When is surgical excision recommended for keratoacanthoma?

A keratoacanthoma can appear as a firm, rapidly enlarging bump with a central keratin plug or crater. Some lesions may shrink, but their clinical appearance can overlap with squamous cell carcinoma, so waiting for natural change is not a safe way to establish the diagnosis. Excision removes the lesion and provides tissue for a pathologist to examine. The dermatologist also considers its site, size, depth, growth pattern, and the person's overall health when choosing the procedure and closure.

Arrange a prompt dermatology appointment and avoid squeezing, scraping, or applying strong acids to the lump. Photographing it can help document change, but it does not replace examination. Tell the clinician how quickly it appeared, whether it bleeds or hurts, and which medicines you take. Discuss local anaesthetic, the expected wound, pathology timing, and how to protect the site while it heals.

Seek prompt medical assessment for a new lump that enlarges quickly, develops a central crust or crater, bleeds, or becomes tender. After removal, contact the clinic about uncontrolled bleeding, worsening pain, spreading redness, pus, fever, or a wound that opens.

Ask whether the lesion needs complete excision, what the pathology examination will determine, how much surrounding tissue may be removed, and what follow-up is needed if the result shows squamous cell carcinoma.