Abstract
Keratoacanthomas (KAs) are a type of skin tumor that rapidly grow (Bosch-Amate et al., 2022). A form of KAs was first identified in 1889 (Jeon et al., 2011). These types of lesions can be challenging to differentiate from cutaneous squamous cell skin carcinoma both through histopathology and clinically (Higgins et al., 2015; Ko et al., 2012; Mei et al., 2022). Adding to the complexity, there are no current evidence-based guidelines for treatment of KAs. Although KAs can be self-resolving, the persistence and growth of the KA is unpredictable (Bettoli et al., 2023; Ko et al., 2012). Treatment of KAs with surgical excision or Mohs are typically considered first line due to the possibility of misdiagnosis and invasion into local tissue (Ambur et al., 2022). Dependent upon the location and size of the KA, comorbidities, patient preference, and other considerations, surgical treatment may not be the most ideal treatment (Kiss et al., 2019). There are many nonsurgical options including intralesional injections of methotrexate, fluorouracil, corticosteroid, bleomycin, or interferon alpha (Kiss et al., 2019). Ionizing radiation, systemic agents, destructive therapy, topical imiquimod, and topical fluorouracil are also possibilities for treatment of KAs (Ambur et al., 2022). Even though conditions of KAs were first identified over 100 years ago, more research is needed to be able to accurately diagnose and appropriately treat KAs (Tisack et al., 2021).