Journal of the American Academy of Dermatology
Volume 56, Issue 6 , Pages 989-993, June 2007

Intralesional methotrexate treatment for keratoacanthoma tumors: A retrospective study and review of the literature

  • Nicole M. Annest, MD, MS

      Affiliations

    • From the Division of Mohs Surgery, Scripps Clinic and Research Institute, La Jolla
    • Corresponding Author InformationReprint requests: Nicole M. Annest, MD, MS, Division of Mohs Surgery, Scripps Clinic and Research Institute, 10666 N Torrey Pines Rd, MS112, La Jolla, CA 92037.
  • ,
  • Marta J. VanBeek, MD, MPH

      Affiliations

    • Department of Dermatology, University of Iowa Hospitals and Clinics
  • ,
  • Christopher J. Arpey, MD

      Affiliations

    • Department of Dermatology, University of Iowa Hospitals and Clinics
  • ,
  • Duane C. Whitaker, MD

      Affiliations

    • Department of Dermatology, University of Arizona

La Jolla, California; Iowa City, Iowa; and Tuscon, Arizona

Background

Intralesional methotrexate (MTX) is an effective treatment for keratoacanthoma (KA).

Objective

We sought to systematically examine response rates and adverse events in KA treated with intralesional MTX.

Methods

All cases of KA treated with intralesional MTX at our institution from 1991 to 2006 were identified. A MEDLINE and PubMed search of cases of KA treated with intralesional MTX was also performed.

Results

In all, 38 cases of KA treated with intralesional MTX were identified: 18 from our institution and 20 from the literature. Intralesional MTX achieved resolution in 92%, requiring an average of 2.1 injections an average of 18 days apart. Adverse events were rare, with two reports of pancytopenia in patients with chronic renal failure.

Limitations

Use of single case reports, small series, and retrospective analysis are limitations.

Conclusion

Intralesional MTX is a useful nonsurgical therapy for the treatment of KA. Histologic diagnosis before initiation of treatment is preferred. A complete blood cell count at baseline and during treatment should be considered to monitor for potential cytopenia.

 

 Funding sources: None.Conflicts of interest: None declared.

PII: S0190-9622(07)00009-6

doi:10.1016/j.jaad.2006.12.017

Journal of the American Academy of Dermatology
Volume 56, Issue 6 , Pages 989-993, June 2007