Keratoacanthoma on Nose

[BT777]

IF I DO NOT HAVE THE MOH'S SURGERY FOR MY POSSIBLE KERATOACANTHOMA WILL I GET AN OUTWARD SIGN ON MY NOSE THAT IT IS GETTING WORSE ON THE INSIDE?  AT THAT TIME I CAN GO HAVE THE SURGERY.  My nose looks great right now with just a little flake like thing right where the bump used to be.  I would rather wait until it comes back to let me know I really should have something done.

Here is my story:
I have been diagnosed with what the dermatologist says appears to be a keratoacanthoma on my nose.  This was after they cut off the big scaly pimple looking thing and did a biopsy.  They gave me 2 options:
1. Mohss surgery
2. Scrape and burn

The Dermatologist really recommended the Moh's surgery.  She said the scrape and burn may not be successful and may leave a bigger scar in the long run.

The biopsy results were:
Probable Surface of Keratoacanthoma
Note: There are also warty features.  The lesion extends to the base of the specimen.
Micoscopic Description: There is acanthosis with proliferation of stratified squamous epithelium surrounding abundant keratin.  These features are highly suggestive of the superficial portion of a keratoacanthoma.

That said, after the Dermatologist removed the bump it came back a little and then with mineral it has almost all gone away.  I just a have a very small scale place left where it used to be.  I am happy with the way it looks right now.

My thing is I don't want to have a surgery that I do not really need.  If I really need the surgery I am all about it.

Can you give me some counsel on this?

[BT777]

Thank you for the answer.  I plan to go ahead and have the surgery which is scheduled for tomorrow.  I appreciate your advise.

[Bhupinder Kaur, MD]

Hello,
Keratoacanthoma is a low grade malignancy and it is less likely to metastasis or invade. Without surgery, prognosis is usually good but it has recently been reclassified as squamous cell carcinoma (SCC)-keratoacanthoma type. Also there is increased risk for developing subsequent nonmelanoma skin cancer. There are no major external signs which may depict severity but if you have been diagnosed with keratoacanthoma then you should go ahead with your dermatologist’s advice and get Mohs surgery done.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.