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CC BY-NC-ND 4.0 · Arch Plast Surg 2023; 50(01): 059-062
DOI: 10.1055/a-1988-2869
Pediatric/Craniomaxillofacial/Head & Neck
Case Report

Solitary Keratoacanthoma at the Recipient Site of a Full-Thickness Skin Graft: A Case Report and Review of the Literature

Jeong Ho Kim    *
1   Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
,
Sang-Hoon Lee    *
2   Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
,
Seung-Phil Hong 
2   Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
,
Jiye Kim 
1   Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
,
Sug Won Kim 
1   Department of Plastic and Reconstructive Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
› Author Affiliations Funding The authors have no funding sources to declare.
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Abstract

A 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative.

Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

Keywords

keratoacanthoma - koebnerization - full-thickness skin graft

* These authors contributed equally to this work.


Patient Consent

The patient provided written informed consent for the publication and use of their images.


Authors' Contributions

Conceptualization: J.H.K., S.H.L. Data curation: J.H.K., S.H.L. Formal analysis: S.H.L. Investigation: J.H.K., S.H.L. Methodology: J.H.K., S.H.L. Project administration: J.H.K., S.W.K. Visualization: S.H.L., S.P.H. Writing-original draft: J.H.K., S.H.L. Writing-review & editing: S.P.H., J.Y.K., S.W.K. Approval of final manuscript: all authors.




Publication History

Received: 27 May 2022

Accepted: 01 November 2022

Accepted Manuscript online:
28 November 2022

Article published online:
06 February 2023

© 2023. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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