Answer: Keratoacanthoma is classified as a benign lesion but shows many signs and microscopic features of malignancy. Although true keratoacanthomas do not metastasize, they can cause significant scarring and alteration when they occur on a cosmetically sensitive site. Treatment is recommended to minimize scarring and to distinguish keratoacanthoma from squamous cell carcinoma.
5. Should you treat keratoacanthoma in this patient, and if so, how? Answer: When a keratoacanthoma is small or occurs in an area that is not cosmetically sensitive, conservative elliptical excision or saucerization followed by curettage and desiccation is acceptable treatment. Giant keratoacanthomas or lesions on cosmetically sensitive areas such as the face should be referred to a der-matologic consultant for consideration of alternative treatments.
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