A 70-year-old man's neck bulges and grows rapidly, and it grows twice as big within 2 weeks without tenderness. It was found to be malignant keratoacanthoma by excision and laboratory examination. This disease is common in middle-aged and elderly men, and often appears in places where the skin is exposed to the sun. If people have inexplicable lumps, they should seek medical attention immediately.
Huang Jiyi, director of the Plastic Surgery Department of Shu Tian Clinic, said that a 73-year-old man noticed a protruding lump on his neck skin 1 month ago, and it grew rapidly, and it doubled in two weeks, with redness and itching around it. The examination showed that the epidermis of the tumor had stratum corneum hyperplasia without tenderness, and the pathological examination after resection confirmed it as malignant keratoacanthoma.
Dr. Huang Jiyi, who is often associated with ultraviolet radiation in middle-aged and elderly men, said that keratoacanthoma, also known as seborrhea wart or pseudocarcinomatous tumor, is a rapidly growing tumor that occurs in proliferative lesions of hair follicle keratinocytes. Some keratoacanthoma may be malignant (the probability is less than 1%), but the probability of benign is high, and it may also fall off on its own.
Keratoacanthoma mainly occurs in middle-aged and elderly men, and the risk factors are related to ultraviolet radiation. The incidence rate is about 65438 0 ‰, which is rare among young people. Skin lesions often appear in the parts of the skin exposed to sunlight, such as face, neck and arms, which may be caused by long-term ultraviolet radiation, human papillomavirus infection or hair follicle cell differentiation.
Keratoacanthoma is a single round protruding mass with obvious depression in the center, and some depressions are similar to craters. The concave position is covered with horny scales, the outer edge is smooth, bloodshot and the skin is reddish. Skin lesions are usually accompanied by itching and discomfort, which grow very fast and may become larger in a short time. Keratoacanthoma is similar to squamous cell carcinoma, basal cell carcinoma, solar keratosis and seborrheic keratosis in appearance, and must be differentiated by pathological section.
8% people will relapse, and less than 1% will become malignant. Dr. Huang Jiyi pointed out that the vast majority of keratoacanthoma is benign, and 8% people will relapse. Less than 1% will become malignant, but it will be cured after resection. Even if it recurs, it will not metastasize far away. In terms of treatment, most benign keratoacanthomas will scab and fall off on their own, and may leave scars at that time. If you don't fall off by yourself or don't fall off completely, you can treat it with freezing or electrocautery first. For people who have repeated occurrences in the same site, surgical resection and pathological section are recommended, and sometimes adjuvant local radiotherapy may be needed. It is helpful to prevent keratoacanthoma by developing the habit of sun protection and avoiding excessive ultraviolet radiation on the skin.