Histopathology of Keratoacanthoma Revisited: Utility of Orificial Size as a Diagnostic Adjunct

International Journal of Surgical Pathology
Phyu P AungMeera Mahalingam


Given the defining histopathologic architecture of keratoacanthoma (KA), the aim of this study was to measure the crateriform orifice ("orificial size") in histopathologically crateriform lesions to ascertain its utility as an objective diagnostic histopathologic adjunct. This cross-sectional, retrospective study included 97 cases with a histopathologic diagnosis of KA. We measured the "orificial size" using the ocular micrometer in a BH-2 Olympus microscope at 4× magnification, in a blinded manner with respect to information. Frequency of histopathologic features observed was also recorded. The average orificial size for different groups was as follows: 2.3 ± 0.2 mm for cases with a clinical presentation of KA/keratotic papule (KP) (n = 30) versus 2.9 ± 0.3 mm for other (n = 67), P = .18. Histopathologic findings in the 2 groups were as follows: crateriform architecture/epithelial lip and sharp demarcation of tumor from stroma (100% in both groups), fibrosis (29/30 vs 64/67), apoptotic keratinocytes (27/30 vs 56/67), dermal islands of "glassy" keratinocytes (26/30 vs 54/67), entrapped elastic fibers (26/30 vs 49/67), and neutrophilic abscesses (11/30 vs 21/670 [P = not significant for all]. Our findings indicate that, in the a...Continue Reading


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Methods Mentioned

imaging techniques

Related Concepts

Prevalence Studies
Retrospective Studies
Dermatologic Disorders
Cross-Sectional Studies
Retrospective Studies
N-succinimidyl 3-(3-hydroxy-5-iodophenyl)propionate

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