Eruptive keratoacanthomatous atypical squamous proliferations (KASPs) arising in skin graft sites

Keratoacanthoma formation after skin grafting: A brief report and pathophysiological hypothesis

“…KA classically presents as a firm, 1–2 cm dome‐shaped nodule filled with a keratinous plug. KA have been associated with HPV, immunosuppression and cutaneous injuries such as surgical trauma and burns . Our patient's KA were negative for HPV DNA on PCR analysis.…”

“…Only two cases of multiple KA developing at both STSG donor and recipient sites have been reported in the existing literature . Similarities among the three cases (including this one) were primarily the patient's age, the location of the KA and the treatment response.…”

“…These KA were also generally treatment‐resistant. Two cases demonstrated KA with a high recurrence rate despite rigorous treatment (including topical chemotherapy and surgery), but responded well to acitretin . While some KA spontaneously involuted in the third case, some of his KA did not and were resistant to radiation therapy …”

“…In current practice, systemic retinoids are generally reserved for cases of multiple or refractory KA . We recommend early consideration of systemic retinoids in patients with postoperative KA as they tend to be multiple and treatment resistant . A wait‐and‐watch approach should be avoided unless there are clear signs of involution, as spontaneous regression has been inconsistently observed .…”

Altered epigenetic pathways and cell cycle dysregulation in healthy appearing skin of patients with koebnerized squamous cell carcinomas following skin surgery

“…Beside UV radiation, human papillomaviruses (HPV) and immunosuppression may participate in the pathogenesis of NMSC . The latter, including keratoacanthoma (KA) as well as ‘true’ potentially metastasizing squamous cell carcinomas (SCC), have sporadically been reported arising at sites of surgical trauma also including split‐thickness skin graft donor sites . Lee et al .…”