Analysis: Drug Class Influences Clinical Management of Eruptive Keratoacanthoma/Squamous Cell Carcinoma
Key Takeaways
Kinase inhibitors and immune checkpoint inhibitors produce distinct clinical patterns of eruptive keratoacanthoma (KA) and squamous cell carcinoma (SCC).
Younger patients with head/neck lesions were more common in kinase-associated cases; older patients with leg lesions predominated in ICI-linked cases.
The study showed a variety of management strategies, underlining the potentially pathophysiology.
The clinical features and management of drug-induced eruptive keratoacanthoma (KA) and squamous cell carcinoma (SCC) differ significantly depending on the causative drug class, according to a new analysis of 172 reported cases.
The retrospective review, published in the Journal of Drugs in Dermatology, examined published reports of eruptive KA/SCC tied to oncologic and immunomodulatory therapies. Researchers identified significant distinctions between lesions induced by kinase inhibitors and those triggered by immune checkpoint inhibitors (ICIs).
Kinase inhibitor-associated lesions were more commonly found in younger patients and involved fewer tumors, often localized to the head and neck. These lesions were more frequently managed with surgical excision alone. ICI-associated lesions tended to affect older patients, presented with multiple lesions, and were frequently pruritic. Treatment strategies for ICI-induced cases were more likely to incorporate intralesional and topical corticosteroids, oral retinoids, and niacinamide.
“Significant differences in the clinical presentation of eruptive KA/SCC between drug etiologies were identified,” the authors wrote in the study. “These findings indicate that different underlying cellular mechanisms may be responsible for the rapid growth of these lesions, further suggesting that different treatments may be appropriate depending on the causative medication.”
Source: Bray ER, Tordjman L, Nouri K. J Drugs Dermatol. 2025;24(5):476-481. doi:10.36849/JDD.8986