What is Keratoacanthoma?

Keratoacanthoma is a skin tumor that is common that originates in the neck from the hair follicles. It is considered to be a form of squamous cell carcinoma. It is a rapid growing type of skin cancer. It usually occurs in older people. It erupts in sun damaged skin, and can grow for several months, then shrink and resolve itself. It may appear first as a small pimple or boil. It has a solid core that is filled with keratin.  Keratoacanthoma can be related to the infection of the HPV( Human Papilloma Virus), which is the cause of warts. However, the majority of individuals with keratoacanthoma are not found to have HPV.  The most common places to see keratoacanthoma on the body include the center of the face, the ears, forearms, scalp, lower legs (seen more commonly in woman), and the back of the hands.

Those who are at risk for developing keratoacanthoma include the following:

  • Individuals that are over the age of 50, particularly males
  • Individuals that have fair skin, eyes or hair
  • Those who suffer from chronic ulcers
  • Individuals who have had skin cancer previously
  • Those who have long term exposure to sunlight and UV rays
  • Those who have been exposed repeatedly to certain chemicals, such as tar
  • Individuals who have long term presence of scars, such as a gasoline burn
  • Persons who have long term suppression of the immune system
  • Those that have had exposure to radiation for internal cancers
  • Individuals who have the presence of the human papilloma virus

Treatment of keratoacanthoma include any of the following options:

  • Cryotherapy- This treatment involves freezing of the skin tumor. There are many cryogens that are used to freeze the skin, including liquid nitrogen, which is the most commonly used, carbon dioxide snow, and dimethyl ether and propane or DMEP, which is an over the counter agent.  This process is inexpensive, safe and very reliable.
  • Curettage and Cautery- The skin lesion or tumor will be scraped off the skin and then heat will be applied. A local anesthetic will be injected into the area that is being treated. The skin will then be numb so no pain will be felt. A pushing sensation can be felt, but the pain is tolerable.  The skin tumor will then be scraped away with a curette. The wound created will then be cauterised with a hot wire tip to stop the bleeding and destroy any remaining skin tumor cells. Using this method, a scar will be produced.
  • Excision- This method involves cutting the skin lesion or tumor out of the skin. Some sort of scar will be left with this process. An injection will be given to numb the area, then the dermatologist will cut around and under the skin lesion or tumor with sharp scissors and a scalpel. The wound will then be stitched together and a dressing could be applied.
  • Radiotherapy- Radiation will be used to treat the skin tumor. Radiation will target the area to destroy the cells, while trying to keep normal cell damage minimised.

If you have a new lesion form on skin that has been exposed to sun, you will need to see your doctor.  If a spot does not stop bleeding, or does not heal, you should make an appointment as soon as you can with your doctor. Should the spot change colour, size or shape, or starts to itch or become sore to the touch, make an appointment to have the keratoacanthoma examined.  Your doctor will examine the skin and more than likely perform a skin biopsy to make sure there is a proper diagnosis

3 replies
  1. Veronica
    Veronica says:

    If you use a tanning bed, you are also putting yourself at risk for keratoacanthoma. Many just think that it is the UV rays from the sun that are damaging the skin but in reality, tanning beds and booths can also cause this skin disorder. Just thought that I would lay that one on the table, because those lights are just as damaging. And something that everyone needs to keep in mind is that if you have had keratoacanthoma, and have it removed, you are not necessarily in the clear. You must maintain follow ups with your doctor or dermatologist. They will need to periodically examine the skin to make sure that the skin cancer did not come back or that it is not developing in new places. I suffered from keratoacanthoma, and I make sure to exam my skin all the time. I had mine froze off with cryotherapy. If I would happen to see anything unusual, I will have my doctor exam my skin. As far as the cryotherapy goes, I felt that it was the best treatment for me. It was safe and easy and did not hurt me at all.

  2. Mohs surgery
    Mohs surgery says:

    I have suffered from keratoacanthoma. I decided, along with my dermatologist, that the best way for me to remove it, was using Mohs micrographic surgery. This procedure involved taking shavings of the cancer site until it was completely removed. I had it on the nose, so this method worked well for me. It is an outpatient surgery. How this procedure works is they take small sections of the skin, and then test it. They will continue to take skin until no cancer shows up in the testing. I had to have 6 layers of my skin removed before the test came back OK. The area you are having the surgery on will be numbed, and you will be awake for the entire procedure. I spent quite a bit of that day in the doctor’s office, because they test the layer as soon as they take it, but it took about an hour between each layer for the results to come back. I thought that this method worked quite well for me. With Mohs micrographic surgery, there is a very high success rate for the cancer to not return. However, do note that you should be checking the skin to make sure that all is well and nothing new is going on with it.

  3. Juliette JJ
    Juliette JJ says:

    I am very surprised that radiation is used for this as a treatment because one of the causes is radiation. To me that does not make sense, but I guess it is formed from internal radiation, and the skin cancer would be treated with external radiation. I would have to say that possible the best treatment for this would be in my mind the cryotherapy. I would not think that there would be a scar left with that type of treatment.


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