Periocular keratoacanthoma: can we always rely on the clinical diagnosis?

The British Journal of Ophthalmology
Igal LeibovitchDinesh Selva

Abstract

To present a series of patients with a clinical diagnosis of periocular keratoacanthoma and assess the incidence of histologically proven invasive squamous cell carcinoma (SCC). This retrospective case series included all patients with periocular tumours seen in the authors' unit between 1996 and 2004, and who were initially diagnosed with keratoacanthoma based on the clinical presentation. Twelve patients (eight males, four females) were clinically diagnosed with keratoacanthoma. The final histological diagnosis revealed two cases (16.7%) of invasive SCC, and 10 cases (83.3%) of keratoacanthoma. The lower lid was most commonly involved in cases of keratoacanthoma (50.0%). Six patients (60.0%) underwent Mohs surgery, and four (40.0%) were treated with excision under frozen section control. There were no cases of recurrence during a mean follow up period of 21 (SD 13) months. Although the clinical presentation of periocular keratoacanthoma is usually characteristic, a significant percentage of patients will prove to have invasive SCC. Complete excision with margin control offers a definitive diagnosis, as well as tissue conservation and a low recurrence rate.

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Citations

Mar 13, 2012·Dermatologic Surgery : Official Publication for American Society for Dermatologic Surgery [et Al.]·Jordan B Slutsky, Evan C Jones
Dec 25, 2013·The American Journal of Dermatopathology·Jacqueline A Savage, John C Maize
Mar 17, 2007·Clinical & Experimental Ophthalmology·Vanessa LimawararutDinesh Selva
Jul 23, 2013·International Journal of Dermatology·Mhair S DekmezianJ A Tschen
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Related Concepts

Squamous Cell Carcinoma
Differential Diagnosis
Eyelid Diseases
Eyelid Neoplasms
Keratoacanthoma
Retrospective Studies

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