Topical Imiquimod 5% as a Treatment Option in Solitary Facial Keratoacanthoma

Abstract

BACKGROUND:Keratoacanthoma (KA) is a rapidly growing epithelial tumour with histopathologic and clinical features similar to squamous cell carcinoma (SCC) and a certain tendency toward spontaneous regression.CASE PRESENTATION:This article presents a unique and rare case of keratoacanthoma arising from the upper lip of a young male patient. These two features are in contrast to most of the reported cases in elder male individuals and on the lower lip. Relevant management protocol of the case has also been discussed.CONCLUSION:The article emphasises the significance of discerning such lesions from squamous cell carcinoma thus carrying diagnostic and therapeutic implications. However, in case of the dilemma it is prudent to assume that the lesion is SCC unless proved otherwise clinically and histologically.

Relative Efficacy of Nonoperative Treatment of Keratoacanthomas

“…7,24 -37 Similarly, 5 studies used topical 5-FU 5,19,38 -40 and 12 studies used topical imiquimod (Table 2). 3,6,41 -50 Biopsy-proven diagnosis of KA was reported in most cases; however, some reports utilized a clinical diagnosis (Tables 1 and 2). Average age and time elapsed from KA formation were similar across all treatment types (61-66 years, 4.0-6.4-week lesion age, Table 3).…”

Soluble Factors and Receptors Involved in Skin Innate Immunity—What Do We Know So Far?

“…Thus, conservative treatments using podophyllin, 5-fluorouracil, imiquimod, or even intralesional injection of methotrexate or corticosteroids may be beneficial. Topical imiquimod 5% was successfully used in some solitary facial KA [ 61 ], and low-dose acitretin association was documented to promote complete resolution in multiple KAs patients [ 62 ]. Contrariwise, a retrospective study showed that conservative treatments led to significantly higher recurrence rates when compared to surgical treatment [ 63 ].…”

Successful treatment of a keratoacanthoma in a young patient with the application of topical 5% imiquimod cream

“… 1 The treatment of choice for KAs is surgical excision, as it provides the advantage of complete tumor removal in a short period of time. 1 , 2 However, conservative therapeutic strategies are also to be considered. 2 …”

“…Keratoacanthomas (KA) are epithelial tumors that present as rapidly evolving nodules with a central hyperkeratotic plug and occasionally show signs of spontaneous regression 1 . The treatment of choice for KAs is surgical excision, as it provides the advantage of complete tumor removal in a short period of time 1,2 . However, conservative therapeutic strategies are also to be considered 2 …”