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

References 

  1. Beham A, Regauer S, Soyer HP, Beham-Schmid C. Keratoacanthoma: a clinically distinct variant of well-differentiated squamous cell carcinoma. Adv Anat Pathol. 1998;5:269–280
  2. Manstein CH, Frauenhoffer CJ, Besden JE. Keratoacanthoma: is it a real entity?. Ann Plast Surg. 1998;40:469–472
  3. Benest L, Kaplan RP, Salit R, Moy R. Keratoacanthoma centrifugum marginatum of the lower extremity treated with Mohs micrographic surgery. J Am Acad Dermatol. 1994;31:501–502
  4. Larson PO. Keratoacanthomas treated with Mohs' micrographic surgery (chemosurgery): a review of forty-three cases. J Am Acad Dermatol. 1987;16:1040–1044
  5. Wong WY, Kolbusz RV, Goldberg LH, Guana A. Treatment of a recurrent keratoacanthoma with oral isotretinoin. Int J Dermatol. 1994;33:579–583
  6. Goldschmidt H, Sherwin WK. Radiation therapy of giant aggressive keratoacanthomas. Arch Dermatol. 1993;129:1162–1165
  7. Caccialanza M, Sopelana N. Radiation therapy of keratoacanthomas: results in 55 patients. Int J Radiat Oncol Biol Phys. 1989;16:475–477
  8. Reymann F. Treatment of keratoacanthomas with curettage. Dermatologica. 1997;155:90–96
  9. Nedwich JA. Evaluation of curettage and electrodesiccation in treatment of keratoacanthoma. Australas J Dermatol. 1991;32:137–141
  10. Sheridan AT, Dawber RP. Curettage, electrosurgery and skin cancer. Australas J Dermatol. 2000;41:19–30
  11. Klein E, Milgram H, Traenkle HL. Tumors of the skin, II: keratoacanthoma, local effect of 5-fluorouracil (5-FU). Skin. 1962;1:153–156
  12. Bergin DJ, Lapins NA, Deffer TA. Intralesional 5-fluorouracil for keratoacanthoma of the eyelid. Ophthal Plast Reconstr Surg. 1986;2:201–204
  13. Parker CM, Hanke CW. Large keratoacanthomas in difficult locations treated with intralesional 5-fluorouracil. J Am Acad Dermatol. 1986;14:770–777
  14. Thiele JJ, Ziemer M, Fuchs S, Elsner P. Combined 5-fluorouracil and Er:YAG laser treatment in a case of recurrent giant keratoacanthoma of the lower leg. Dermatol Surg. 2004;30:1556–1560
  15. Melton JL, Nelson BR, Stough DB, Brown MD, Swanson NA, Johnson TM. Treatment of keratoacanthomas with intralesional methotrexate. J Am Acad Dermatol. 1991;25:1017–1023
  16. Hurst LN, Gan BS. Intralesional methotrexate in keratoacanthoma of the nose. Br J Plast Surg. 1995;48:243–246
  17. Cuesta-Romero C, de Grado-Pena J. Intralesional methotrexate in solitary keratoacanthoma. Arch Dermatol. 1998;134:513–514
  18. Remling R, Mempel M, Schnopp N, Abeck D, Ring J. Intralesional methotrexate injection: an effective time and cost saving therapy alternative in keratoacanthomas that are difficult to treat surgically. Hautarzt. 2000;51:612–614
  19. Spieth K, Gille J, Kaufmann R. Intralesional methotrexate as effective treatment in solitary giant keratoacanthoma of the lower lip. Dermatology. 2000;200:317–319
  20. Richard MA, Gachon J, Choux R, Laurans R, Folchetti G, Grob JJ. Treatment of keratoacanthoma with intralesional methotrexate injections. Ann Dermatol Venereol. 2000;127:1097
  21. de Visscher JG, van der Wal KG, Blanken R, Willemse F. Treatment of giant keratoacanthoma of the skin of the lower lip with intralesional methotrexate: a case report. J Oral Maxillofac Surg. 2002;60:93–95
  22. Cohen PR, Schulze KE, Teller CF, Nelson BR. Intralesional methotrexate for keratoacanthoma of the nose. Skinmed. 2005;4:393–395
  23. Oh CK, Son HS, Lee JB, Jang HS, Kwon KS. Intralesional interferon alfa-2b treatment of keratoacanthomas. J Am Acad Dermatol. 2004;51:1040
  24. Dendorfer M, Oppel T, Wollenberg A, Prinz JC. Topical treatment with imiquimod may induce regression of facial keratoacanthoma. Eur J Dermatol. 2003;13:80–82
  25. Olsen EA. The pharmacology of methotrexate. J Am Acad Dermatol. 1991;25:306–318
  26. Goebeler M, Lurz C, Kolve-Goebeler ME, Brocker EB. Pancytopenia after treatment of keratoacanthoma by single lesional methotrexate infiltration. Arch Dermatol. 2001;137:1104–1105
  27. Cohen PR, Schulze KE, Nelson BR. Pancytopenia after a single intradermal infiltration of methotrexate. J Drugs Dermatol. 2005;4:648–651

 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

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