phenylephrine-hydrochloride and Keratoacanthoma

The giant keratoacanthoma (KA) is a rare variant of KA with a maximum size exceeding 2-3 cm. Like other forms of KA, it has a tendency to spontaneously regress but can cause significant anatomic damage. A 69-year-old male presented to our hospital with a giant KA of the nose that showed complete pathological regression by the time of surgery. Pathology showed dermal scar with keratin granulomas extending through the nasal wall to the respiratory mucosa. A total of 57 similar cases from the English literature were reviewed for comparison. Few provide similar details of histological regression. Literature cases occurred predominately in males (74.1%) with a mean age of 59 years. Head tumors were most common (70.7%) and most were treated by surgery (34.5%) or a combination of surgery and radiotherapy (24.1%). Other treatment modalities reported include methotrexate, 5-fluorouracil, and interferon.

Topics: Aged; Humans; Keratoacanthoma; Male; Nose; Skin Diseases

Like all surgical procedures, dorsal nasal flaps may be followed by both early and late complications. The aim of this study was to evaluate the surgical complications and cosmetic outcome of dorsal nasal flaps over a 7-year period in an academic dermatologic surgery unit.. Data were collected retrospectively for all patients undergoing dorsal nasal flap between 1 January 2006 and 31 December 2013. Early and late complications were recorded. Patients were contacted by phone to assess long-term outcomes.. A total of 35 patients were included. Early complications included bleeding (n=2), local infection (n=2) and focal flap necrosis (n=1). Late complications comprised flap thickening (n=7), restriction of the medial canthus (n=2), opening of the labionasal angle (n=1), stitch granuloma (n=1) and telangiectasia on the flap (n=1). Regarding the aesthetic result, seven patients were very satisfied with the flap. Four patients underwent corrective surgery and one patient had laser treatment for telangiectasia on the flap.. Two thirds of patients were satisfied with the aesthetic results and one third had late complications of the flap. Consequently, patients undergoing Rieger-Marchac procedures must be informed of the potential need for further corrective measures following nasal dorsal flap repair.

Topics: Aged; Aged, 80 and over; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Esthetics; Female; Granuloma; Humans; Keratoacanthoma; Keratosis, Actinic; Male; Middle Aged; Necrosis; Nose; Nose Neoplasms; Patient Satisfaction; Postoperative Hemorrhage; Retrospective Studies; Rhinoplasty; Surgical Flaps; Surgical Wound Infection

Postoperative evaluation of results of reconstructive procedures of the lips mainly consists of describing the technique, complications and subjectively interpreted patient photographs. The authors present a photo-assisted pre- to postoperative evaluation of reconstructive procedures of the lips based on anthropometric measurements and functional outcome. Forty-eight patients underwent partial or full thickness excision of tumours of the lips and subsequent reconstruction. An analysis of standardized pre- and postoperative photographs included measurements of intercanthal width, mouth width, philtrum width, lateral upper lip height, upper and lower lip height, cutaneous upper and lower lip height, upper and lower vermilion arc and upper and lower vermilion height. Assessment of functional outcome consisted of the evaluation of oral competence, changes of oral opening and sensation. The effects on the described parameters were analysed, when partial or full thickness reconstruction had to be performed. Intercanthal mouth width index, vermilion arc index, vermilion and cutaneous total lower lip height index showed statistically significant effects postoperatively which indicates a postoperative tightened lower lip, when full-thickness excision was performed. In all patients the indices were proven reproducible and reliable. The standardized measurements described are accurate and objective for evaluating postoperative results.

Topics: Aged; Anatomic Landmarks; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Cephalometry; Dissection; Female; Follow-Up Studies; Humans; Hypesthesia; Keratoacanthoma; Lip; Lip Diseases; Lip Neoplasms; Male; Mouth; Mouth Mucosa; Nose; Photography; Plastic Surgery Procedures; Postoperative Complications; Sensation; Skin; Surgical Flaps; Treatment Outcome

Topics: Aged; Aged, 80 and over; Cicatrix; Diagnosis, Differential; Female; Humans; Keratoacanthoma; Leg; Male; Nose; Skin Diseases

To date, the retroangular flap has been used only for reconstruction of defects of the nose and the glabella.. The objective was to expand the indications of the retroangular flap in facial reconstruction.. We repaired the facial defects of 11 patients using 12 retroangular flaps. These defects were located on the nose in 4 patients, the lower eyelid in 4 patients, the upper eyelid in 2 patients, and the cheek in 1 patient.. The mean follow-up time was 13.2 months. All of the flaps survived, and no revisional procedures were required. Cosmetic and functional outcomes were satisfactory in all patients.. The retroangular flap is a valuable alternative for the management of small- to moderate-sized defects of the midface. We strongly suggest extending the use of this flap to include reconstruction of nasal, eyelid, and cheek defects.

Topics: Adolescent; Adult; Aged; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Cheek; Child; Child, Preschool; Eyelids; Follow-Up Studies; Humans; Keratoacanthoma; Male; Middle Aged; Nose; Plastic Surgery Procedures; Skin Diseases; Surgical Flaps; Treatment Outcome

Keratoacanthoma is a relatively common benign squamous neoplasm that may show spontaneous clearing. Although the cause of the tumour is unknown, there are some reports describing keratoacanthoma following various types of trauma or secondary to other skin lesions. Thermal burns are reported to be important preceding traumas in the development of keratoacanthomas. whereas there is only one report of cold trauma of cryotherapy. We report a rare case of keratoacanthoma arising in the site of cryotherapy applied for solar keratosis.

