- A skin tumor (dome-shaped) that can occur on sun-exposed areas
- The lesion may appear similar to squamous cell cancer (SCC), which is a more solemn skin condition.
- develops in the hair follicles epithelium above the sebaceous glands
- Symptoms include a raised, dome-shaped lesion with a central area of depression on a sun-exposed area such as the face, ears or hands.
- Treatment often includes surgical removal to rule out a more serious condition
- If you catch the problem early, treatment usually works well
RISK FACTORS OF KERATOACONTHOMA
- Sunlight and chemical carcinogens have been implicated.
- Long-term suppression of the immune system, like organ transplant recipients
- Long term presence of scars, such as from a gasoline burn
- Chronic ulcers
- Presence of particular strains of the wart virus (human papillomavirus)
- Previous skin cancer
- Trauma, genetic factors and immune compromised status have also been associated
- Industrial workers long term exposure to pitch and tar
- People who are addicted to chewing tobacco or smoking have a higher risk for keratoaconthoma.
- Typically intense growth over a few weeks to months, followed by a slow spontaneous resolution over 4-6 months
- Most occur on sun- exposed areas, e.g the face, neck, and dorsum of hands and forearms.
- They are usually solitary and begin as firm, round, skin colored or red color papule
- Rapidly progress to dome- shaped nodules with a smooth shiny surface.
- A central crater of ulceration may develop a keratin plug that may project like a horn.
- It leaves a residual scar if not excised
- sometimes presents as multiple tumors
keratoacanthoma commonly found on the :
- Centre of the face
- Dorsum of hands
- Lower legs, especially in women
DIAGNOSIS OF KERATOACANTHOMA
- Tissue biopsy or excision
- Because this lesion cannot be relied on to involute, biopsy or excision is recommended.
TREATMENT OF KERATOACANTHOMA
REMOVAL (SURGERY) TREATMENTS
Treatment options depend on the site and size of the lesion, patient’s health history. A minor surgery is the most common treatment, under a local anesthetic, to remove the tumor.
Some Other treatments include:
- Cryosurgery- in this procedure used liquid nitrogen to freeze or destroy the lesion.
- Electrodesiccation (curettage) – this procedure used to scrap or burn off the growth.
- Used radiation or X-ray therapy for people who are unable to have a surgical procedure.
Medications are used if patients are unable for surgery and have numerous lesions.
The medical treatments are:
- Intralesional methotrexate
- Injecting a folic acid that halts dna synthesis and kills cancer cells
- Intralesional 5-fluorouracil
- Topical 5-fluorouracil
- A 25 % solution of podophyllin
- Oral acitretin
- Chemical vitamin a
- Oral isotretinoin (accutane)
These medications can reduce the number and size of lesions, making the removal treatments or surgeries easier and less aggressive. They aren’t a substitute for actual surgery or other removal.
AYURVEDIC POINT OF VIEW
In Ayurveda, keratoacanthoma may be considered under Charma Kushtha, a type of Kshudra Kushtha (minor skin diseases), due to the similarity in signs and symptoms with HLP. Charma Kushtha is dominant of Vata Dosha and Kapha Dosha. In this condition, the skin over the patch becomes thick like the skin of an elephant.
AYURVEDIC TREATMENT OF KERATOACANTHOMA AT CHANDIGARH AYURVEDIC CENTRE
Ayurvedic treatment of keratoacanthoma involves a comprehensive treatment strategy which involves strengthening of the digestive system, detoxification of the body and rejuvenation.
Detoxification of the body with Panchakarma:
- Detoxing the body is a significant and crucial part of most Ayurvedic treatments, to expel out toxins that have accumulated in the body.
- After assessing the patient’s condition, the treatment may involve Virechana (induced purgation), Basti (enema) and Nasya (purifying nasal therapy).
Correcting functioning of Agni and preventing further generation of Ama(Toxin)
- The doctors at “Chandigarh ayurvedic Centre” can correct the imbalance digestion (Agni).
- This involves diet modifications to boost the digestive fire.
Pacifying the symptoms:
- In order to then control the symptoms of gargling (Kavala), medicated oil/decoction pouring (Dhara), medicines for external application (Lepa), herbal oil massage (Abhyanga) are useful.
Rasayana or Rejuvenating Medicines:
- The treatment procedures to rejuvenate and restore the body tissues along with some herbal formulation to reduce the symptoms of keratoacanthoma.
SELF-CARE GUIDELINES FOR KERATOACANTHOMA
- Keep yourself away from pollution and chemicals.
- Avoid excessive ultraviolet light which may damage your immunity system.
- Lowering stress and aiming for good mental health is crucial to tackle this condition.
- Include practice of meditation and yoga in your daily routine.
- Wear wide-brimmed hats and long-sleeved shirts.
- Avoid artificial tanning devices.
- Limit intake of spicy, fried, sour, oily, heavy, processed and fermented food, curd, fast food, refined sugar and sour foods.
- Turmeric, cumin, bitter vegetables, ginger, holy basil and cardamom should be consumed.
- These all are effective for dealing with keratoacanthoma.
Vaidya Karanvir Singh is the younger Vaidya in Chandigarh Ayurved & Panchakarma Centre. He is the fourth generation in his family who is practicing as a general consultant in Ayurved & Panchakarma treatment at Chandigarh. In his practice, he had treated more than 1000 plus patients worldwide.