Images in Clinical Medicine

Keratoacanthoma

Rachid Frikh, M.D., and Omar Sedrati, M.D.

N Engl J Med 2008; 359:1717October 16, 2008

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Article

A 45-year-old man presented with a kerotic nodule of the second right toe that had been increasing in size for 4 months. There was no history of trauma and no relevant medical history, and there was no family history of skin cancer. Examination revealed a tender, painful keratotic nodule on the medial aspect of his second toe. A radiograph showed no evidence of associated bony erosions. This cutaneous lesion was completely excised surgically, and a diagnosis of keratoacanthoma was confirmed after histologic examination. Keratoacanthoma is typically a benign crateriform neoplasm that often involutes spontaneously after a few months of rapid growth. It is important to differentiate keratoacanthoma from squamous-cell carcinoma. In this patient, at follow-up 2 months later, the surgical site had healed well, with no evidence of residual abnormality or recurrence.

Rachid Frikh, M.D.
Omar Sedrati, M.D.
Military Hospital Mohammed V, Rabat 10000, Morocco