Topics: Cicatrix; Cryotherapy; Diagnosis, Differential; Humans; Keratoacanthoma; Keratosis; Male; Middle Aged; Nose; Skin Diseases; Sunlight

Retinoids have the capacity to accelerate the involution of multiple keratoacanthomas, including unusual variants such as keratoacanthoma marginatum centrifugum and keratoacanthoma en plaque that may persist and be associated with progressive growth and provide difficulties in diagnosis and management.. We describe 3 patients who had unusual infiltrated and keratotic plaques affecting the lower legs or nasolabial area that persisted or recurred that may be related to this group of unusual keratoacanthomas. The 3 patients had differing clinical lesions that did not resemble classic keratoacanthomas, but were linked by their biopsy findings of hypertrophic lichen planus-like reaction and pseudoepitheliomatous hyperplasia with a prominent infundibulocystic component that progressed to multiple keratoacanthomas or infundibulocystic squamous cell carcinoma. Polymerase chain reaction analysis of biopsy material from 2 patients failed to detect human papillomavirus. All 3 presentations provided a therapeutic dilemma, but responded rapidly to acitretin treatment at a dosage of 10 to 25 mg daily, which was continued for 15 to 24 months.. These cases illustrate an unusual reaction pattern that is hypertrophic lichen planus-like but, instead of evolving to classic lichen planus, progresses to infundibulocystic hyperplasia and the development of multiple keratoacanthomas or infundibulocystic squamous cell carcinomas. Retinoids represent a therapeutic option for this difficult clinical problem and may obviate repeated and extensive surgery.

Topics: Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Diagnosis, Differential; Female; Humans; Hypertrophy; Keratoacanthoma; Lichen Planus; Lower Extremity; Male; Nose; Skin Neoplasms

Transposition flaps are old but are the method of choice in reconstruction of defects of the dorsum of the nose. Eleven consecutive patients with such defects were treated with 22 transposition flaps. The nasal defects resulted from tumour (n = 9), trauma (n = 1), and keratoacanthoma (n = 1). The dissection is rapid, easy and the complication rate is low.

Topics: Aged; Carcinoma, Basal Cell; Female; Humans; Keratoacanthoma; Male; Middle Aged; Nose; Nose Neoplasms; Rhinoplasty; Surgical Flaps

A 90 year old woman presented with a rapidly growing nodular tumor at the tip of the nose. Clinically, keratoakanthoma was tentatively diagnosed. Histological examination, however, revealed Merkel cell carcinoma. This case supports the necessity of a surgical excision with a subsequent histological examination even when the clinical aspect is suggestive for keratoacanthoma.

Topics: Aged; Aged, 80 and over; Carcinoma, Merkel Cell; Diagnosis, Differential; Female; Humans; Keratoacanthoma; Neoplasm Recurrence, Local; Nose; Nose Neoplasms

Three patients, two men aged 54 and 72 years, respectively, and a woman aged 52 years, were treated successfully for (recurrence of a) keratoacanthoma with methotrexate. Since the sixties 11 patients with recurrent keratoacanthoma treated with methotrexate have been described. Dose schedules were widely different and dosages were in general high, resulting in more or less severe side effects. The patients now presented were treated according to the Weinstein schedule, with small doses and during a short period, which minimises the adverse effects.

Topics: Aged; Drug Administration Schedule; Ear, External; Female; Forehead; Humans; Keratoacanthoma; Male; Methotrexate; Middle Aged; Nose; Recurrence; Skin Diseases

Topics: Adult; Facial Dermatoses; Humans; Keratoacanthoma; Male; Nose

On the previously unaffected skin of the nose of a 48-year-old patient a very rapidly growing tumour had been unsuccessfully excised twice. The second recurrence had been misinterpreted as erysipelas because of its rapid spread, inflammatory reddening at the margin and sensitivity to pressure. Increasing hardness and yellow discolouration eventually led to the diagnosis "plate-shaped keratoacanthoma". Spontaneous regression of the tumour resulted in complete cure within six months.

Topics: Biopsy; Humans; Keratoacanthoma; Male; Middle Aged; Nose; Nose Diseases; Recurrence

Topics: Biopsy; Carcinoma, Squamous Cell; Diagnosis, Differential; Humans; Keratoacanthoma; Male; Middle Aged; Nose; Nose Neoplasms; Skin Transplantation; Transplantation, Autologous

Topics: Adipose Tissue; Adolescent; Adult; Aged; Carcinoma, Basal Cell; Cartilage; Child; Ear, External; Female; Follow-Up Studies; Humans; Keratoacanthoma; Male; Middle Aged; Nose; Nose Deformities, Acquired; Nose Neoplasms; Pigmentation Disorders; Skin Transplantation; Transplantation, Autologous

Topics: Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Female; Humans; Keratoacanthoma; Male; Methods; Nose; Nose Neoplasms; Prostheses and Implants; Skin Transplantation; Surgery, Plastic; Transplantation, Autologous