Keratoacanthoma Centrifugum Marginatum Research Articles

Keratoacanthoma centrifugum marginatum

Keratoacanthoma centrifugum marginatum (KCM) is an uncommon variant of keratoacanthoma. Keratoacanthoma centrifugum marginatums are most commonly seen on sun-exposed surfaces and present with progressive peripheral expansion and raised, hyperkeratotic borders. Central clearing with atrophy and lack of spontaneous clearance are other key clinical characteristics. The majority of cases are benign with a low risk of metastasis. The size of such growths is variable with reported cases ranging from 5.0cm×5.0cm to as large as 20.0cm×14.0cm. Treatment options include surgical excision, oral retinoids, and intralesional chemotherapeutics such as methotrexate or bleomycin. We herein present a case of KCM manifesting as an exophytic, crateriform plaque in a 61-year-old man.

Dermoscopy of Keratoacanthoma Centrifugum Marginatum.

Dermoscopy of Keratoacanthoma Centrifugum Marginatum.

Multiple keratoacanthoma centrifugum marginatum—a case report and systematic review

Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma (KA). Although many cases and reviews of solitary KCM have been reported, few studies have been published on multiple KCM. This article describes a typical case of multiple KCM, and summarizes the clinical characteristics, especially the treatment and prognosis of patients with multiple KCM. We systemically searched for “keratoacanthoma centrifugum marginatum” in the MEDLINE, EMBASE, Cochrane, and SinoMed databases, without time limitation. Sixty-five KCM records were found. After the selection process, ten available articles on multiple KCM were included. We present the case of a female patient with multiple progressive lesions, which are typical of KCM, on the face, a site where few KCM lesions have been observed. Multiple KCM is more common in males; the male-to-female ratio is 7:2 based on the cases that have been reported to date. KCM occurs mostly on the limbs, but lesions on the face and buttocks have also been reported. Both oral and topical (iso)retinoid treatments for multiple KCM were shown to be effective. In patients who are unresponsive to retinoid treatment, methotrexate and prednisone can be used as second-line treatments. Multiple KCM has characteristic clinical features. Although it progresses rapidly without treatment, proper treatment, including retinoids, immunosuppressants, corticosteroids, and excisional surgery, often leads to a favorable outcome.

Eruptive keratoacanthomas after radiation therapy for keratoacanthoma centrifugum marginatum

Keratoacanthomas are crateriform squamous proliferations commonly accepted as a variant of well-differentiated squamous cell carcinoma (SCC). Typically, keratoacanthomas demonstrate rapid growth that causes local tissue destruction followed by spontaneous resolution with residual scarring. There are several morphological variants of keratoacanthomas, including solitary, multiple, grouped, and keratoacanthoma centrifugum marginatum (KCM). KCM is characterized by progressive peripheral tumor expansion with the ability to grow up to 30 cm in diameter. Because of their destructive capabilities and rare reports of metastasis, [1] Hodak E. Jones R.E. Ackerman A.B. Solitary keratoacanthoma is a squamous-cell carcinoma: Three examples with metastases. Am J Dermatopathol. 1993; 15: 332-342 Crossref PubMed Scopus (206) Google Scholar keratoacanthomas require definitive treatment.

Two cases of giant keratoacanthoma centrifugum marginatum accompanied by α-human papillomavirus infection

Two cases of giant keratoacanthoma centrifugum marginatum accompanied by α-human papillomavirus infection

Keratoacanthoma centrifugum marginatum—A rare variant of keratoacanthoma: Case report and literature review

Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma and is characterized by progressive peripheral growth with accompanying central healing. Here, we report a case of multiple KCM. A 53-year-old man presented with multiple erythematous papulonodules on both upper limbs and neck for >2 years. His skin lesions enlarged in an annular manner with central residual cribriform scarring that eventually formed confluent plaques (2–8 cm in diameter) with elevated hyperkeratotic borders. Skin biopsy of a developed matured nodule on the right forearm was consistent with that of classical keratoacanthoma. KCM was diagnosed on the basis of clinical and pathological presentation. Low-dose acitretin (0.7 mg/kg/day) was administered and the skin lesions improved significantly within 3 months after the treatment. In this case, we present the clinical and histological features of KCM and discuss the different effective treatment modalities.

