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Keratoacanthoma, large wart like growths that can be cancerous

by admin on June 6, 2011

We have seen a number of people recently at our Skin Cancer clinic in Brisbane with large wart-like growths, sometimes multiple, suddenly appearing on the sun exposed surfaces of their limbs. These are called keratoacanthomas.

Keratoacanthoma - Skin Cancer clinic Brisbane

Keratoacanthoma

A keratoacanthoma, or KA, is a curious low grade skin cancer (squamous cell carcinoma, SCC) most commonly found on the exposed surfaces of the forearms, hands and lower limbs but they can grow on any sun exposed surface. It is more common in people over 60 years. KAs grow quickly sometimes to the size of a golf ball. Most are non-invasive skin cancers but a small number, between 2% to 6%, are invasive SCCs. Patients commonly believe that they are caused by a foreign body because they are often tender and suddenly appear. Because of their potential to be large early removal is advisable. It used to be the practice to let them grow to the maximum size, become necrotic and then fall off. But this may lead to considerable scarring or a defect in the skin and if invasive SCCs they may well spread to other parts of the body.

If the tumour is not too big excision and suture is the best treatment, the specimen should always be sent to a pathologist for examination. If the KA is very large then removal by shaving is appropriate. When we do this we attempt to get the base of the lesion to exclude invasive squamous cell carcinoma. The resultant skin is then treated with an oily moisturiser until healed. If there is any doubt about the adequacy of removal the skin can always be surgically excised at a later date.

If the lesion turns out to be an invasive SCC then a wide excision is necessary. Anyone who has a KA is likely to also have other forms of skin cancer, will get them in the future and a total body examination is advised with regular skin checks thereafter.

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