Keratoacanthoma Clinical Presentation

Updated: Jul 25, 2018
  • Author: Tsu-Yi Chuang, MD, MPH, FAAD; Chief Editor: William D James, MD  more...
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Presentation

History

Keratoacanthoma (KA) typically grows rapidly, attaining 1-2 cm within weeks, followed by a slow involution period lasting up to 1 year and leaving a residual scar if not excised preemptively. Since expedient therapy almost always is instituted, the true natural course of the tumor cannot be confirmed with certainty.

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Physical Examination

Pertinent physical findings in keratoacanthoma (KA) are limited to the skin. Lesions typically are solitary and begin as firm, roundish, skin-colored or reddish papules that rapidly progress to dome-shaped nodules with a smooth shiny surface and a central crateriform ulceration or keratin plug that may project like a horn. Most keratoacanthomas occur on sun-exposed areas. The face, neck, and dorsum of the upper extremities are common sites. Truncal lesions are rare. Lesions usually are skin-colored to pinkish-red. Unaffected skin retains its normal appearance. Note the images below.

Keratoacanthoma (squamous cell carcinoma-keratoaca Keratoacanthoma (squamous cell carcinoma-keratoacanthoma or SCC-KA type) on inner canthus.
Keratoacanthoma of the left forehead. Keratoacanthoma of the left forehead.
Close-up view of the keratoacanthoma. Close-up view of the keratoacanthoma.
Keratoacanthoma lesion (squamous cell carcinoma-ke Keratoacanthoma lesion (squamous cell carcinoma-keratoacanthoma or SCC-KA type).
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