TITLE:
Eruptive Keratoacanthomas within a Red Ink Tattoo: A Case Report
AUTHORS:
Brayden Healey, William Galbraith, Yasser M. Sammour, Diane Baird
KEYWORDS:
Keratoacanthoma, Squamous Cell Carcinoma, Tattoo, Red Ink, Acitretin
JOURNAL NAME:
Case Reports in Clinical Medicine,
Vol.7 No.8,
August
13,
2018
ABSTRACT: Background: There has been a longstanding debate regarding whether keratoacanthomas (KAs) are neoplastic or reactive/inflammatory lesions. Aim: The aim of this case report is to, within the aforementioned debate, offer support in favor of the potential reactive nature of keratoacanthomas. Case Presentation: A 64-year-old male presented with an eruption of 25 keratoacanthomas within a red ink tattoo. Eruptions were partially resolved over a matter of months, and completely resolved with treatment using oral Acitretin therapy. We believe this to be the third such reported case of eruptive KAs within only the red ink portions of a tattoo. Prior cases involved 2 and 8 KAs each. Discussion: Multiple studies suggest that KAs are neoplastic in nature and very distinct from cutaneous squamous cell carcinoma. Especially interesting is the finding that KAs have increased expression of apoptotic genes; this is particularly notable because of the tendency for these lesions to spontaneously involute. Skin tumorigenesis can occur in predisposed individuals after carcinogen exposure, thus red ink possesses theoretical potential as a carcinogen. KAs could be seen in this case as in fact a reactive neoplasm.