Efficacy of electrochemotherapy for eruptive legs keratoacanthomas

Abstract

Generalized eruptive keratoacanthoma, is considered a serious condition because the eruptions are diffuse, persistent, and recurrent. Constant pruritus, visceral neoplasms, and unsatisfactory response to treatment are ominous prognostic factors. Even if skin cancers are usually well controlled with surgical and/or radiotherapic approaches, there are some cases in which these two techniques are not effective. With respect to surgery, radiotherapy and other standard treatments, ECT acts rapidly on multiple lesions with limited side effects and no functional impairment; moreover, repeated sessions can be performed to achieve or maintain the clinical response. We report a case of generalized eruptive keratoacanthomas in which electrochemotherapy was effective in inducing local regression of skin lesions. A 72-year-old woman with eruptive and painful keratoacanthomas for 3 months on both the lower limbs in which the conventional treatments could not be cosmetically acceptable. One session of electrochemotherapy with bleomycin sulfate was then performed on all isolated skin lesions. The treatment was well tolerated and led to a rapid clinical regression of the treated lesions. Use of ECT should be considered as an excellent alternative to current therapies in treatment of painful eruptive keratoacanthomas with a significant improvement of quality of life.

Successful Treatment of a Keratoacanthoma with Electrochemotherapy: A Case Report

“…ECT has been shown in clinical trials to have a high response rate in the treatment of patients with primary or metastatic skin cancers [ 8 ]. Interestingly, ECT has been already successfully used to treat eruptive KAs [ 12 ]. In the case presented here, the patient showed an excellent response to the ECT treatment and at the moment of writing this report is well.…”

Research gaps in the management and prevention of cutaneous squamous cell carcinoma in organ transplant recipients

“…Management can be challenging and evidence‐based treatment guidelines are lacking. Multiple off‐label options aimed at managing ulceration and destruction have been reported, including topical 5‐fluorouracil (5‐FU) and imiquimod, as well as intralesional 5‐FU, methotrexate and bleomycin, for which safety in OTR has not been determined . Topical 5‐FU under zinc oxide‐impregnated compression bandages (chemowraps) can be an effective treatment option .…”

Generalized eruptive keratoacanthoma with vitiligo followed by the development of prurigo nodularis: A case report and published work review

“…Topical therapies include intralesional injection (5-fluorouracil, bleomycin, corticosteroids, methotrexate), topical use (retinoic acid, podophyllotoxin), operation, cryotherapy, radiation therapy and electrochemical treatment. 15 In the present case, oral acitretin was dramatically effective, while the mechanism was still unclear. Retinoic acid seems to inhibit keratinization, regulate terminal differentiation of epidermal cells and increase both IL-2 production and mitogen-induced lymphocyte proliferation.…”

“…Systemic therapies include: retinoic acid, cytostatic agents (methotrexate, cyclophosphamide, cyclosporine, α/γ‐interferon), epidermal growth factor receptor inhibitor (erlotinib), glucocorticoids and antihistamines. Topical therapies include intralesional injection (5‐fluorouracil, bleomycin, corticosteroids, methotrexate), topical use (retinoic acid, podophyllotoxin), operation, cryotherapy, radiation therapy and electrochemical treatment . In the present case, oral acitretin was dramatically effective, while the mechanism was still unclear.…”