A case of Grzybowski's generalized eruptive keratoacanthomas

Abstract

We report a case of Grzybowski's generalized eruptive keratoacanthoma which demonstrates the characteristic features of this rare condition. The recurring nature of the eruption each summer supports the suggestion that UV irradiation may act as a precipitating factor in eruptive keratoacanthoma.

Multiple Keratoacanthomas Arising Post-UVB Therapy

“…As well, less pronounced crater formation is commonly described in smaller lesions of multiple KA. 15 Well-differentiated SCC was the main entity that we considered in the differential diagnosis. KA can sometimes be impossible to differentiate from SCC histologically.…”

“…Arguments for the involvement of UV radiation in multiple KA development include the observation that most of the lesions of eruptive KA develop on sun-exposed areas, a case (described above) of multiple KA after sunburn, 23 a case of initiation and exacerbation of multiple KA during the summer months with resolution during the winter, 15 and occurrence of multiple KA in xeroderma pigmentosum. 24,25 It is a distinct possibility that our patient's long-term exposure to UVB radiation was a major causal factor in the development of multiple KAs.…”

“…Although individual KAs resolve spontaneously within 6-8 months, the eruption usually follows a chronic and progressive course that is recalcitrant to treatment. 11,13,15,16 The multiple persistent variant of KA is characterized by the appearance in an adult of a few to ten relatively large KAs which are slow healing.…”

Generalized eruptive keratoacanthomas of Grzybowski

“…Smaller lesions exhibit less crater formation and might be mistaken for pseudoepitheliomatous hyperplasia or welldifferentiated squamous cell carcinoma. 8 Muir-Torre syndrome, a condition that can include the presence of multiple persistent keratoacanthomas, may also be considered in the differential diagnosis of keratoacanthomas of Grzybowski. 2 Muir-Torre syndrome is an autosomal dominant genodermatosis of malignant potential characterized by the development of sebaceous neoplasms associated with a visceral malignancy.…”

Eruptive Keratoacanthoma of Grzybowski

“…Течение длительное, рецидивиру-ющее. Отдельные кератоакантомы разрешают-ся спонтанно в течение полугода [9], на их месте остаются атрофические рубцы.…”