Keratoacanthoma Clinical Behavior

Savage, Jacqueline; Maize, John C.

doi:10.1097/dad.0000000000000031

Cited by 66 publications

(72 citation statements)

References 107 publications

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“…[11][12][13][14] In addition, there is a preponderance of evidence that keratoacanthoma and squamous cell carcinoma have distinct clinicopathological features. 1,2,[5][6][7] The differentially expressed genes and enriched molecular biological pathways that separate keratoacanthoma from normal skin suggest that keratoacanthoma is a neoplasm that may regress due to upregulation in the cell death/apoptosis pathway. Furthermore, we believe that actinic keratoacanthomas should be treated conservatively and hope that our findings will help prevent radical treatments including wide excision, radiotherapy, and neck dissection for this benign involuting squamous neoplasm.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Others believe that keratoacanthoma is a distinct selfresolving benign squamoproliferative lesion. 1,2,[5][6][7] To investigate the relationship of keratoacanthoma to squamous cell carcinoma and normal skin, we analyzed the gene expression profile of over 47 000 genes using one of the most comprehensive GeneChip microarrays available (human U133 plus 2.0 array) to study differential gene expression between keratoacanthoma and squamous cell carcinoma and keratoacanthoma and normal skin in formalin-fixed and paraffin-embedded tissue.…”

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confidence: 99%

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Keratoacanthoma and squamous cell carcinoma are distinct from a molecular perspective

Seong

et al. 2015

Modern Pathology

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Keratoacanthoma is a controversial entity. Some consider keratoacanthoma as a variant of squamous cell carcinoma, whereas others see it as a distinct self-resolving squamoproliferative lesion. Our objective is to examine the relationship of keratoacanthoma with squamous cell carcinoma and normal skin by using DNA microarrays. DNA microarray studies were performed on formalin-fixed and paraffin-embedded blocks from ten cases of actinic keratoacanthoma utilizing the U133plus2.0 array. These results were compared with our previously developed microarray database of ten squamous cell carcinoma and ten normal skin samples. Keratoacanthoma demonstrated 1449 differentially expressed genes in comparison with squamous cell carcinoma (45-fold change: Po0.01) with 908 genes upregulated and 541 genes downregulated. Keratoacanthoma showed 2435 differentially expressed genes in comparison with normal skin (45-fold change: Po0.01) with 1085 genes upregulated and 1350 genes downregulated. The most upregulated genes, comparing keratoacanthoma with normal skin included MALAT1, S100A8, CDR1, TPM4, and CALM1. The most downregulated genes included SCGB2A2, DCD, THRSP, ADIPOQ, adiponectin, and ADH1B. The molecular biological pathway analysis comparing keratoacanthoma with normal skin showed that cellular development, cellular growth and proliferation, cell death/apoptosis, and cell cycle pathways are prominently involved in the pathogenesis of keratoacanthoma. The most enriched canonical pathways were clathrin-mediated endocytosis signaling, molecular mechanisms of cancer and integrin signaling. The distinctive gene expression profile of keratoacanthoma reveals that it is molecularly distinct from squamous cell carcinoma. The molecular pathways and genes differentially expressed in comparing keratoacanthoma with normal skin suggest that keratoacanthoma is a neoplasm that can regress due to upregulation of the cell death/apoptosis pathway.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Keratoacanthoma and squamous cell carcinoma are distinct from a molecular perspective

Seong

et al. 2015

Modern Pathology

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“…argues strongly for the benign nature of the lesions, citing that of 445 cases studied over time, zero cases of metastasis were reported and no deaths occurred at the hand of the disease. To the contrary, 5.6% of SCCs directly resulted in death [8].…”

Section: Discussionmentioning

confidence: 99%

Eruptive Keratoacanthomas within a Red Ink Tattoo: A Case Report

Healey¹,

Galbraith²,

Sammour³

et al. 2018

CRCM

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Background: There has been a longstanding debate regarding whether keratoacanthomas (KAs) are neoplastic or reactive/inflammatory lesions. Aim: The aim of this case report is to, within the aforementioned debate, offer support in favor of the potential reactive nature of keratoacanthomas. Case Presentation: A 64-year-old male presented with an eruption of 25 keratoacanthomas within a red ink tattoo. Eruptions were partially resolved over a matter of months, and completely resolved with treatment using oral Acitretin therapy. We believe this to be the third such reported case of eruptive KAs within only the red ink portions of a tattoo. Prior cases involved 2 and 8 KAs each. Discussion: Multiple studies suggest that KAs are neoplastic in nature and very distinct from cutaneous squamous cell carcinoma. Especially interesting is the finding that KAs have increased expression of apoptotic genes; this is particularly notable because of the tendency for these lesions to spontaneously involute. Skin tumorigenesis can occur in predisposed individuals after carcinogen exposure, thus red ink possesses theoretical potential as a carcinogen. KAs could be seen in this case as in fact a reactive neoplasm.

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“…As far as clinical behavior of KA is concerned, only extremely rare cases of metastatic KAs were reported in the literature and a recent meta-analysis on the subject concluded that, when classified with certainty, KAs have a benign, self limited clinical course 26 . However, cSCC can definitely arise from KAs 27 and often it is very difficult to make a certain distinction between the two.…”

Section: Keratoacanthomamentioning

confidence: 99%