Keratoacanthoma centrifugum marginatum at an unusual site

Keratoacanthoma (KA) is a rapidly evolving tumor, composed of keratinizing squamous cells originating in pilosebaceous follicles and resolving spontaneously if left untreated. It is relatively uncommon in dark-skinned and occurs in middle aged individuals. Males are three times more affected than females. It presents as firm, rounded, flesh-colored or reddish papule; with a rapid growth phase followed by spontaneous healing over three months. Two types of KA exist i.e., solitary and multiple. There are three rare clinical variants of solitary KA, namely giant KA, keratoacanthoma centrifugum marginatum (KCM) and subungual KA. In KCM, lesions are large, reaching upto 20cms. There is peripheral extension with raised, rolled border and atrophy in the center. There is no tendency toward spontaneous involution. The most common locations are dorsa of hands and legs, lesions on scalp being rare. A rare case of KCM occurring on scalp which is an unusual site is reported.

Keratoacanthoma Centrifugum Marginatum with Atypical Scar

Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma (KA). It is characterized by a progressive peripheral expansion and central healing leaving atrophic scar. It is sometimes confused with squamous cell carcinoma (SCC) both clinically and histopathologically. We here report a case of KCM over the extensor aspect of the right forearm in a 57-year-old man with an abnormal looking scar.

Multiple keratoacanthoma centrifugum marginatum

Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma characterized by a progressive peripheral growth with concomitant central healing. We report here a case of multiple KCM of the lower legs in a 48-year-old man. The lesions had progressively evolved over 3 years. They were multiple asymptomatic and confluent annular plaques of 5 to 20 cm, having papulo-nodular with hyperkeratotic and crusted borders and cicatricial center. Within the centers were numerous firm and pigmented minipapules of 1 to 2 mm. The typical clinical aspect, together with characteristic histological features confirmed the diagnosis of KCM. Herein we will highlight the clinical and histological features of KCM, as well as the different effective treatments. We will also briefly discuss KCM among the other types of keratoacanthomas.

Refractory aggressive keratoacanthoma centrifugum marginatum of the scalp controlled with the epidermal growth factor receptor inhibitor erlotinib

Keratoacanthomas are squamous cell neoplasms known to be abundant in epidermal growth factor receptors (EGFRs). Erlotinib (Tarceva(®); Roche) is a low molecular weight oral quinazoline compound that binds to the intracellular EGFR tyrosine kinase domain and inhibits receptor phosphorylation and downstream signalling. We report a case of refractory, locally aggressive keratoacathoma centrifugum marginatum of the scalp having strong EGFR expression and demonstrating excellent response to erlotinib.

Keratoacanthoma centrifugum marginatum: unresponsive to oral retinoid and successfully treated with wide local excision.

We describe a case of a 65-year-old male presenting with a large plaque with a rolled-out interrupted margin, atrophic center, and island of normal skin over the left arm. It grew peripherally with central healing, and there was a history of recurrence after inadequate excision. Investigations ruled out other clinical mimickers; namely, squamous cell carcinoma, lupus vulgaris, botryomycosis, and blastomycosis-like pyoderma. Histopathological sections showed irregularly shaped craters filled with keratin and epithelial pearl but no evidence of granuloma or cellular atypia. Clinicopathological correlation proved the lesion to be keratoacanthoma centrifugum marginatum (KCM), a rare variant of keratoacanthoma, which spreads centrifugally, attains a huge size, and never involutes spontaneously. Treatment of KCM has been a problem always and, in our case, systemic retinoid (acitretin for three months) proved ineffective. The patient also had a history of recurrence following surgical intervention previously, necessitating wide excision to achieve complete clearance of tumor cells. Hence, after failure of retinoid therapy, the decision of excision with a 1-centimeter margin was taken and the large defect was closed by a split thickness skin graft. The graft uptake was satisfactory, and the patient is being followed-up presently and shows no signs of recurrence after six months, highlighting wide local excision as a useful treatment option.

Keratoacanthoma centrifugum marginatum: unresponsive to oral retinoid and successfully treated with wide local excision.

We describe a case of a 65-year-old male presenting with a large plaque with a rolled-out interrupted margin, atrophic center, and island of normal skin over the left arm. It grew peripherally with central healing, and there was a history of recurrence after inadequate excision. Investigations ruled out other clin­ical mimickers; namely, squamous cell carcinoma, lupus vulgaris, botryomycosis, and blastomycosis-like pyoderma. Histopathological sections showed irregularly shaped craters filled with keratin and epithelial pearl but no evidence of granuloma or cellular atypia. Clinico­pathological correlation proved the lesion to be keratoacanthoma centrifugum marginatum (KCM), a rare variant of keratoacanthoma, which spreads centrifugally, attains a huge size, and never involutes spontaneously. Treatment of KCM has been a problem always and, in our case, systemic retinoid (acitretin for three months) proved ineffective. The patient also had a history of recurrence following surgical intervention previously, necessitating wide excision to achieve complete clearance of tumor cells. Hence, after failure of retinoid therapy, the decision of excision with a 1-centimeter margin was taken and the large defect was closed by a split thickness skin graft. The graft uptake was satisfactory, and the patient is being followed-up presently and shows no signs of recurrence after six months, highlighting wide local excision as a useful treatment option.

