From the Research
Shave excision is a suitable treatment option for keratoacanthoma (KA), but considering the most recent evidence, a more conservative approach with intralesional therapy or topical treatments should be prioritized to minimize morbidity and improve quality of life. For KA treatment, I recommend considering the patient's overall health, the size and location of the lesion, and the potential risks and benefits of each treatment option. According to the study by 1, KA is considered a benign lesion, distinct from squamous cell carcinoma, which supports a less invasive treatment approach.
Treatment Options
- Intralesional therapy with methotrexate or 5-fluorouracil, as discussed in 2 and 3, can be an effective treatment option for KA, especially for larger lesions or those in cosmetically sensitive areas.
- Topical treatments, such as 5% imiquimod cream, as reported in 4, can also be considered for smaller lesions or for patients who prefer a more conservative approach.
- Shave excision, as described in the example answer, can still be a viable option for KA treatment, especially for smaller lesions or those that are easily accessible.
Considerations
- The patient's overall health and potential comorbidities should be taken into account when selecting a treatment option.
- The size and location of the lesion should also be considered, as larger lesions or those in cosmetically sensitive areas may require alternative treatments.
- The potential risks and benefits of each treatment option should be discussed with the patient, including the risk of recurrence, scarring, and potential side effects.
Post-Treatment Care
- Regardless of the treatment option chosen, post-procedure care involves keeping the wound clean, applying petroleum jelly, and covering with a bandage for 1-2 weeks until healed.
- Follow-up appointments should be scheduled to monitor the patient's progress and ensure complete removal of the lesion.