Myriad Facades of Keratocanthoma: Benignity VS Malignancy

Keratoacanthoma (KA) is a self-limiting benign epithelial neoplasm. It occurs predominantly on sun-exposed areas of the body and is believed to arise from hair follicle. It shows a unique behavior in being clinically benign and microscopically malignant. Earlier it was considered as a pseudomalignant lesion but now it is believed to be pseudobenign in nature. The most common concern is related to its nosological position at the border of malignancy and benignity. We hereby report a rare case of keratoacanthomatous type of squamous cell carcinoma in an elderly female showing aggressive nature of the lesion. The various terminologies used for KA in the past have also been tabulated.