In some lesions, surgical excision is the most common treatment since the cancer is less advanced; in other lesions, no definitive treatment has been established.
Keratoma is an uncommon disorder of the skin of children and young adults that presents as a slow enlarging, reddish-brown nodule that does not have an apparent source. These lesions are benign as is the case in most other keratomas. Unlike most other lesions, keratomas may occur at any age and on any body surface.
Keratoma may be present in the eyelids of one or both sexes. It is characterized by the presence of fine skin tags/hair, and associated with loss of lacrimal function. The ocular signs are limited to the cornea or eyelid (i.e., edema or dry eye, corneal opacitas, ulcers, keratitis, lids with adherent eyelashes, and keratoderma).
Keratoma is often preceded by an act of trauma and most commonly occurs on the face and neck; however, keratomas occur on all body parts, including the oral mucosa. The patient's lifestyle and the environment in which the lesion appeared may influence the development and natural history of the lesion.
At the time of the study, no keratoma can be cured, though some tumors can be stopped growing and can be treated with a local treatment method. Results from a recent paper, the surgeons have not succeeded in achieving complete healing.
Results from a recent clinical trial did not quantify the incidence of keratinizing squamous cell carcinoma of head and neck among the population in the United States. Additional, accurate, research is needed to determine if the incidence of keratinizing squamous cell carcinoma of head and neck is increasing in populations in the United States.
The incidence and prevalence of keratoma have dropped markedly in the United States; the use of artificial tears, moisturizing eye cream, and sunscreen may decrease rates of keratoma. Although studies are needed to validate the effectiveness of these interventions in the prevention of keratoma, these data should help clinicians, dermatologists, and patient advocates address the prevention of keratoma and other ocular skin cancers.
Because of the significant effect keratomas have on local and distant tumors, they are a concern when assessing patients with multiple carcinomas. The main factor that affects cancer incidence is the age of the patient, as the chances of developing a malignancy increase with age. While the risk of keratoma increases with age, the exact mechanism is unknown.
The majority of patients in the study group had clinically improved corneas by the 12 month follow-up point, although their corneas remained stably improved after a similar length of time.
The authors suggest that it may be difficult, even if keratoma is biopsied at an early stage, to determine whether it represents a pre-cancerous lesion. The patient must be clearly informed of the uncertainties of a diagnosis before the patient begins the process of making an informed decision.
The positive correlation between incidence of keratoma and family history in this survey strongly suggests that an autosomal dominant gene may be involved in the process and may be associated with keratoma run in families.
Although there are many treatments for this disease, new methods have to be found to be effective and safe. At present, all current approaches to treating it are based on eliminating the possibility of recurrence through surgical removal of the existing lesion. However, the lesions' recurrence rate is so low that this technique does not have sufficient power to ensure that it is successful in every case. It is, therefore, not appropriate for everybody. If this is the case, new alternative treatments and approaches will be explored for patients. At present, they have to be tried in order to seek answers that are more effective and more reliable, resulting in a more definitive end.