Gray R J, Meland N B
Department of Surgery, Mayo Clinic Scottsdale, AZ 85259, USA.
Ann Plast Surg. 2000 Jan;44(1):82-5. doi: 10.1097/00000637-200044010-00015.
Keratoacanthoma is a common, benign cutaneous neoplasm that displays rapid growth on sun-exposed skin. Keratoacanthomas usually involute spontaneously after several months but rarely progress to squamous cell carcinoma. Because this is a benign, self-limited lesion of exposed skin, effective treatment should emphasize patient comfort and cosmetic results in addition to effectiveness. The authors present 2 patients with keratoacanthomas treated with topical 5-fluorouracil. Both patients had complete resolution of their lesions within 8 weeks. The cosmetic result was superb in both patients. Patient satisfaction with this therapy was excellent. Treatment can be instituted based on a clinical diagnosis; no diagnostic biopsy is necessary. Most keratoacanthomas respond to topical 5-fluorouracil therapy within 3 weeks, whereas squamous cell carcinomas respond poorly. Any lesion that shows a poor response after 3 weeks of therapy or that does not resolve within 8 weeks should undergo prompt excisional biopsy for definitive diagnosis and treatment. Topical 5-fluorouracil is an effective, convenient, relatively inexpensive treatment for keratoacanthoma that produces excellent cosmetic results. It should be added to the therapeutic armamentarium of all physicians who treat keratoacanthoma.
角化棘皮瘤是一种常见的良性皮肤肿瘤，在暴露于阳光下的皮肤上生长迅速。角化棘皮瘤通常在数月后自行消退，但很少进展为鳞状细胞癌。由于这是一种暴露皮肤的良性、自限性病变，除了有效性外，有效的治疗还应注重患者舒适度和美容效果。作者介绍了2例接受局部5-氟尿嘧啶治疗的角化棘皮瘤患者。两名患者的病变均在8周内完全消退。两名患者的美容效果都非常好。患者对这种治疗的满意度很高。可根据临床诊断进行治疗；无需进行诊断性活检。大多数角化棘皮瘤在3周内对局部5-氟尿嘧啶治疗有反应，而鳞状细胞癌反应较差。任何在治疗3周后反应不佳或在8周内未消退的病变都应立即进行切除活检以明确诊断和治疗。局部5-氟尿嘧啶是一种有效、方便且相对便宜的治疗角化棘皮瘤的方法，能产生极佳的美容效果。它应被纳入所有治疗角化棘皮瘤的医生的治疗手段中。
