AI Article Synopsis

  • The study focuses on conjunctival keratoacanthomas, rare eye lesions, by analyzing patient data from 2005 to 2023, including clinical characteristics and treatment outcomes.
  • Out of nine patients identified, most were middle-aged Hispanic males, with lesions commonly found in the right eye and on the temporal conjunctiva, showing rapid growth and specific imaging features.
  • Histopathological examination revealed distinct features such as keratin-filled lesions, and after surgical removal, most patients (except two lost to follow-up) showed no recurrence over an average follow-up period.

Article Abstract

Objective: To present a series of conjunctival keratoacanthomas and provide clinical, histopathological, immunohistochemical, and imaging results that characterize this rare entity.

Methods: A retrospective chart review of records from 2005 to 2023 from the Florida Lions Ocular Pathology Laboratory was conducted. Nine patients with histologically proven conjunctival keratoacanthoma were identified. Data extracted includes demographics, clinical history, diagnostic testing, histopathological and immunohistochemical testing, treatment modalities, and recurrences.

Results: Patients' mean age was 55.2 ± 21.1 years (range: 22-83). 77.8% (7/9) of patients were male. 55.6% (5/9) were Hispanic. 55.6% of lesions (5/9) were in right eyes. 55.6% of lesions (5/9) were on the temporal, bulbar conjunctiva. The lesions were rapidly growing, with mean onset time of 4.71 ± 3.30 weeks (range: 2-12). High-resolution anterior segment optical coherence tomography of three lesions revealed hyper-reflective, thickened epithelium with abrupt transition between normal and abnormal epithelium. Underlying disorganized subepithelial tissue was noted. However, the overlying abnormal epithelium caused considerable shadowing, which obscured subepithelial structures. Prominent, keratin-filled, cup-shaped lesions with faulty maturational sequencing that extend full thickness, variably pale cytoplasm, and foci of dyskeratosis and hyperkeratosis were present on all lesions' histopathology. All lesions were surgically excised, but two demonstrated partial spontaneous resolution before surgery. Two patients were lost to follow-up; the remaining seven had no signs of recurrence at a of mean of 36.9 ± 45.4 months (range: 3 to 141 months) of follow-up.

Conclusions: Conjunctival keratoacanthomas are rare lesions of the ocular surface with distinct clinical, histopathologic, and diagnostic features.

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Source
http://dx.doi.org/10.1016/j.jcjo.2024.07.023DOI Listing

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