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Intralesional Methotrexate for the treatment of Keratoacanthoma, Squamous Cell Carcinoma, and in-situ disease in high risk patients
Halka, Joshua T
Leberfinger, Ashley
Diulus, Lewis
Pennington, Gary
Summa Health
2022-01-15
Presenter: Joshua Halka
Affidavit:
All of the work to be presented is original to the resident presenting, they did the data mining and abstract writing
Director Name: Ananth Murthy
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background:
Intralesional Methotrexate (MTX) has been shown in multiple studies to be safe and effective for use in the treatment of keratoacanthoma (KA), a skin lesion which can harbor or progress to Squamous Cell Carcinoma (SCC). While MTX has been studied for KA, it has not been extensively studied for Squamous Cell Carcinoma in Situ (SCCis), or SCC.
Methods:
We performed a retrospective chart review of all patients who underwent intralesional MTX injection for KA, SCCis, or SCC at our institution between 2015 and 2020. We reviewed patient demographics and data regarding the type of lesion the patient had, the site, the dose of MTX injection, and whether the patient had and recurrence, needed excision, re-injection, or if they had any complications.
Results:
The sample consisted of 162 subjects at an average age of 77.5 (SD-9.9) years. Average follow up was 4.3 months (SD-4.2 months). Diagnoses included 41 cases of KA, 68 cases of SCC, and 53 cases of SCCis. Recurrence occurred in 16 cases (9.8%), whereas complications occurred in 4. There were 9 recurrences in the SCC group, 5 in the SCCis group, and 2 in the KA group (p=0.36). There were 4 complications with no statistical significance between groups (0.93).
Conclusions:
In our cohort of patients who received MTX for KA, SCCis, or SCC, the risk of recurrence was 9.8% with very few complications (1.8%). Intralesional MTX is an option to be considered in the treatment of SCC, SCCis, and KA in high risk patients.
