Azaz B, Lustmann : J. Keratoacanthoma of the lower lip. Oral Surg 38 : 53, 1980
8 Sagol O, Kurtoglu B, Ozer E, et al. : Stereological estimation of mean nuclear volume and staining pattern of Ki-67 antigen in Keratoacanthomas and squamous cell carcinomas. Gen Diagn Pathol 143 : 305, 1998   PUBMED
9 May Kenneth. P, Jesunas, MC Keratoacanthoma : Facial lesion requiring southern medical J 68 : 1116, 1975   DOI   ScienceOn
10 Klein E, Helm F, Milgron H, et al : Keratoacanthoma: Local effect of 5-fluorouracil. Skin 1 : 153, 1962   PUBMED
11 Kim HC, Jang MS, Chae YS et al : bcl-2 expression in Basal cell carcinoma, Squamous ce11 carcinoma, Keratoacanthoma, and Trichoepithelioma. Korean J Dermatol 34 : 793, 1996
12 Forslund O, Ly H, Higgins G : Improved detection of cutaeneous human papillomavirus DNA by single tube nested hanging droplet PCR. J Virol Methods 110 : 129, 2003   DOI   ScienceOn
13 Kwon KS, Lee HT, Chung TA et al : Immunohistochemical study on expression of Transforming Growth Factor-betas in Keratoacanthoma and Squamous cell carcinoma. Korean J Dermatol 35 : 863, 1997
14 Ho T, Horn T, Finzi E : Transforming growth factor alpha expression helps to distinguish Keratoacanthomas from Squamous ce11 carcinomas. Arch Dermatol 127 : 1167, 1991   DOI   ScienceOn
15 Lee MR, Won YH, Lee SC et al : Treatment of Keratoacanthoma by 5-Fluorouracil intralesional injection. Korean J Dermatol 33 : 401, 1995
16 Hutchinson J : The crateriform ulcer of the face: A form of epithelial cancer. Trans Pathol. Soc London 40 : 275, 1889
17 Philip S, Lewis R, George P : Contemporary oral and maxillofacial pathology, 1st ed, USA, Mosby, 1997, p.159
18 Smoller BR, Kwan TH, Said JW et al : Keratoacanthomas and Squamous cell carcinoma of the skin : Immunohistochemical localization of involucrin and keratin proteins. J Am Acad Dermatol 14 : 226, 1986   DOI   ScienceOn
19 Forslund O, DeAngeles PM, Beigi M et al : Identification of human papillomavirus in keratoacanthomas. J Cutan Pathol 30 : 423, 2003   DOI   ScienceOn
20 Kwon KS, Park SM, Moon DC et al : The significance of Lectin(PCA) in the Differentiation between Keratoacanthoma and Squamous ce11 carcinoma. Department of Dematology, College of Medicine Pusan National University. 28 : 239, 1988
21 Melton JL, Nelson BR, Stough DB et al : Treatment of keratoacanthomas with intralesional methotrexate. J Am Dermatol 25 : 1017, 1991   DOI   ScienceOn
22 Neville D, Allen B : Oral and maxillofacial pathology, 1st ed, USA, WB Saunders, 1995, p.270
23 Rook A, Whimster I : Keratoacanthoma : a thirty-year retrospect. Br J Dermatol 100 : 41, 1979   DOI   ScienceOn
24 Champion RH, Burton JL, Burns DA et al : Textbook of dermatology, 6th ed. Blackwell science, 1998, p1662
25 Schwartz RA : Keratoacanthoma. J Am Acad Dermatol 30 : 1, 1994   DOI   PUBMED   ScienceOn
26 Ghadially F, Barton B, Kerridge D : The etiology of keratoacanthoma. Cancer 16 : 603, 1963   DOI   PUBMED   ScienceOn
27 Elder D, Elenitsas R, Jaworsky C et al : Histopathology of the skin. 8th ed. Philadelphia, Lippincott-Raven, 1997, p731
28 Azaz B, Lustmann : J. Keratoacanthoma of the lower lip. Oral Surg 38 : 918, 1974   DOI   ScienceOn
29 Popkin GL, Brodie SJ, Hyman AB et al : A technique of biopsy recommended for Keratoacanthoma Arch. Dermatol 94 : 191, 1966   DOI   ScienceOn
30 Kerschmann RL, McCalmont TH, Leboit PE : p53 oncoprotein expression and proliferation index in keratoacanthoma and squamous cell carcinoma. Arch Dermatol 130 : 181, 1992
31 Ghadially R, Ghadially FN : Keratoacanthoma. In : Freedberg IM, Eisen AZ, Wolff K, Goldsmith LA, Katz SI, Fitzpatrick TB, et al. Fitzpatrick's dermatology in general medicine. 5th ed. New York, McGraw-Hill, 1999, p865
32 Linell F, Mansson B : Mollusccum pseudocarcinomatosum. Acta Radiol 48 : 123, 1957   DOI   ScienceOn
33 Cobb MW pellegrini AE : Sqamous cell carcinoma following fluorouracil-responsive keratoacanthoma. Arch Dermatol 123 : 987, 1987   DOI   ScienceOn
34 Kannon G, Park HK : Utility of peanut agglutinin(PNA) in the diagnosis of squamous cell carcinoma and keratoacanthoma. Am J Dermatopathol 12 : 31, 1990   DOI   PUBMED   ScienceOn
35 Zigarelli D : Solitary intra-oral Keratoacanthoma Oral Surg 40 : 785, 1975   DOI   ScienceOn
36 Grinspan D, Abulafia J : Idiopathic cutaneous pseudoepitheliomatous hyperplasia, verrugoma (Gougerot), molluscum sebaceum (MacCormac and Scarff), self-healing, primary, squamous-cell epithelioma (Ferguson Smith), and keratoacanthoma (Rook and Whimster). Cancer 8 : 1047, 1955   DOI   PUBMED   ScienceOn
37 Smoller BR, Kwan TH, Said JW et al : Keratoacanthoma and squamous cell carcinoma of the skin: Immunohistochemical localization of involucrin and keratin proteins. J Am Acad Dermatol 14 : 226. 1986   DOI   ScienceOn