Multiple Giant Keratoacanthoma Treated with Acitretin / 대한피부과학회지

Giant keratoacanthoma is an uncommon variant of keratoacanthoma, which may increase to a diameter of several centimeters. Although keratoacanthomas usually resolve spontaneously, giant keratoacanthoma can be invasive and destructive. A 49-year-old man presented with a 5-year history of multiple large hyperkeratotic and crusted plaques and nodules on sun-exposed areas such as the face, ear, hand, and forearm. Some lesions involuted spontaneously, whereas others became rather enlarged. The biopsy specimen revealed horn-filled crater formation, epidermal extending resembling a buttress, and an eosinophilic glassy appearance in the keratinocytic cytoplasm. We treated the lesions with acitretin, and they almost completely resolved after 13 weeks. Here we describe a case of multiple giant keratoacanthoma treated with acitretin.

Two Cases of Giant Keratoacanthoma Treated with Intralesional Methotrexate / 대한피부과학회지

Keratoacanthoma is a rapidly-growing tumor, which histologically resembles squamous cell carcinoma. Although it may regress spontaneously, keratoacanthoma is routinely treated by excision. Although excisional surgery is the treatment of choice, this can result in functional and cosmetic defects when large or strategically located lesions are treated. An effective nonsurgical treatment would be desirable in such cases. We report two cases of giant keratoacanthoma treated with intralesional methotrexate. Each case showed complete resolutions over 6 injections within 10 weeks. No recurrence occurred during the followup period. We suggest that intralesional injection of methotrexate is an effective and non-operative modality for the treatment of giant keratoacanthoma.

A Case of Giant Keratoacanthoma

A 63-year-old man had a huge verrucous protruding mass over the suprasternal area. The lesion enlarged rapidly over 3 mooths, and measured about 10×8 cm. The histologic finding of the biopsy specimen showed nests of squamous epithelium with central keratinization, infiltrating the dermis. The neoplasm was treated successfully with surgical excision.