Canas G C, Robson K J, Arpey C J
Department of Dermatology, University of Iowa Hospitals, Iowa City 52242.
Dermatol Surg. 1998 Dec;24(12):1364-9. doi: 10.1111/j.1524-4725.1998.tb00016.x.
Keratoacanthoma is a common cutaneous neoplasm, although the persistent form is less common and often more difficult to manage. Multiple treatment approaches have been attempted with variable efficacy. Establishing the diagnosis and selecting a treatment plan for persistent keratoacanthoma is often challenging.
Our purpose is to describe the difficulty one may encounter in the diagnosis and treatment of persistent keratoacanthoma. Hopefully, review of this clinical conundrum may facilitate the management of the reader's future patients.
We describe a case of persistent keratoacanthoma where the diagnosis was initially elusive and the management challenging. Our thought process during each stage of diagnosis and management is described in the form of "issues" with references to the appropriate literature.
After several diagnostic and therapeutic interventions, successful treatment was achieved with administration of oral isotretinoin. Long-term remission continued as the dosage was tapered.
Persistent keratoacanthoma may be challenging to diagnose and manage, presenting a clinical conundrum. Careful review of the clinicopathologic presentation and an understanding of the various treatment options may result in a successful outcome.
角化棘皮瘤是一种常见的皮肤肿瘤，尽管持续性角化棘皮瘤较少见且通常更难处理。人们尝试了多种治疗方法，疗效各不相同。对于持续性角化棘皮瘤，确立诊断并选择治疗方案往往具有挑战性。
我们的目的是描述在持续性角化棘皮瘤的诊断和治疗中可能遇到的困难。希望通过对这一临床难题的回顾，能有助于读者对未来患者的管理。
我们描述了一例持续性角化棘皮瘤病例，其诊断起初难以明确，治疗也颇具挑战性。我们在诊断和治疗各阶段的思考过程以“问题”的形式呈现，并参考了相关文献。
经过多次诊断和治疗干预后，口服异维甲酸成功实现了治疗。随着剂量逐渐减少，患者持续保持长期缓解。
持续性角化棘皮瘤的诊断和管理可能具有挑战性，是一个临床难题。仔细回顾临床病理表现并了解各种治疗选择可能会带来成功的结果。
