The first report of diagnosing of keratoacanthoma in Chinese Han patients using dermoscopy and reflectance confocal microscopy

Abstract

Background Keratoacanthoma (KA) is a special kind of tumor, which is regarded as a variant of squamous cell carcinoma (SCC) in some academic disciplines. But differentiating KA from SCC remains a diagnostic challenge. The noninvasive techniques dermoscopy and reflectance confocal microscopy (RCM) can provide new insights for diagnosis. Objective To observe the characteristics of KA under dermoscopy and reflectance confocal microscopy (RCM), in order to gain experience and reference for clinicians to facilitate earlier diagnosis. Methods We collected two cases of KA, which were confirmed by clinical and histopathological examination. The two cases were examined by dermoscopy and RCM, respectively. Then, we collected the microscopic characteristics of KA lesions. Results The dermoscopy features of KA are concentric circles of central crater, keratin mass, keratin scale, and polymorphic vascular pattern. The RCM features are described as refractile crust, atypical honeycomb pattern, dark center cells, large round nucleated cells, dendritic cells, and linear or round vessels traversing dermal papillae in the dermis. Conclusion KA has some specific dermoscopy and RCM features, which can provide a basis for doctors to diagnose and intervene earlier.

Case Report: Amyloidosis Cutis Dyschromica: Dermoscopy and Reflectance Confocal Microscopy and Gene Mutation Analysis of a Chinese Pedigree

“…The value of the combination of dermoscopy and RCM has been confirmed in the diagnosis of diseases such as primary cutaneous amyloidosis and keratoacanthoma ( 12 , 13 ).…”

Surgical excision of a giant solitary keratoacanthoma in the cheek: a case report and literature review

“…In the literature concerning the use of dermoscopy and reflectance confocal microscopy in Chinese Han patients, the dermoscopic features of keratoacanthoma include concentric circles of the central crater, keratin mass, keratin scale, and polymorphic vascular pattern. Reflectance confocal microscopic features include refractile crust, atypical honeycomb pattern, dark-centered cells, large round nucleated cells, dendritic cells, and linear or round vessels traversing the dermal papillae ( 12 ). Currently, there is a web application in the latest research literature to process large numbers of free-text histopathology reports and classify diagnoses of keratinocytic cancers with a high degree of accuracy ( 13 ).…”

Interventional treatment of keratoacanthoderma: a case report

“…A recent study used dermoscopy and reflection confocal microscopy (RCM) to effectively detect KA and discovered that KA has unique dermoscopy and RCM features. 24 This approach may serve as a foundation for the early identification of KA. 24 At present, there is no standard treatment for KA.…”

“…24 This approach may serve as a foundation for the early identification of KA. 24 At present, there is no standard treatment for KA. Although surgical resection is seen to be the best option, it comes with a number of disadvantages, including increased discomfort, a higher chance of infection following the removal of large tumours and scars that can be unsightly.…”