Keratoacanthoma

Keratoacanthoma is a rapidly growing skin tumor that typically develops within a few weeks and usually appears on sun-exposed areas. The growth is characterized by a dome-shaped nodule with a central keratin-filled crater. Keratoacanthoma is currently considered a low-grade variant of squamous cell carcinoma (SCC). Although some cases may regress spontaneously, the accepted medical approach is to surgically remove the tumor due to its histological similarity to SCC and the risk of invasive behavior. In Israel, due to high UV levels, keratoacanthoma is particularly common in fair-skinned individuals and in people over the age of 50.

Symptoms

Dome-shaped lump that grows rapidly within a few weeks
Central crater filled with keratin (horn-like material)
Appears mainly on sun-exposed areas such as the face, hands, and arms
Skin-colored, reddish, or pinkish in tone
May be tender to the touch but is usually painless

Treatment Options

Surgical excision for complete removal and histological examination
Mohs micrographic surgery for cosmetically sensitive areas
Curettage and electrodesiccation for small lesions
Intralesional methotrexate or 5-FU injection in selected cases
Close follow-up to detect recurrence

Why Mohs Surgery?

Mohs surgery is recommended for keratoacanthoma in cosmetically sensitive areas such as the face, ears, and lips, where preserving healthy tissue is important. The advantage of Mohs surgery is complete real-time margin control, ensuring full tumor removal with maximum tissue preservation.

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