Keratoacanthoma

A keratoacanthoma or KA is a kind of skin cancer, wherein patients experience rapid development of peak-shaped lumps on the skin. Middle-aged adults and the elderly who have had prolonged contact with sunlight over many years are most vulnerable to developing keratoacanthomas.

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Most experts agree that keratoacanthomas are a form of squamous cell carcinoma, albeit of a less severe variety. A majority of  cases cause limited skin damage. Some patients may however suffer from more aggressive varieties, which also have a tendency to metastasize to the lymph nodes.

Symptoms

Some of the common signs and symptoms are listed below:

  • Keratoacanthomas generally begin as tiny lesions that look like pimples. The skin lesion then grows into a volcano-shaped, flesh-colored bump with a dent in the middle. It is made up of keratin, which is a major protein occurring in skin, hair, and nails.
  • After eruption, these grow rapidly in about 2 to 6 weeks.
  • The size of keratoacanthomas varies. It can grow anywhere between 1 and 2.5 cm.
  • These lesions usually do not cause pain. A few may cause itchiness and discomfort.
  • Most of them appear on the middle part of the face, the scalp, forearms, ears, and back portion of the hands. The lower parts of the legs may also get affected by keratoacanthomas, particularly in females.
  • The appearance of the lesions may uncommonly be an indication of some other serious pre-existing condition.

Causes

Keratoacanthomas generally affect older people with fair skin who have a history of prolonged exposure to sunlight.Some risk factors which can pose increased threat are listed below:

  • An increased age of more than fifty years.
  • People with light hair, fair skin, or light-colored eyes are more vulnerable.
  • Chronic contact with sunlight or other types of UV light.
  • Men are at greater risk than women.
  • Radiation therapy for treatment of cancer of the internal organs increases the threat to development of keratoacanthomas.
  • Prolonged cases of immune system suppression via medications. For example, after organ transplantation.
  • Exposure to toxic chemicals like tar.
  • Chronic instances of ulcers.
  • Long-term scars, like those in case of gasoline burns.
  • Infection with specific strains of the wart virus such as HPV.
  • People with older cases of skin cancer are also at increased risk.

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Treatment

Most instances of keratoacanthomasthat are not medically treated usually tend to disappear all of sudden in about six months. A dented scar is left in its wake.

It is important to note that keratoacanthomas can cause substantial damage to the upper layers of the skin as well as to the tissues occurring beneath. Patients are also likely to suffer from stress and other psychological problems, due to the ugly appearance of the skin disorder. Rare types of keratoacanthomas also pose the risk of spreading to the deeper skin layers and even to the lymph nodes. Hence, all affected individuals must visit a doctor for diagnosis, evaluation, and treatment.

Patients who experience the growth of anomalous bumps on skin areas that remain exposed to the sun, or bleeding from such spots, or nil healing of such spots, should go to their health care provider for diagnosis. Similarly, patients also need to consult a doctor if a pre-existing skin anomaly alters in shape, texture, color, or size, or if it becomes sore, or tender, or itchy.

After doctors have diagnosed an underlying case of keratoacanthomas, it can be treated in the following ways:

  • Surgical removal with the resultant wound being sutured.
  • Keratoacanthomas can be surgically removed and the resultant wound is then sutured.
  • If they are cancerous then doctors may opt for radiation therapy to destroy the malignant cells.
  • In rare instances, doctors may opt for direct use of chemotherapy medications on the abnormal bumps. If the  lesions number two or more, then doctors may prescribe oral isotretinoin to eliminate the cancerous bumps.
  • Cryosurgery is a procedure wherein the keratoacanthoma bumps are destroyed by freezing them in liquid nitrogen.
  • A novel type of surgical procedure called Mohs micrographic surgery involves elimination of small sections of affected skin until keratoacanthomas are fully removed. It is most useful for removing the abnormal lesions from the ears, hands, lips, and nose.

After the  lumpy growths have been successfully removed, patients need to go for regular checkups to verify and remedy any kind of relapse. Doctors will also suggest following the below listed self-care guidelines to prevent the growth of a new batch of keratoacanthomas.

  • Avoid all forms of prolonged contact with UV light, including sunlight and artificial tanning devices, etc.
  • The time frame between 10 AM to 3 PM has the most potent sun rays. Avoid venturing outdoors during this time.
  • Use sunscreens with an SPF of at least 30 before going outdoors. Ensure that the sunscreen is frequently applied on exposed parts of the skin.
  • Other options of sun protection such as wide-brimmed hats, long-sleeved shirts, sunglasses, etc. are also recommended.
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