Eruptive squamous atypia (also known as eruptive keratoacanthoma): Definition of the disease entity and successful management via intralesional 5-fluorouracil - 21/06/19
, Leigh A. Compton, MD, PhD b, c, Chrysalyne D. Schmults, MD, MSCE d, ⁎ Abstract |
Background |
Eruptive squamous atypia (ESA), which is an idiopathic, sometimes koebnerizing, proliferation of atypical but well-differentiated keratinocytes (also termed eruptive keratoacanthoma), is often misdiagnosed as cancer and managed by excisional surgery, provoking further koebnerization. A clear definition of this phenomenon and treatment outcome data are lacking.
Objective |
To define ESA and evaluate efficacy of intralesional (IL) 5-fluorouracil (5-FU) treatment.
Methods |
A retrospective cohort study examined patients with ESA that arose spontaneously or within a recent surgical scar and was treated with IL 5-FU at a tertiary academic center between January 2008 and December 2016. Complete clearance, partial clearance, and number of surgical excisions performed were tabulated.
Results |
Of 30 patients with 136 ESA lesions, 20 (67%) had resolution of ESA with IL 5-FU monotherapy. In all, 10 patients (33%) required additional therapy (topical 5-FU, steroids, cryotherapy, or acitretin). No IL 5-FU–treated ESA lesions required surgical excision. The number of excisional procedures decreased significantly (P = .006), with 27 patients (90%) needing fewer excisions 12 months after versus 12 months before initiation of IL 5-FU therapy. Dyspigmentation was the only adverse event.
Limitations |
Limitations include retrospective analysis and use of data from a single institution.
Conclusion |
With close clinical monitoring, IL 5-FU can be used to successfully treat ESA.
Le texte complet de cet article est disponible en PDF.Key words : atypical squamous proliferation, eruptive keratoacanthoma, eruptive squamous atypia, hypertrophic lichen planus-like reactions, infundibulocystic hyperplasia, intralesional 5-flourouracil, postsurgical koebnerization, pseudoepitheliomatous hyperplasia, squamous cell carcinoma, squamous dysplasia, squamous proliferation
Abbreviations used : 5-FU, D-ESA, ESA, FK-ESA, IL, SCC
Plan
| Funding sources: None. |
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| Conflicts of interest: None disclosed. |
Vol 81 - N° 1
P. 111-122 - juillet 2019 Retour au numéro
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