Solitary Keratoacanthoma at the Recipient Site of a Full-Thickness Skin Graft: A Case Report and Review of the Literature

Author:

Kim Jeong Ho1ORCID,Lee Sang-Hoon2ORCID,Hong Seung-Phil2ORCID,Kim Jiye1ORCID,Kim Sug Won1ORCID

Affiliation:

1. Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

2. Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea

Abstract

AbstractA 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative.Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

Publisher

Georg Thieme Verlag KG

Subject

Surgery

Reference18 articles.

1. Kerato-acanthoma;A Rook;Arch Belg Dermatol Syphiligr,1950

2. A clinical and biological review of keratoacanthoma;A Tisack;Br J Dermatol,2021

3. Keratoacanthoma (KA): an update and review;B Kwiek;J Am Acad Dermatol,2016

4. The multiple growth of molluscum sebaceum in donor and recipient sites of skin graft;F A Dibden;Aust N Z J Surg,1955

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