Intralesional chemotherapy for nonmelanoma skin cancer: A practical review

Eruptive keratoacanthomas after radiation therapy for keratoacanthoma centrifugum marginatum

“…In this clinical scenario, a reasonable treatment approach for the eruptive keratoacanthomas is acitretin combined with intralesional chemotherapy. This treatment combination has been successful in multiple patients, [3][4][5][6] including the present case. …”

“…2,3 We report a patient with a history of multiple keratoacanthomas not associated with Ferguson-Smith disease who underwent radiation treatment for a large KCM. The primary tumor resolved completely, but the patient subsequently erupted with multiple keratoacanthomas within the well-defined field of radiation treatment.…”

Pancytopenia, mucositis, and hepatotoxicity after intralesional methotrexate injection in a patient treated with peritoneal dialysis

“…5 Although used clinically for squamous cell carcinoma of the skin, there is little published evidence to support its use for this indication. 4,10 Methotrexate toxicity seems to be more common in patients with renal impairment, despite the low doses used intralesionally. Goebeler et al 11 reported pancytopenia, stomatitis, and bleeding in a 69-year-old man who was receiving hemodialysis and was treated with methotrexate 12.5 mg intralesionally for keratoacanthoma of the nose.…”

“…2012; 69:578-82ion are limited to case reports and case series [3][4][5]. Furthermore, little is known about the removal of methotrexate by peritoneal dialysis 6.…”

Keratoacanthoma – Non surgical treatment modalities

“…Alternative therapies include electrodessication and curettage, intralesional pharmacologic therapy, ionizing radiation, and topical agents, but all these lack the histopathologic confirmation of the tumor. Intralesional therapy with 5-FU (50 mg/mL) is administered on a weekly basis for three to eight treatment sessions [6]. Intralesional injection of 1 mL of methotrexate in a concentration of 12.5 or 25 mg/ml every two to three weeks for one to four treatment sessions.…”