Recurrent Keratoacanthomas Developing after Spontaneous Resolution

Misago, Noriyuki; Koba, S; Narisawa, Yutaka

doi:10.2340/00015555-1561

Cited by 9 publications

(6 citation statements)

References 16 publications

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“…Keratoacanthoma has three stages in terms of its natural history: an early/proliferative stage, a fully developed stage and an involutional (regressing/regressed) stage . A rare fourth stage, the recurrent (renewal) stage, also may be seen . Early/proliferative‐stage KA show keratin‐filled areas of invagination with infundibular differentiation associated with partial large pink cells (isthmic differentiation) .…”

Section: Discussionmentioning

confidence: 99%

Cases with a spontaneous regression of an infiltrating non‐crateriform keratoacanthoma and squamous cell carcinoma with a keratoacanthoma‐like component

Misago

Takai

Murata

et al. 2014

The Journal of Dermatology

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We herein report the natural course of an early/proliferative stage keratoacanthoma (KA) with infiltrating islands of cytological malignancy (case 1) and a squamous cell carcinoma (SCC) with a KA-like component (case 2), which were observed until their complete regression. The presented case 1 suggests that one of the histopathological forms of KA includes this unusual, infiltrating, non-crateriform architecture, and also indicates the possibility of complete remission in the KA associated with infiltrating islands of cytological malignancy. In the presented case 2, the peripherally-associated KA-like focus was histopathologically considered to be either a remnant of KA focus or verrucous keratosis (hyperplasia). Therefore, the complete spontaneous regression of case 2 suggests that SCC arising in KA still has the potential of spontaneous regression, or that an extremely rare event, namely, the spontaneous regression of (traditional) SCC occurred in the present case.

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Section: Discussionmentioning

confidence: 99%

Cases with a spontaneous regression of an infiltrating non‐crateriform keratoacanthoma and squamous cell carcinoma with a keratoacanthoma‐like component

Misago

Takai

Murata

et al. 2014

The Journal of Dermatology

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“…Two lesions out of these regressing/regressed stage lesions were associated with the development of a neighboring early or proliferative stage KA. 39 No cases with multiple KAs were included. All of the lesions were surgically and completely removed.…”

Section: Methodsmentioning

confidence: 99%

The changes in the expression levels of follicular markers in keratoacanthoma depend on the stage: keratoacanthoma is a follicular neoplasm exhibiting infundibular/isthmic differentiation without expression of CK15

et al. 2014

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KA is a follicular neoplasm with infundibular/isthmic (upper segmental region of hair follicles) differentiation. It is considered that early or proliferative stage tumors show keratin-filled invaginations with infundibular differentiation and gradual isthmic differentiation. Well-developed examples of KA generally show isthmic differentiation in the whole lesions. The regressed stage KAs lose the features of this type of follicular differentiation and show epidermal characteristics. No expression of CK15 (clone C8/144B) was observed in KAs, although this finding is insufficient to completely rule out the correlation between the regression of KA and the hair follicle cycle.

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“…[13][14][15][16] It is currently difficult to conclude whether KA is benign or malignant. However, the characteristic clinical evolution in KA, such as their rapid appearance, often in association with various types of antecedent trauma, including tattoos, [17][18][19] as well as self-regression 20,21 suggests that KAs have a separate biological process and belong to a distinct entity from traditional SCCs. The existence of a rare generalized form, such as the Grzybowski type, 22 also supports this view.…”

Section: Introductionmentioning

confidence: 99%

Keratoacanthoma and other types of squamous cell carcinoma with crateriform architecture: Classification and identification

Misago

Inoue

Koba

et al. 2013

The Journal of Dermatology

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The terminology and classification of keratoacanthoma (KA) and other types of squamous cell carcinoma (SCC) with crateriform architecture have not been clarified. The study evaluated the clinicopathological features of 41 nodular (exo-endophytic) SCC lesions with a central keratin-filled crater, including KA (well-developed stage). The lesions were histopathologically classified into six categories: (i) KA (well-developed stage) (27 lesions); (ii) KA-like SCC (three lesions); (iii) KA with malignant transformation (three lesions); (iv) infundibular SCC (crateriform) (four lesions); (v) crateriform SCC arisen from actinic keratosis (three lesions); and (vi) crateriform Bowen's disease (one lesion). The true characteristics of KA-like SCC remain unresolved, but there are three possibilities, namely, that it is one step in the evolution of KA, it is a borderline lesion between KA and invasive SCC, or it is one form of "KA with malignant transformation". KA, KA-like SCC, KA with malignant transformation and infundibular SCC (crater form) are considered to be hair follicle-related neoplasms. In contrast, crateriform SCC arisen from actinic keratosis and crateriform Bowen's disease are SCC, which are not related either to the hair follicles or KA. From an etiological standpoint, the presented lesions in these six categories are considered to be mixed up due to the similarity of crateriform architecture between the various types of lesions. However, the information provided in this report is intended to help physicians to make an accurate differential diagnosis of these conditions in clinical practice. The present study provides an opportunity to standardize the terminology for KA and related neoplasms.

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Recurrent Keratoacanthomas Developing after Spontaneous Resolution

Cited by 9 publications

References 16 publications

Cases with a spontaneous regression of an infiltrating non‐crateriform keratoacanthoma and squamous cell carcinoma with a keratoacanthoma‐like component

Cases with a spontaneous regression of an infiltrating non‐crateriform keratoacanthoma and squamous cell carcinoma with a keratoacanthoma‐like component

The changes in the expression levels of follicular markers in keratoacanthoma depend on the stage: keratoacanthoma is a follicular neoplasm exhibiting infundibular/isthmic differentiation without expression of CK15

Keratoacanthoma and other types of squamous cell carcinoma with crateriform architecture: Classification and identification

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