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Squamous Cell Carcinoma Following Fluorouracil-Responsive `Keratoacanthoma'

Squamous Cell Carcinoma Following Fluorouracil-Responsive `Keratoacanthoma' Abstract To the Editor.— The treatment of keratoacanthoma (KA) with fluorouracil cream administered by the intralesional1,2 and topical routes at concentrations of 20%3 and 5%4,5 has been reported. When treating these lesions without histologic confirmation, the following criteria are suggested to preclude the misdiagnosis of squamous cell carcinoma: (1) characteristic morphology of the keratoacanthoma, (2) history of growth of the lesion to its ultimate size within four to six weeks, and (3) prompt response of the lesion to fluorouracil treatment with at least 60% to 70% involution during a two-week treatment period.4 We describe a patient with such a lesion that initially responded to fluorouracil therapy only to recur three weeks after completion of therapy. An excisional biopsy specimen at that time revealed a poorly differentiated squamous cell carcinoma. Report of a Case.— A 76-year-old man presented with a three- to four-week history of a rapidly growing References 1. Odom RB, Goette DK: Treatment of keratoacanthomas with intralesional fluorouracil . Arch Dermatol 1978;114:1779-1783.Crossref 2. Goette DK, Odom RB: Successful treatment of keratoacanthoma with intralesional fluorouracil . J Am Acad Dermatol 1980;2:212-216.Crossref 3. Goette DK, Odom RB, Arrot J, et al: Treatment of keratoacanthomas with topical fluorouracil . Arch Dermatol 1982;118:309-311.Crossref 4. Goette DK: Treatment of keratoacanthoma with topical fluorouracil . Arch Dermatol 1983;119:951-953.Crossref 5. Bennett R, Epstein E, Goette DK, et al: Current management using 5-fluorouracil: 1985 . Cutis 1985;36:218-236. 6. Ebner H: Treatment of skin epitheliomas with 5-fluorouracil ointment: Influence of therapeutic design on recurrence of lesions . Dermatologica 1970;140( (suppl 1) ):42-46.Crossref 7. Klein E, Stoll HL, Milgrom H, et al: Tumors of the skin: XII. Topical 5-fluorouracil for epidermal neoplasms . J Surg Oncol 1971;3:331-349.Crossref 8. Klein E, Holtermann OA, Helm F, et al: Topical therapy for cutaneous tumors . Transplant Proc 1984;16:507-515. 9. Albright SD: Treatment of skin cancer using multiple modalities . J Am Acad Dermatol 1982;7:143-171.Crossref 10. Kurtis B, Rosen T: Squamous-cell carcinoma arising in a basal-cell epithelioma treated with 5-fluorouracil . J Dermatol Surg Oncol 1979;5:394-396.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Squamous Cell Carcinoma Following Fluorouracil-Responsive `Keratoacanthoma'

Archives of Dermatology , Volume 123 (8) – Aug 1, 1987

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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1987.01660320027002
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— The treatment of keratoacanthoma (KA) with fluorouracil cream administered by the intralesional1,2 and topical routes at concentrations of 20%3 and 5%4,5 has been reported. When treating these lesions without histologic confirmation, the following criteria are suggested to preclude the misdiagnosis of squamous cell carcinoma: (1) characteristic morphology of the keratoacanthoma, (2) history of growth of the lesion to its ultimate size within four to six weeks, and (3) prompt response of the lesion to fluorouracil treatment with at least 60% to 70% involution during a two-week treatment period.4 We describe a patient with such a lesion that initially responded to fluorouracil therapy only to recur three weeks after completion of therapy. An excisional biopsy specimen at that time revealed a poorly differentiated squamous cell carcinoma. Report of a Case.— A 76-year-old man presented with a three- to four-week history of a rapidly growing References 1. Odom RB, Goette DK: Treatment of keratoacanthomas with intralesional fluorouracil . Arch Dermatol 1978;114:1779-1783.Crossref 2. Goette DK, Odom RB: Successful treatment of keratoacanthoma with intralesional fluorouracil . J Am Acad Dermatol 1980;2:212-216.Crossref 3. Goette DK, Odom RB, Arrot J, et al: Treatment of keratoacanthomas with topical fluorouracil . Arch Dermatol 1982;118:309-311.Crossref 4. Goette DK: Treatment of keratoacanthoma with topical fluorouracil . Arch Dermatol 1983;119:951-953.Crossref 5. Bennett R, Epstein E, Goette DK, et al: Current management using 5-fluorouracil: 1985 . Cutis 1985;36:218-236. 6. Ebner H: Treatment of skin epitheliomas with 5-fluorouracil ointment: Influence of therapeutic design on recurrence of lesions . Dermatologica 1970;140( (suppl 1) ):42-46.Crossref 7. Klein E, Stoll HL, Milgrom H, et al: Tumors of the skin: XII. Topical 5-fluorouracil for epidermal neoplasms . J Surg Oncol 1971;3:331-349.Crossref 8. Klein E, Holtermann OA, Helm F, et al: Topical therapy for cutaneous tumors . Transplant Proc 1984;16:507-515. 9. Albright SD: Treatment of skin cancer using multiple modalities . J Am Acad Dermatol 1982;7:143-171.Crossref 10. Kurtis B, Rosen T: Squamous-cell carcinoma arising in a basal-cell epithelioma treated with 5-fluorouracil . J Dermatol Surg Oncol 1979;5:394-396.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Aug 1, 1987

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