Patient and Tumour Characteristics of Keratoacanthoma in a Large, Community-based Cohort Study from Queensland, Australia

Abstract

Keratoacanthomas are common keratinocyte skin tumours. However, there is little community-based data published on the clinical features of keratoacanthoma. The aim of this study was to describe the patient and tumour characteristics of keratoacanthomas, as well as their treatment patterns. Data were obtained from the QSkin Sun and Health study, a prospective cohort of 40,438 randomly sampled and consented participants aged 40–69 years in Queensland, Australia. In 2010, a baseline survey collected data, including demography, phenotype, ultraviolet radiation exposure, medical history and lifestyle. Histopathological reports of keratoacanthomas arising until 30 June 2014 were reviewed. In total, 584 participants developed 738 keratoacanthomas; 18% of participants developed multiple tumours. Common patient characteristics were male sex (58%), age ≥ 60 years (76%), fair skin (80%), and previous history of actinic keratoses/keratinocyte cancers (89%). Keratoacanthomas were commonly located on the legs/feet (48%), and rarely on the the head/neck (7%). Excision was the most frequently used surgical method (71%) Evidence of histopathological regression was reported in 67% of keratoacanthomas, suggesting a potential for spontaneous resolution in a significant proportion of keratoacanthomas.

Computer Image Analysis Reveals C-Myc as a Potential Biomarker for Discriminating between Keratoacanthoma and Cutaneous Squamous Cell Carcinoma

“…However, genomic differences, prognosis, and metastasis rates that exist between KA and cSCC suggest that these two conditions do not belong to the same category [3][4][5]. Moreover, reports showing a high incidence of KA (409/ 100,000 person-years) concentrated among residents of Queensland, Australia [6] also suggest that notable differences are present between KA and cSCC. Alternatively, such findings may likely grossly underestimate the incidence of KA due to the misclassification of these lesions as welldifferentiated cSCC, underreporting, and/or spontaneous regression of KA prior to diagnosis.…”

Surgical excision of a giant solitary keratoacanthoma in the cheek: a case report and literature review

“…In the recent World Health Organization (WHO) classification of cutaneous tumors, keratoacanthoma was classified as a low-grade SCC, suggesting that it is biologically stable and that some keratoacanthomas evolve into conventional SCCs with a gradual loss of capacity for spontaneous regression ( 6 ). Individuals with keratoacanthoma are most likely to be men aged ≥60 years ( 7 ).…”

“…The origin of keratoacanthoma has not been completely elucidated; however, causative factors include immunosuppression, ultraviolet (UV) or X-ray exposure, drug treatments, foreign bodies, various traumas ( 5 ), and human papillomavirus DNA. Male sex, older age, smoking, and alcohol consumption have been reported to be hazardous variables ( 7 ).…”

A Comment on: “Patient and Tumour Characteristics of Keratoacanthoma in a Large, Community-based Cohort Study from Queensland, Australia”

“…We read with interest the article by Kolmodin and colleagues ( 1 ), which raises some interesting issues. The authors state “Importantly, this study found a high proportion of histologically regressing tumours, indicating that spontaneous resolution of KA may be common.” We find this statement confusing.…”

“…We are grateful for the comments from Mazzoni & Muir on our article ( 1 ) on the occurrence of keratoacanthoma (KA) in Queensland, Australia. We concur with their input and appreciate their contribution.…”