Clinical features

Keratoacanthoma is characterised by rapid growth followed by slow, spontaneous involution over several months {881}. Exact figures about regression time, however, are difficult to obtain, since the common mode of treatment is excision. The mature lesion is usually bud- or dome-shaped and is brownish or slightly reddish. Over time a central ker-atinous crater appears at the expense of the surrounding softer tumour tissue until finally a cup- or saucer-shape lesion develops that appears ulcerated, but is, in fact, lined by tumour epithelium and often covered with horn masses. An eruptive variant can be distinguished which is multifocal and often lacks the central keratin-filled crater. Following trauma and/or infection, true ulceration may occur, especially in areas like the lips, probably due to repeated scratching or biting. In the oral cavity, the above-described phe-notypes rarely occur. Instead, the puta tive oral lesion mimics a broad spectrum of pseudoneoplastic and neoplastic lesions {1929}.

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