Liu Xian-Guang, Liu Xing-Guang, Wang Cai-Jiao, Wang Han-Xi, Wang Xu-Xia
Department of Oral and Maxillofacial Surgery, Shandong University, Jinan 250100, Shandong Province, China.
Department of Oral Pathology, Shandong University, Jinan 250100, Shandong Province, China.
World J Clin Cases. 2022 Jul 16;10(20):6960-6965. doi: 10.12998/wjcc.v10.i20.6960.
This paper introduces a case of recurrent keratoacanthoma (KA). KA is a self-healing disease. Recurrence after surgical resection is rare. In this case, the local application of retinoic acid ointment after the second operation achieved a good prognosis after 2 years of follow-up.
A 76-year-old male patient was admitted to the hospital for "lower lip rupture and scab for 3 mo". Treatment: A rectangular incision was made in the healthy tissue about 3 mm outside the periphery of the lower lip mass, and a modified Bernard sliding flap was designed to completely remove the mass. Pathology showed (lower lip) KA. When the patient returned 6 mo after surgery, the middle mucosa of the lower lip had a bulge with a diameter of about 0.5 cm. The boundary was still clear, the surface was ulcerated. A recurrence of lower lip KA was suspected and a fan-shaped incision was performed in the healthy tissue about 5 mm outside the lesion to completely resect. Pathological showed lower lip KA had recurred. Topical application of tretinoin cream was applied once a day for 3 mo. The lower lip wounds were clean at the 2-year postoperative follow-up and the mucosa was normal.
Adjuvant retinoic acid treatment after KA surgical resection can achieve good results.
本文介绍一例复发性角化棘皮瘤（KA）。KA是一种自愈性疾病。手术切除后复发罕见。在此病例中，第二次手术后局部应用维甲酸软膏，经过2年随访取得了良好预后。
一名76岁男性患者因“下唇破溃结痂3个月”入院。治疗：在距下唇肿物边缘约3 mm的健康组织处做矩形切口，设计改良Bernard滑行瓣以完全切除肿物。病理显示（下唇）KA。患者术后6个月复诊时，下唇中部黏膜有一隆起，直径约0.5 cm，边界仍清晰，表面溃疡。怀疑下唇KA复发，在距病变约5 mm的健康组织处做扇形切口以完全切除。病理显示下唇KA复发。局部应用维甲酸乳膏，每天1次，共3个月。术后2年随访时，下唇伤口清洁，黏膜正常。
KA手术切除后辅助维甲酸治疗可取得良好效果。
