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.