What should you know about giant keratoacanthoma?

Keratoacanthoma often appears as a firm, dome-shaped growth with a central plug or crust. A giant form is unusually large and may become painful, tender, or ulcerated. It commonly develops on sun-exposed skin, so a history of cumulative sun damage can be relevant, but appearance alone cannot confirm the diagnosis.

Keratoacanthoma and squamous cell skin cancer can look similar. A dermatologist may examine the lesion closely and arrange a biopsy or removal so a pathologist can assess the tissue. Do not wait for it to stop growing before arranging review.

Book a prompt dermatology appointment and take a photograph with a size reference so growth can be documented. Keep the lesion clean, cover it lightly if it rubs against clothing, and do not squeeze, shave, burn, or pick the central plug.

Treatment is selected after examination and may include surgical excision. Curettage and cautery may be considered for selected lesions, while the size, site, depth, and tissue findings guide the recommendation. Ask how the wound will be closed and cared for.

Seek urgent medical review if the lesion is enlarging quickly, bleeding, becoming increasingly painful, producing discharge, or developing a deep ulcer. Get immediate help for uncontrolled bleeding, fever with spreading redness, or severe pain. These signs need assessment and do not establish the diagnosis by themselves.

Ask whether a biopsy or complete removal is needed, how quickly treatment should happen, which procedure suits the lesion’s location, whether nearby tissue will be examined, and how to protect the area from further sun damage.