Multiple Persistent Keratoacanthomas

Abstract

A unique case of multiple keratoacanthomas is described, with involvement of the face and lower extremities with persistent lesions clinically and histologically diagnostic of keratoacanthomas. The lower extremity lesions appear as giant keratoacanthomas, with evolution into a distinctive confluent plaque. This important tumor and its present classification are reviewed.

Keratoacanthoma: A Clinico-Pathologic Enigma

“…The KA tends to be solitary but occasionally may be multiple (Figures 1 and 2). 1,20 Unusual variants include an agglomerated form, 21 an enlarging type up to 20 cm in diameter (KA centrifugum), 22 a giant KA up to 9 cm or larger, 23,24 a subungual KA, 17,25 intraoral and other mucous membrane KAs, 26 multiple eruptive KAs of Ferguson Smith type, 9,19,27 multiple familial KAs of Witten and Zak, 28 multiple persistent KAs (Figure 2), 29 generalized eruptive KAs of Grzybowski type with thousands of tiny disseminated 2-to 3-mm KAs present, 3,10,11 plate-shaped KA, 30 and KA in special situations: Muir-Torre syndrome, 31 xeroderma pigmentosum, 32 florid cutaneous papillomatosis, 33 nevus sebaceous of Jadassohn, 34,35 pseudorecidive KA, 36,37 reactive KAs, [38][39][40][41][42] occupational (chemical induced-mainly tar) KAs, 20 and KAs in immunosuppressed patients. 43,44 The KA evolves in three clinical stages: proliferative, mature, and resolving 1,19,45 (Figures 1 and 2).…”

Hypertrophic Lichen Planus–Like Reactions Combined With Infundibulocystic Hyperplasia

“…The clinical presentation of the plaque in patient 1 shares features with keratoacanthoma marginatum centrifugum, 21,22 and in patient 3, the confluent verrucous keratotic plaque over the graft may be compared with keratoacanthoma en plaque. 23,24 These are unusual keratoacanthomas, often associated with a progressive history, and they may not readily involute. This pattern differs from that of classic keratoacanthoma.…”

The keratoacanthoma: A review

“…4) [lo] . As noted by Reid and Cheesbrough [ l l ] and others [12] in presenting distinctive patients with multiple KAs, the classification for multiple KAs leaves room for improvement. a number of recognized special morphologic or syndromic types: form a large plaque [S] .…”