Rapidly growing, painless lesions

March 31, 2010

A papular lesion developed rapidly during the previous 11 days on the left forearm of an 89-year-old man. Another patient noticed a similar growth that developed over a 3-week period on his finger.

 

Case 3:

A papular lesion developed rapidly during the previous 11 days on the left forearm of an 89-year-old man (A). Another patient noticed a similar growth that developed over a 3-week period on his finger (B).

Are these squamous cell carcinomas or another type of lesion?

 

Answers on Next Page

 

Case 3: Keratoacanthomas

These are keratoacanthomas, benign neoplasms that occur predominantly on the extensor surfaces of hands and forearms of white men older than 50 years. Because these lesions are grossly indistinguishable from squamous cell carcinoma, microscopic diagnosis is mandatory.

 

Spontaneous regression occurs, but a disfiguring scar may ensue. Surgical excision or electrodesiccation with curettage is recommended.

 

(Case and photograph A courtesy of Dr Robert P. Blereau; case and photograph B courtesy of Dr Daniel L. Savitt.)