Keratoacanthoma is a benign epithelial tumor with favorable evolution which poses a considerable problem of differential diagnosis with squamous cell carcinoma. we report the case of a patient who presented an unusual location of this tumor, causing an essentially diagnostic and aesthetic problem, it is a large keratoacanthoma taking the central part of the lower lip which appeared two months previously and increasing in size suddenly and which required surgical, diagnostic and therapeutic ablation in order to eliminate the risk of squamous cell carcinoma in situ. postoperative treatment was simple but at the cost of a visible scar that can be improved by a combination of aesthetic techniques.