Treatment of giant keratoacanthoma with intralesional 5-fluorouracil.

Giant keratoacanthomas measure greater than 2 cm and have a predilection for the nose and eyelids. As a result, they often present a significant therapeutic challenge. A 36-year old woman was referred for evaluation of a 4.0 x 4.0 cm giant keratoacanthoma on the nose. The patient was treated with intralesional 5-fluorouracil, and the tumor underwent complete regression leaving a full thickness nasal cleft. The defect was then reconstructed with a paramedian forehead flap with good cosmesis.