Keratoacanthoma (KA) may be a rapidly growing carcinoma usually appearing as a volcano-like bump on the sun-exposed skin of middle-aged and elderly individuals. Many scientists consider keratoacanthoma to be a less serious sort of epithelial cell carcinoma. Most keratoacanthoma cause only minimal skin destruction, but a couple of behave more aggressively and may spread to lymph nodes.
Who's at risk?
Keratoacanthoma is most ordinarily seen in elderly, light-skinned people with a history of sun exposure.
Risk factors for the development of keratoacanthoma include:
Ø Age over 50
Ø Fair skin, light hair, or light eyes
Ø Chronic exposure to sunlight or other ultraviolet light
Ø Exposure to certain chemicals, such as tar
Ø Exposure to radiation, such as X-ray treatment for internal cancers
Ø Long-term suppression of the immune system, such as organ transplant recipients
Ø Long-term presence of scars, such as from a gasoline burn
Ø Chronic ulcers
Ø Presence of particular strains of the wart virus (human papillomavirus)
Ø Previous skin cancer
Signs and Symptoms
The most common locations for keratoacanthoma include:
Ø Center of the face
Ø Backs of hands
Ø Lower legs, especially in women
A keratoacanthoma appears and grows rapidly over the course of 2–6 weeks. Starting as alittle , pimple-like lesion, a keratoacanthoma typically develops into a dome-shaped, skin-colored nodule with a central depression crammed with keratin (the major protein found in hair, skin, and nails). Keratoacanthoma usually range in size from 1–2.5 cm.
In rare cases, multiple keratoacanthomas may develop as a part of a bigger group of symptoms (syndrome).
Most keratoacanthoma are painless, though some could also be itchy. Depending on the location of involvement, keratoacanthoma may interfere with normal function of the affected area.
There are no effective self-care treatments for keratoacanthoma. Preventing sun damage is crucial to avoiding the event of keratoacanthoma:
Ø Avoid ultraviolet (UV) light exposure from natural sunlight or from artificial tanning devices.
Ø Wear broad-spectrum sunscreens (blocking both UVA and UVB) with SPF 30 or higher, reapplying frequently.
Ø Wear wide-brimmed hats and long-sleeved shirts.
Ø Stay out of the sun in the middle of the day (between 10:00 AM and 3:00 PM).
When to Seek Medical Care
If you develop a replacement bump (lesion) on sun-exposed skin, or if you've got a spot that bleeds easily or doesn't seem to be healing, then you ought to make an appointment with your primary care physician or with a dermatologist. You should also make a meeting if an existing spot changes size, shape, color, or texture, or if it starts to itch, bleed, or become sore to the touch.
Try to remember to tell your doctor when you first noticed the lesion and what symptoms, if any, it has. Also, young adults should ask adult relations whether or not they need ever had a carcinoma and relay this information to their physician.
Treatments Your Physician May Prescribe
If left untreated, most keratoacanthoma spontaneously disappear (resolve) within 6 months, leaving a depressed scar. However, they'll cause significant damage to the skin and underlying layers of tissue also as psychological distress. Additionally, rare sorts of keratoacanthoma may spread (invade) aggressively below the skin level and into the lymph glands, and your doctor has no thanks to tell this sort from the more common form. Therefore, prompt diagnosis and treatment are recommended.
If your physician suspects a keratoacanthoma, he or she is going to first want to determine the right diagnosis by performing a biopsy. The procedure involves:
Ø Numbing the skin with an injectable anesthetic.
Ø A small piece of skin by using a flexible razor blade, a scalpel, or a tiny cookie cutter (called a "punch biopsy"). If a punch biopsy is taken, a stitch (suture) or 2 could also be placed and can get to be removed 6–14 days later.
Ø Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).
Once the diagnosis of keratoacanthoma is established, the treatment options usually include:
Ø Freezing with liquid nitrogen (cryosurgery), in which very cold liquid nitrogen is sprayed on the keratoacanthoma, freezing it and destroying it in the process.
Ø Electrodesiccation and curettage, also known as "scrape and burn." After numbing the lesion, the doctor uses a sharp instrument (curette) to "scrape" the skin cancer cells away, followed by an electric needle to "burn" (cauterize) the tissue. The electrodesiccation helps to kill the cancer cells and also to prevent any bleeding at the location.
Ø Removal (excision), in which the doctor uses a knife-like instrument (scalpel) to cut out the keratoacanthoma and then place stitches to bring the wound edges together.
Ø Mohs micrographic surgery, in which the physician takes tiny slivers of skin from the cancer site until it is completely removed. This technique is especially useful for keratoacanthoma located on the nose, the ears, the lips, and therefore the hands.
Ø Radiation treatment, where X-ray therapy is often useful for patients who might have difficulty with a surgical procedure because of other health issues.
Very rarely, keratoacanthoma are treated with medicine injected directly into the skin lesion (intralesional chemotherapy). In patients with quite one keratoacanthoma, the doctor may suggest taking a pill (isotretinoin) to scale back their size and number.
Finally, it's important to recollect that treatment of keratoacanthoma isn't complete once the carcinoma has been removed. Frequent follow-up appointments with a dermatologist or with a physician trained to look at the skin are essential to make sure that the keratoacanthoma has not returned which a replacement skin cancer has not developed elsewhere on your body. In addition, good sun protection habits (see the above Self-Care section) are vital to preventing further damage from UV light.
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