Chronic involuting relapsing keratoacanthoma with grouping tendency of lesions in seven staggering cases
Keywords:
involuting, relapsing, keratoacanthoma, chronic, CIRKAAbstract
Background There are case reports in the medical literature showing some patients have recurrent keratoacanthoma in selected regions and given different names such as chronic keratoacanthoma serpiginous, eruptive keratoacanthoma centerifugum and involuting keratoacanthoma. Objective To report seven patients with keratoacanthoma who had recurrent relapsing and involuting keratoacanthoma in selected body regions and to suggest a covering reprehensive name for this specific medical condition. Methods This is a cross sectional descriptive study that was carried out during the period from 2013-2020 where all patients with keratoacanthoma were collected and from among them the recurrent involuting keratoacanthoma were isolated. Full demographic and clinical examination was done. Skin biopsies were performed for histopathological evaluation. Results Forty-five patients with keratoacanthoma were described with Fitzpatrick skin type III, IV among them seven (15.5%) male patients with chronic involuting relapsing keratoacanthoma (CIRKA) were detected, their ages ranged from 25-60 years with a mean of 50 years, with negative family history. All had chronic picture with 3-4 years duration. Patients gave history of old and new lesions appearing on the sites. The sites of lesions were on the dorsa of hands in three patients with one patient with addition of chest involvement. The other four patients had their lesions on the legs and one patient also had lesion on the face. All patients ahd lesions on the sun exposed sites including face, hands and legs. All patients on all sites showed different stages of lesion maturation, early umblicated papules and nodules, small and large plaques, and large tumor size some with characteristic keratoacanthoma with crateriform. All patients had grouping of their lesions in well selected sites. In addition, some had atrophic areas which were the sites of involution. Histopathological evaluation demonstrated a picture of keratoacanthoma in all patients. Conclusion All patients showed features of recurrent involuting relapsing keratoacanthoma on well-defined areas. The histopathology was that of keratoacanthoma and all cases are not part of syndrome. As literature described this entity by different names; hence we suggest the name chronic relapsing involuting keratoacanthoma (CIRKA) as a representative, new and informative name.References
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