Keratoacanthomas generally regress spontaneously and resolve within 6–12 weeks. However, they are difficult to distinguish from cutaneous squamous cell carcinoma (cSCC), both clinically and histologically on incisional biopsy (see: Pathology of keratoacanthoma and Clinical features of squamous cell carcinoma and related keratinocyte tumours).
Overview of evidence (non-systematic literature review)
There have been very few clinical trials of RT in the treatment of keratoacanthoma.
Radiotherapy hastens the natural history of resolution of keratoacanthomas, with advantages to the patient of shorter lesion duration and less scarring. A low dose of 25 Gy is sufficient.
However, since keratoacanthomas can be difficult to distinguish from aggressive primary cSCCs they should be managed as an invasive cSCC if the diagnosis is in doubt.
Radiotherapy may be considered in the treatment of keratoacanthoma to hasten the natural history of resolution.
- Radiotherapy – Introduction
- Radiotherapy with or without surgical treatment for keratinocyte cancer
- Radiotherapy for basal cell carcinoma
- Radiotherapy for cutaneous squamous cell carcinoma
- Radiotherapy for regional (nodal) metastatic disease (non-distant)
- Radiotherapy for actinic keratosis and cutaneous squamous cell carcinoma in situ
- Recent advances in the radiotherapy of skin cancer
- Management of side effects of radiotherapy
- Radiotherapy – health system implications and discussion
- Veness MJ. The important role of radiotherapy in patients with non-melanoma skin cancer and other cutaneous entities. J Med Imaging Radiat Oncol 2008 Jun;52(3):278-86 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18477123.
- Shimm DS, Wilder RB. Radiation therapy for squamous cell carcinoma of the skin. Am J Clin Oncol 1991 Oct;14(5):383-6 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/1951174.