Keratoacanthoma

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Keratoacanthoma is clinically worrisome lesion that classically arise on the nose. It is abbreviated KA.

General

Clinical

  • May grow rapidly (weeks or months) then involute.
  • Main DDx is squamous cell carcinoma.
  • Exophytic lesion, well-circumscribed.

Gross

  • Raised dome-like lesions with a central crater-like defect.

Microscopic

Features:[2]

  • Expansion of stratum spinosum - pushing tongue-like downward growth of epidermis into the dermis.
  • Keratin collection ("keratin plug") at the center of lesion-superficial aspect.
  • Cells have glassy pink cytoplasm.
  • Minimal/no nuclear atypia.

Note:

  • Classically described as a "volcano lesion" with pale pink cells.
  • May have features of regression - PMNs, fibrosis (???).

DDx:[3]

Image

See also

References

  1. Mandrell JC, Santa Cruz D (August 2009). "Keratoacanthoma: hyperplasia, benign neoplasm, or a type of squamous cell carcinoma?". Semin Diagn Pathol 26 (3): 150–63. PMID 20043514.
  2. Klatt, Edward C. (2006). Robbins and Cotran Atlas of Pathology (1st ed.). Saunders. pp. 378. ISBN 978-1416002741.
  3. Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 379. ISBN 978-0443066542.