Histopathologists' approach to keratoacanthoma: a multisite survey of regional variation in Great Britain and Ireland

J Clin Pathol. 2014 Jul;67(7):637-8. doi: 10.1136/jclinpath-2014-202255. Epub 2014 Apr 24.

Abstract

Introduction: This survey examines regional variation in the diagnosis of keratoacanthoma (KA).

Methods: Twenty-three departments from Great Britain and Ireland were invited. The number of cases coded as KA or cutaneous SCC in the previous 12 months was retrieved. An SCC: KA ratio was calculated. Participants also provided free text responses.

Results: Seventeen departments replied. A total of 11,718 cases were included with a breakdown of 998 KA and 10,720 SCC. The mean SCC:KA ratio was 10.7:1, range (2.5:1 to 139:1). Free text responses are presented.

Discussions: An extreme variation in approach is highlighted by this survey. We believe a multidisciplinary team approach to the diagnosis of KA is essential. There seems to be a need for a carefully considered clinicopathological study, backed up by molecular studies, to better understand the natural biology of this diagnosis.

Keywords: Dermatopathology; DiagnosiS; Skin Tumours.

Publication types

  • Multicenter Study

MeSH terms

  • Carcinoma, Squamous Cell / pathology*
  • Diagnosis, Differential
  • Diagnostic Errors / prevention & control
  • Health Care Surveys
  • Humans
  • Ireland
  • Keratoacanthoma / pathology*
  • Pathology / standards*
  • Practice Patterns, Physicians' / standards*
  • Predictive Value of Tests
  • Skin Neoplasms / pathology*
  • United Kingdom