Keratoacanthoma: an unusual hand tumor

Keratoacanthoma is a common skin lesion of the head and neck, and is well described in the literature. It seldom presents to the Orthopedic surgeon as a hand tumor. The lesion does not require radical approach, but mimics squamous cell carcinoma which usually does. The clinical behavior and pathology, as well as the biological behavior of the tumor, are discussed. Fifteen cases treated by the authors are reported and their clinical and pathological course and treatment are discussed. Serious errors in treatment may arise from reliance on the histologic characteristics alone. Conservative treatment of keratoacanthoma should be avoided but radical excision of the part is unnecessary. Prompt and total excision is the treatment of choice, with closure either primarily or with split skin graft.