July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Conjunctival Keratoacanthoma: A Clinicopathologic Case Series
Author Affiliations & Notes
  • Sander R Dubovy
    Ophthalmology, Bascom Palmer Eye Institute/University of Miami, Miami, Florida, United States
    Florida Lions Ocular Pathology Laboratory, Florida, United States
  • Nandini Venkateswaran
    Ophthalmology, Bascom Palmer Eye Institute/University of Miami, Miami, Florida, United States
  • Jared Matthews
    Ophthalmology, Bascom Palmer Eye Institute/University of Miami, Miami, Florida, United States
  • Ghada AlBayyat
    Ophthalmology, Bascom Palmer Eye Institute/University of Miami, Miami, Florida, United States
  • George W Elgart
    Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida, United States
  • Carol L. Karp
    Ophthalmology, Bascom Palmer Eye Institute/University of Miami, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Sander Dubovy, None; Nandini Venkateswaran, None; Jared Matthews, None; Ghada AlBayyat, None; George Elgart, None; Carol Karp, None
  • Footnotes
    Support  Florida Lions Eye Bank
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3564. doi:
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      Sander R Dubovy, Nandini Venkateswaran, Jared Matthews, Ghada AlBayyat, George W Elgart, Carol L. Karp; Conjunctival Keratoacanthoma: A Clinicopathologic Case Series. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3564.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Keratoacanthomas are squamoproliferative lesions that typically occur on sun-exposed areas of the skin that are thought to arise from pilosebaceous units. Conjunctival keratoacanthoma is a rare entity. Herein we present a series of seven cases of conjunctival keratoacanthoma and provide the the clinicopathologic and diagnostic imaging results to characterize this rare entity.

Methods : The database of the Florida Lions Ocular Pathology Laboratory was searched for surgical specimens diagnosed with keratoacanthoma. The histopathologic slides were reviewed and diagnoses confirmed by two of us (SRD and GE). Retrospective chart reviews were conducted for all patients. Demographics, clinical history, diagnostic testing, treatment modalities, histopathologic and immunohistochemical testing and outcomes were extracted.

Results : The patients ranged from 22 to 83 years of age and were most commonly of Hispanic ethnicity. The lesions were rapidly growing, nodular and leukoplakic in appearance. All lesions were surgically excised, while on underwent partial spontaneous resolution prior to surgical excision. No cases recurred on follow-up. Well circumscribed foci of faulty epithelial maturation with central keratin filled cores were noted on histopathology. Hyperreflective, thickened epithelium overlying a disorganized subepithelial lesion was identified on high resolution anterior segment optical coherence tomography of two of the lesions.

Conclusions : Conjunctival keratoacanthoma is a rare lesion with distinct clinical and histologic features. Treatment is typically with surgical excision using a no-touch technique with cryotherapy; however, topical or intralesional chemotherapeutic agents have been employed. It is important to be aware of this lesion when confronted with a rapidly growing conjunctival mass.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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