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Solitary keratoacanthomas (KAs) form part of the spectrum of squamous cell carcinomas as suggested by immunohistochemical determinations¹ or constitute a variant of regressive squamous cell carcinoma, probably by immunological mediation of CD4⁺ T lymphocytes activated by interleukin 2 and adhesion molecules.²

Surgical excision with frozen section control of the margins remains the treatment of choice in KA, but these lesions are situated predominantly in strategic anatomical areas, with the frequent requirement for reconstructive procedures.

Melton et al³ were the pioneers in the use of intralesional methotrexate to maximize the local concentration, achieving complete regression in 9 patients after an average of 3 weeks, 1.7 treatments per patient, and an average dose of 21.9 mg.

Report of Cases

Six patients with morphologically typical solitary KA lesions were selected for intralesional therapy with methotrexate sodium (Figure 1 and Table 1). Four patients had pretreatment biopsy specimens compatible with KA. At each session the . . . [Full Text of this Article]

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Pancytopenia After Treatment of Keratoacanthoma by Single Lesional Methotrexate Infiltration
Goebeler et al.
Arch Dermatol 2001;137:1104-1105.
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