Wong W Y, Kolbusz R V, Goldberg L H, Guana A
Department of Dermatology, Baylor College of Medicine, Houston, Texas.
Int J Dermatol. 1994 Aug;33(8):579-83. doi: 10.1111/j.1365-4362.1994.tb02902.x.
Keratoacanthoma is a benign epithelial tumor that occurs on the sun-exposed skin of elderly people. Development of KAS on functionally and cosmetically important areas such as the face poses the therapeutic challenge to minimize functional and cosmetic damage. Oral isotretinoin (Accutane, Roche Laboratories) has been reported to be an effective treatment of multiple as well as solitary keratoacanthomas.
A 45-year-old man with a large keratoacanthoma on the nasal ala, recurrent after surgical excision, was treated with 1 mg/kg/day (80 mg/day) oral isotretinoin (Accutane). Cessation of tumor progression was evident within 1 week after initiation of therapy, and tumor regression was evident within 2 weeks. Tumor size diminished rapidly over the ensuing weeks and complete resolution at 12 weeks was confirmed by biopsy.
An initial trial of oral isotretinoin is an alternative to immediate surgical excision for the treatment of large keratoacanthomas in instances when tumor removal would cause considerable cosmetic deformity.
角化棘皮瘤是一种发生于老年人暴露于阳光下皮肤的良性上皮肿瘤。在面部等功能和美观重要区域发生角化棘皮瘤，对将功能和美观损害降至最低构成了治疗挑战。据报道，口服异维A酸（异维甲酸，罗氏制药公司）是治疗多发及单发角化棘皮瘤的有效方法。
一名45岁男性，鼻翼处有一个巨大的角化棘皮瘤，手术切除后复发，接受了1毫克/千克/天（80毫克/天）的口服异维A酸（异维甲酸）治疗。治疗开始后1周内肿瘤进展停止明显，2周内肿瘤消退明显。在随后几周内肿瘤大小迅速缩小，活检证实12周时完全消退。
对于切除肿瘤会导致相当大的美容畸形的情况，口服异维A酸的初步试验是治疗大型角化棘皮瘤的替代即时手术切除的方法。
