Background: Keratoacanthomas are neoplastic proliferations of keratinocytes thought to originate from follicular epithelium. There is only one previously reported case in which keratoacanthoma involved the vulva.
Case: A 54-year-old woman presented with a nonulcerated vulvar lesion of approximately 1 month's duration. The lesion was 1 cm in diameter, located on the mid-right labium majus, with no surrounding induration or hyperkeratosis. The patient underwent wide local excision and the clinical-pathologic diagnosis was keratoacanthoma. After 2 years, she remains free of vulvar recurrence.
Conclusion: Because of similarities in clinical presentation and histology to squamous cell carcinoma, the diagnosis of keratoacanthoma can be challenging. History and physical examination findings should be correlated with the histologic diagnosis, with consideration for dermatopathology consultation.