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Treatment of a recurrent keratoacanthoma with oral isotretinoin
W Y Wong1, R V Kolbusz, L H Goldberg
1Department of Dermatology, Baylor College of Medicine, Houston, Texas.
Background:
Keratoacanthoma is a benign epithelial tumor that occurs on the sun-exposed skin of elderly people. Development of KAS on functionally and cosmetically important areas such as the face poses the therapeutic challenge to minimize functional and cosmetic damage. Oral isotretinoin (Accutane, Roche Laboratories) has been reported to be an effective treatment of multiple as well as solitary keratoacanthomas.
Case Report:
A 45-year-old man with a large keratoacanthoma on the nasal ala, recurrent after surgical excision, was treated with 1 mg/kg/day (80 mg/day) oral isotretinoin (Accutane). Cessation of tumor progression was evident within 1 week after initiation of therapy, and tumor regression was evident within 2 weeks. Tumor size diminished rapidly over the ensuing weeks and complete resolution at 12 weeks was confirmed by biopsy.
Conclusion:
An initial trial of oral isotretinoin is an alternative to immediate surgical excision for the treatment of large keratoacanthomas in instances when tumor removal would cause considerable cosmetic deformity.