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Are keratoacanthomas really squamous cell carcinomas?

G H Sanders, T A Miller

    Annals of Plastic Surgery
    |October 1, 1982
    PubMed
    Summary
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    Distinguishing keratoacanthoma from squamous cell carcinoma is challenging and often unwise. Lesions suspected of being keratoacanthomas should be surgically excised due to their potential for aggressive behavior and metastasis.

    Area of Science:

    • Dermatology
    • Oncology
    • Surgical Pathology

    Background:

    • Keratoacanthomas (KAs) present a diagnostic challenge, with ongoing debate regarding their classification as benign lesions.
    • Accurate differentiation between KAs and squamous cell carcinoma (SCC) remains difficult in clinical and pathological settings.

    Observation:

    • Clinical experience and evidence suggest that attempting to distinguish KAs from SCCs can be unreliable.
    • Some lesions initially diagnosed as KAs exhibit aggressive behavior, including metastasis.

    Findings:

    • The distinction between keratoacanthoma and squamous cell carcinoma is often unreliable.
    • Lesions presumed to be benign keratoacanthomas can demonstrate aggressive behavior and metastasize.

    Implications:

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    • Surgical excision is recommended for all suspected keratoacanthoma lesions.
    • Observation for spontaneous involution is discouraged due to the risk of aggressive disease progression.