Fast growing tumor

A 65-year-woman consulted for this lesion on her left arm which was present for 3 months.

Dermoscopy revealed peripheral hairpin-like vessels on a whitish area, and a central brownish structureless area.

This lesion was excised and pathology revealed a kératoacanthoma.

Keratoacanthoma

This rapidly engrowing lesion for 2 months was clinically in favor of a keratoacanthoma.


In our case dermoscopy revealed:

• an unspecific pattern
• a central ulceration with blood crusts
• a corona of elongated hairpin blood vessels on a white background corresponding to a white keratotic halo
  

Other dermoscopic features of keratoacanthomas are:

• multicomponent pattern
• polymorphous vessels
• central keratotic plug
  

Elongated hairpin blood vessels on a white keratotic halo are non specific of keratoacanthomas and can be observed in invasive squamous cell carcinomas.

Keratoacanthomas is considered as "benign" variant of squamous cell carcinoma. The first line therapy consists in an excision although other alternatives are possible (imiquimod, PDT, etc...)

Other cases: 1

Keratoacanthoma

A 72-year-old man consulted for a rapidly enlarging tumor on his right forearm. The lesion appeared 3 to 4 months before.


The main clinical diagnosis was a keratoacanthoma.

Dermoscopy revealed:

• a central brownish structureless area corresponding to a central mass of keratin
• a whitish area with presence of elongated hairpin vessels
  

A central brownish structureless area (black circle) and hairpin vessels on a whitish background (white circle) are the two main dermoscopic signs in favor of a keratoacanthoma.

The diagnosis was confirmed by pathology after the complete excision of the tumor.