Multiple Keratoacanthomas Associated with Chronic Renal Failure and Hemodialysis

Multiple Keratoacanthomas Associated with Chronic Renal Failure and Hemodialysis L. Temmerman M. De Clippele Fig. 1. Three keratoacanthoma lesions on the forearms. A few months ago a 50-year-old man on maintenance hemodialysis started developing pruriginous, slowly growing verrucous and greyish tumours on his forearms. The lesions were 0.5-1.5 cm in size and some of them showed a central depression filled with crusty material (fig. 1). Histologically, a picture of keratoacanthoma was found. Skin tests with bacterial and mycotic allergens (tuberculin, streptococci, staphylococci, trichophytin, candidin) were negative. There was no response to DNCB. The number of circulating T lymphocytes was decreased. Lymphocyte transformation with non-specific mitogens (phytohaemagglutinin, concanavalin, pokeweed) was diminished. There was spontaneous regression of existing tumours while new keratoacanthomas appeared.