MULTIPLE KERATOACANTHOMAS OF GRZYBOWSKI

By Gary M. White, MD


Multiple keratoacanthomas of Grzybowski (MKG) is also known as eruptive keratoacanthomas.

Proposed Criteria

Clinical

Hundreds to thousands of 1-5 mm follicular papules with a central keratotic plug in an adult is characteristic. The sun-exposed areas are preferred. Intraoral and laryngeal lesions may occur causing pain, dysphagia, and hoarseness. Other than potential upper airway involvement, no systemic manifestations occur. Onset is usually during the fifth to seventh decades of life. Significant facial involvement is common and ectropion may occur. Internal malignancy has been associated in several cases.

See multiple KAs for a discussion of the differential diagnosis.

Treatment

The disease tends to be chronic, resistant to therapy. Isotretinoin and etretinate are usually tried first. Methotrexate has also been used. Cyclophosphamide produced a good response in one case. The combined use of photodynamic therapy and acitretin was successful in one case [JAAD CR 2017 Sept].

References

Dermatology Online Journal

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