Bettoli Vincenzo, Zedde Pierantonia, Schettini Natale, Pacetti Lucrezia, Odorici Giulia, Corazza Monica
Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
Skin Appendage Disord. 2023 Jan;9(1):69-72. doi: 10.1159/000526629. Epub 2022 Nov 1.
Solitary keratoacanthoma (SKA) is generally considered as a well-differentiated form of squamous cell carcinoma, but it usually runs a benign course and a not aggressive behavior. Diagnostic criteria, prognosis, and treatment of SKA are not fully defined yet. Surgical treatment with fusiform excision represents the gold standard; nonoperative intralesional therapy of KA is uncommon but may provide a valid option in some categories of patients.
We report our experience regarding the treatment of SKA with a hybrid treatment consisting of a minimally invasive technique such as curettage followed by intralesional corticosteroid administration in the same session. Six patients affected with KA were treated ending in a complete resolution, with good esthetic outcome, no relapse after 1 year, and satisfaction of the patients.
The combined treatment allows us on the one hand to avoid radical surgery in selected patients and particular anatomic areas and on the other the side effects that the use of intralesional chemotherapy/immunosuppressive drugs can entail.
孤立性角化棘皮瘤（SKA）通常被认为是一种高分化型鳞状细胞癌，但它通常病程呈良性且行为不具侵袭性。SKA的诊断标准、预后及治疗尚未完全明确。梭形切除的手术治疗是金标准；KA的非手术病灶内治疗并不常见，但在某些类型的患者中可能提供一种有效的选择。
我们报告了我们使用一种混合治疗方法治疗SKA的经验，该方法包括在同一次治疗中采用刮除术等微创技术，随后进行病灶内注射皮质类固醇。6例KA患者接受了治疗，最终完全消退，美容效果良好，1年后无复发，患者满意。
这种联合治疗一方面使我们能够在特定患者和特定解剖区域避免根治性手术，另一方面避免了使用病灶内化疗/免疫抑制药物可能带来的副作用。