Systemic photodynamic therapy as an option for keratoacanthoma centrifugum marginatum treatment

Systemic photodynamic therapy as an option for keratoacanthoma centrifugum marginatum treatment

Keratoacanthoma centrifugum marginatum: a rare atypical variant of keratoacanthoma

Keratoacanthoma centrifugum marginatum (KCM) is an extremely rare variant of keratoacanthoma (KA), with about 30 cases reported since it was first described in 1962. Clinically, KA is an exoendophytic lesion of 10-25 mm with a horn-filled crater that resolves spontaneously within 6 months. In contrast, KCM is characterized by a larger diameter continuous centrifugal spread, concurrent central atrophy and lack of spontaneous remission. Histologically, KCM is similar to KA, with a central keratin-filled crater, overhanging lips of epithelium, a sharp outline between the tumour nests and stroma, and lack of anaplasia and stroma desmoplasia. We describe a 63-year-old agricultural worker with a 9-month history of a multinodular tumour, 70-75 mm in size, on his right hand. The clinical diagnosis of KCM was confirmed by histological examination. Local radiotherapy proved effective, with no recurrence during a 4-year follow-up.

A case of Ferguson–Smith type multiple keratoacanthomas associated with keratoacanthoma centrifugum marginatum: response to oral acitretin

Keratoacanthoma centrifugum marginatum (KCM) is a rare entity, usually classified as solitary keratoacanthoma (KA). The Ferguson-Smith type is the most common form of multiple KAs. Because development of multiple KAs and KCM in a single patient has rarely been reported, this association presents a therapeutic challenge. We report a 46-year-old man with Ferguson-Smith multiple KAs and KCM, who was successfully treated with acitretin.

A case of keratoacanthoma centrifugum marginatum with a curious mast cell accumulation at tumour sites

A case of keratoacanthoma centrifugum marginatum with a curious mast cell accumulation at tumour sites

A case of multiple keratoacanthomas associated with keratoacanthoma centrifugum marginatum

This article does not have an abstract.

Keratoacanthoma centrifugum marginatum: Response to topical 5-fluorouracil

Keratoacanthoma centrifugum marginatum (KCM) is a rare variant of keratoacanthoma, characterized by progressive peripheral growth with concomitant healing of the central area of the tumor. We present a patient with KCM who was treated with topical 5% 5-fluorouracil. This is the third reported case of KCM treated with this agent.

Keratoacanthoma centrifugum marginatum accompanied by extensive granulomatous foreign body reaction

We describe a 58-year-old woman with a 4-year history of papular lesions with a partly verruciform appearance on the eyelids and the adjacent areas of the nose. The lesions progressed slowly but constantly into the surrounding areas with central scarring. Histopathology showed epidermal endophytic proliferations under a pronounced hyperparakeratosis. In the adjacent dermis a lymphohistiocytic infiltrate with giant cells of the foreign-body-reaction type was seen in close contact to extracellular keratin deposits. Although some cytopathological signs typical for viropathic effects were observed, no human papilloma virus-DNA was detected within the lesions by polymerase chain reaction. According to the histological picture and the clinical course we diagnosed a keratoacanthoma centrifugum marginatum. We present this case because of the strong granulomatous foreign body reaction which might complicate the diagnosis and has not been described for this keratoacanthoma variant so far.

Ferguson smith type multiple keratoacanthomas and a keratoacanthoma centrifugum marginatum in a woman from Japan

We report a case of multiple keratoacanthomas on the sun-exposed skin of a 37-year-old woman from Japan. She had experienced 4 similar episodes of evolution and involution of multiple keratoacanthomas during a period of 10 years since she was 27 years old. She was given the diagnosis of Ferguson Smith type keratoacanthoma. This is the seventh Japanese case of Ferguson Smith type keratoacanthoma described in detail in the literature. In addition, the patient was found to have an annular, coral reef–like eruption on the front of her neck, which was diagnosed as a keratoacanthoma centrifugum marginatum. A combination of different variants of keratoacanthoma in 1 patient is uncommon, and only 2 patients with the same combination of lesions, as that seen in our patient, have been reported. Our patient was treated by a relatively low dose (0.5 mg/kg body weight) of etretinate. Both variants of keratoacanthoma showed good response to the treatment. Effectiveness of etretinate for treating keratoacanthoma centrifugum marginatum has only been reported in a few cases. Our patient had no relapse during a period of 15 months after cessation of etretinate treatment.