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. 2019 Jun;9(2):369-372.
doi: 10.1007/s13555-019-0286-1. Epub 2019 Feb 21.

Intralesional Methotrexate for the Treatment of Keratoacanthoma: The Neapolitan Experience

Massimiliano Scalvenzi  1 , Angela Patrì  1 , Claudia Costa  1 , Matteo Megna  1 , Maddalena Napolitano  2 , Gabriella Fabbrocini  1 , Nicola Balato  3
Affiliations

Intralesional Methotrexate for the Treatment of Keratoacanthoma: The Neapolitan Experience

Massimiliano Scalvenzi et al. Dermatol Ther (Heidelb). 2019 Jun.

Abstract

Introduction: Keratoacanthomas are cutaneous neoplasms known for their rapid growth and spontaneous regression over a long time period. Their treatment can be difficult because of the potentially large field size and number of lesions. Intralesional methotrexate constitutes an effective, nonsurgical treatment of keratoacanthomas, as proven by our experience.

Methods: We treated 11 elderly patients affected by keratoacanthoma with intralesional methotrexate. The injections were performed weekly, followed by 10 mg of folic acid to be taken 24 h later.

Results: All our patients underwent complete resolution of the lesions after 4-8 injections, without side effects.

Conclusion: Intralesional methotrexate seems to be an effective and safe nonoperative treatment modality for keratoacanthoma, especially when it arises in anatomic areas difficult to treat with surgery, in elderly debilitated patients, and in those refusing surgery.

Keywords: Keratoacanthoma; Methotrexate; Nonsurgical treatment.

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Figures

Fig. 1
Fig. 1
Treatment course summary for KA in two patients. a Appearance of the tumor on the lower lip prior to treatment. b Appearance of the tumor 2 weeks after starting treatment. c Appearance of the tumor 6 weeks after starting treatment (total of 6 methotrexate injections), with minimal atrophic cicatricial outcomes. d Appearance of the tumor on the front prior to treatment. e Appearance of the tumor 4 weeks after starting treatment. f Appearance of the tumor 8 weeks after starting treatment (total of 8 methotrexate injections), with minimal atrophic cicatricial outcomes
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References

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