Keratoacanthoma centrifugum marginatum; upon a rare clinical case [Cheratoacantoma centrifugo marginato: su di un raro caso clinico]

CCM is a rare variety of keratoacanthoma which typically shows progressive peripheral progression and central atrophic regression. It is a benign tumor whose etiology is unknown, more frequently seen in males, usually in the lower limbs. Histology, conducted on several biopsy specimens (four from the margin and two from the centre of the lesion) has shown crateral epithelial proliferation, with ortokeratotic hyperkeratosis and no karyodysplasia. Hystology conducted with Polymerase Chain Reaction for some subgroups of HPV, seems to indicate a common etiology but a different progression for CCM, verrucous and spinocellular carcinomas. Our patient had already been treated at the Dermatological Clinic with etretinate and topic micronized silver which had achieved reduction of the lesion size. After a period of 6 months the lesion had not disappeared and surgical teratment was recommended. The operation was carried out with excision of about 1 cm of normal tissue around the lesion; the residual defect was covered with dermo-epidermal grafts from the other limb. The patient was followed -up, after the wound had healed, every two months and 18 months after surgery there is no sign of recurrence.