The Journal of the Arkansas Medical Society Issue 6 Volume 115 | Page 11

Special Section: Short Dermatological Cases Derm Dilemma: Keratoacanthoma Hunter Cochran 1 ; Kevin St. Clair, MD Candidate UAMS, class 2020 1 A 60-year-old white male presents complaining of a rapidly enlarging, painless, centrally-umbilicated, papulonodule located on the dorsal hand. The nodule was noted initially about five weeks ago. The patient admits he attempted to drain the lesion at home unsuccessfully. Subsequent appropriate step(s) in the evaluation or management of this patient should include: More Than Healthcare, Correct Care Solutions. WHO WE ARE CCS is a national public healthcare leader caring for underserved patients in correctional settings, psychiatric hospitals and residential treatment facilities. Opportunities for: Physician Locations throughout Arkansas Full-time, part-time and PRN available Comprehensive Benefits • 401K Tuition Reimbursement Competitive Compensation • So Much More... A. Destruction by cryotherapy Empathy B. Reassurance and observation C. Shave biopsy Compassion D. Warm compresses and one-week course of oral cephalexin E. Intralesional injection of triamcinolone acetonide CALL TODAY OR APPLY ONLINE Chris Phillips [phone] or email [email protected] ccs.careers CCS IS PROUDLY AN EQUAL OPPORTUNITY EMPLOYER Put your business or service in the hands of 4,500 Arkansas physicians. Answer: C. The clinical features of an erythematous, exophytic papulonodule with a central keratin-filled crater located in a sun-exposed area coupled with relatively rapid growth suggest that this lesion most likely represents a keratoacanthoma (KA). Most authorities consider KA a low-grade variant of squamous cell carcinoma (SCC), although untreated KA may resolve spontaneously within a few months. Ethical and medicolegal considerations preclude observation of suspected KA, as aggressive and potentially metastatic SCC may present in a similar fashion. Following definitive diagnosis via skin biopsy, the most commonly employed treatment modalities are excision or destruction by curettage and electrodessication. For more advertising information, contact Penny Henderson at 501.224.8967 or [email protected] NUMBER 6 DECEMBER 2018 • 131