The aetiology of these lesions is unknown. They are more common in men. The rapid growth often raises clinical suspicion of a squamous cell carcinoma. Diagnosis can be confirmed by a biopsy that transects the lesion, including subcutaneous tissue, as diagnosis depends on its histological architecture rather than cytological features. The important points differentiating a keratoacanthoma from a squamous cell carcinoma are the raised rolled edges with absence of rapidly dividing neoplastic keratinocytes below the level of the deepest skin appendages.
Treatment is by excision biopsy.
This results in a cosmetically more acceptable scar than if spontaneous resolution is allowed to occur. Recent papers Skidmore R A. Flowers F P. Non-melanoma skin cancer.