Kerato-acanthoma in Ocular Pathology.

THE main interest of kerato-acanthoma (molluscum sebaceum) is its resemblance to squamous-cell carcinoma of the skin: it is, however, benign and even self-healing, and it seems very likely that an appreciable number of lesions diagnosed as malignant in the past, and followed-up as such, were in fact examples of this condition, so that a mistaken diagnosis may result in gross over-treatment and in statistical and prognostic errors in assessing skin tumours. Since the description of the original series by MacCormac and Scarff (1936), many papers have appeared in the general literature. As regards ocular conditions, Beare (1953), analysing a series of 76 cases of kerato-acanthoma, found that ten of these occurred in the skin of lids or canthi, or in the vicinity of the eye. In the American ophthalmic literature, Christensen and Fitzpatrick (1955) and Givner, Kallos, Medine, and Orfuss (1960) have reported similar cases, and Freeman, Cloud, and Knox (1961) reported the first case of kerato-acanthoma of the conjunctiva. The lesion can occur in either sex, and is commoner in the older age groups; tar has been mentioned as a factor in kerato-acanthoma in general, but it is not known if this plays a part in the site under review. There is no evidence available of a virus origin. As distinct from multiple self-healing squamous carcinoma (Fergnson Smith, 1934), a kerato-acanthoma is usually single and appears as a papule 7 ll<in previously normal skin; the growth enlarges rapidly, becoming a raised nodule with a round edge, and attaining a _diameter of 1 or 2 cm. in only 0;B si;¢6 to 8 weeks (Fig. 1).