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Updated: Sep 14, 2025

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Keratoacanthoma-Type Invasive Squamous Cell Carcinoma Managed Non-surgically With Topical Immunomodulators.

Brian A Moreno1, Moises Lutwak2, Stanley Skopit2

  • 1Dermatology, Lake Erie College of Osteopathic Medicine, Bradenton, USA.

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|July 21, 2025
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Summary

Rapidly growing squamous cell carcinoma (SCC) can mimic keratoacanthoma, complicating diagnosis. This case highlights the importance of biopsy for atypical skin lesions and successful topical treatment for keratoacanthoma-like SCC.

Keywords:
case report dermatologyclinical dermatologydermatology caredermatology oncologydermatology treatmentsdermatology trendsgeneral dermatologymedical dermatologypreventive dermatologyskin disease/dermatology

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Area of Science:

  • Dermatology
  • Oncology

Background:

  • Cutaneous squamous cell carcinoma (SCC) typically grows slowly.
  • Lesions with keratoacanthoma-like features can exhibit rapid growth, posing diagnostic challenges.

Observation:

  • A 71-year-old male with a history of actinic keratoses and non-melanoma skin cancer presented with a blistering, erythematous forearm eruption.
  • Initial KOH prep suggested a fungal infection, leading to antifungal treatment.
  • Biopsy revealed a well-differentiated invasive SCC of the keratoacanthoma type.

Findings:

  • The keratoacanthoma-like SCC was successfully treated with topical immunomodulation.
  • Positron Emission Tomography (PET) imaging confirmed no metastasis.
  • Clinical resolution was achieved on follow-up.

Implications:

  • This case emphasizes the diagnostic complexity of keratoacanthoma-like SCCs.
  • Biopsy is crucial for atypical or rapidly growing skin lesions.
  • Topical immunomodulation may be a viable treatment option for select cutaneous SCC cases, especially in elderly patients or those avoiding surgery.