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Description This chapter describes the dermoscopy criteria of Keratoacanthoma
Author(s) Florentia Dimitriou · Teresa Deinlein · Iris Zalaudek
Responsible author Iris Zalaudek→ send e-mail
Status unknown
Status update June 19, 2017
Status by Ralph P. Braun


Keratoacanthoma is a well-differentiated variant of Squamous cell carcinoma. Clinically, it is distinguished by its initial rapid growth followed by spontaneous involution over a period of a few months.



Dermoscopy criteria
  • White circles: White ring-like structures within the hair follicle
  • Keratin mass: Centrally located, amorphous, yellow-white to light brown areas without any recognizable structure
  • White structureless areas: Absence of any structure; they may be associated with large targetoid hair follicles

The central keratin plug is an architectural criterion for the diagnosis of keratoacanthoma also on the histopathological analysis and may be typically surrounded by elongated and sometimes thick telangiectasias.

Keratoacanthoma schematic.jpg


Keratoacanthoma.jpg




Vascular architecture of Keratoacanthoma


  • Hairpin vessels: Vascular Loops frequently twisted and bending, usually surrounded by whitish halo
  • Linear-irregular vessels: Serpentine or branched Serpentine; irregularly shaped, sized and distributed red structures
  • Glomerular (coiled) vessels: Larger than dotted vessels with convoluted morphology and often distributed in clusters




References
  1. An Atlas of Dermoscopy, Second Edition. Marghoob A. et al. CRC Press; 2012.
  2. Argenziano, G., Zalaudek, I., Corona, R., et al., 2004, Vascular structures in skin tumors: a dermoscopy study. Arch Dermatol, 140, 1485–9.
  3. Kittler, H., Riedl, E., Rosendahl, C. & Cameron, A., 2008, Dermatoscopy of unpigmented lesions of the skin: a new classification of vessel morphology based on pattern analysis. Dermatopathol Pract Conc, 14, 4.
  4. Kreusch, J. & Koch, F., 1996, Auflichtmikroskopische Charakterisierung von Gefassmustern in Hauttumoren. Hautarzt, 47, 264–72.
  5. Kreusch, J.F., 2002, Vascular patterns in skin tumors. Clin Dermatol, 20, 248–54.
  6. Mogensen, M. & Jemec, G.B., 2007, Diagnosis of nonmelanoma skin cancer/ keratinocyte carcinoma: a review of diagnostic accuracy of nonmelanoma skin cancer diagnostic tests and technologies. Dermatol Surg, 33, 1158–74.
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