Three out of 11 siblings of a nonconsanguineous marriage suffering from biopsy-proven multiple small eruptive keratoacanthoma (KA) of Grzybowski as well as large nodular KA of Ferguson-Smith are reported. The response to oral methotrexate was not encouraging. Intravenous 5-fluorouracil (5-FU) at a dose of 12 mg/kg/day in isotonic saline given in weekly 5-day cycles resulted in almost complete resolution of small eruptive lesions and signs of involution in older large agglomerate noduloulcerative KA after 6 cycles. Thus, intravenous 5-FU was found to be an effective therapeutic modality for the Witten and Zak type of KA.

Keywords:
Multiple familal keratoacanthoma, 5-Fluorouracil, intravenous
1.
Schwartz RA: Keratoacanthoma. J Am Acad Dermatol 1994;30:1–19.
2.
Witten VH, Zak FG: Multiple primary, self-healing prickle cell epithelioma of the skin. Cancer 1952;5:539–550.
3.
Goette DK, Odom RB: Successful treatment of keratoacanthoma with intralesional 5-fluorouracil. J Am Acad Dermatol 1980;2:212–216.
4.
Parker CM, Hanke CW: Large keratoacanthomas in difficult locations treated with intralesional 5-fluorouracil. J Am Acad Dermatol 1986;14:770–777.
5.
Singal A, Mohanty S, Bhattacharya SN, Baruah MC, Singh N: Unusual multiple KA in a child successfully treated with 5-fluorouracil. J Dermatol 1997;24:546–548.
6.
Kennedy BJ, Theologides A: The role of 5-fluorouracil in malignant diseases. Ann Intern Med 1961;55:719–730.
7.
Mittal RR, Popli R, Parsad D: Multiple keratoacanthoma in a female infant. Indian J Dermatol Venereol Leprol 1992;58:227–228.
8.
Pavithran K: Multiple keratoacanthomas on the mons pubis and labia majora. Indian J Dermatol Venereol Leprol 1988;54:262–263.
9.
Subba Rao D: Familial multiple keratoacanthomas. Indian J Dermatol Venereol Leprol 1993;59:27–28.
10.
Subramanyam CSV, Verma RN, Saikia DK: Multiple keratoacanthoma. Indian J Dermatol Venereol Leprol 1983;49:275–277.
11.
Sommerville J, Milne JA: Familial primary self healing squamous epithelioma of the skin (Ferguson-Smith type). Br J Dermatol Syphilis 1950;62:485–490.
12.
Rook A, Moffatt JL: Multiple self healing epithelioma of Ferguson-Smith type: Report of a case of unilateral distribution. Arch Dermatol 1956;74:525–532.
13.
Currie AR, Ferguson-Smith J: Multiple primary spontaneous healing squamous-cell carcinomata of the skin. J Pathol Bacteriol 1952;64: 827–839.
14.
Fauracres FA, Whittick JW: The relationship of molluscum sebaceum (keratoacanthoma) to spontaneously healing epithelioma of the skin. Br J Cancer 1953;7:58.
15.
Melton JL, Nelson BR, Stough DB, Brown MD, Swanson NA, Johnson TM: Treatement of keratoacanthomas with intralesional methotrexate. J Am Acad Dermatol 1991;25:1017– 1023.
16.
Grob JJ, Suzini F, Weiller RM, Zarour H, Noe C, Munoz MH, Bonerandi JJ: Large keratoacanthomas treated with intralesional interferon alfa-2a. J Am Acad Dermatol 1993;29: 237–241.
17.
Street ML, White JW Jr, Gibson LE: Multiple keratoacanthomas treated with oral retinoids. J Am Acad Dermatol 1990;23:862–866.
18.
Tarnowski WM: Multiple keratoacanthomata: Response of a case to systemic chemotherapy. Arch Dermatol 1966;94:74–80.
19.
Kestel JL Jr, Blair DS: Keratoacanthoma treated with methotrexate. Arch Dermatol 1973;108:723–724.
1999
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.