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Periocular keratoacanthoma: clinical features, pathology, and management
Mark J Donaldson1, Timothy J Sullivan, Kevin J Whitehead
1Eyelid, Lacrimal and Orbital Clinic, Department of Ophthalmology, Royal Brisbane Hospital, Herston, Queensland 4029, Australia.
Purpose:
To review the clinical features and results of surgical treatment of keratoacanthoma of the eyelids.
Design:
Retrospective, interventional case series.
Participants:
Ten patients.
Methods:
Chart review of all eyelid keratoacanthomas treated between 1992 and 2001.
Main Outcome Measures:
Adequate excision, recurrence rate, and complications.
Results:
Patient ages ranged from 27 to 78 years, with a mean age of 59 years. Six patients were male and four were female. The lesion was found on the lower lid in five patients, upper lid in two, medial canthus in two, and lateral canthus in one. The maximum diameter of the lesion varied from 2 to 25 mm, with a mean of 7.2 mm. All lesions were treated by surgical excision, with frozen-section control of margins in five cases. All lesions were excised completely with clear resection margins, and there were no cases of recurrence. The only complication was a minor wound infection in one patient. Mean follow-up was 34.5 months.
Conclusions:
Because of the aggressive nature and uncertain relationship to squamous cell carcinoma, we recommend excision of periocular keratoacanthoma. Surgical excision of eyelid keratoacanthoma provides good results and a very low risk of recurrence. Frozen-section control of margins should be used in selected cases to ensure complete excision.