Loss of heterozygosity analysis of keratoacanthoma reveals multiple differences from cutaneous squamous cell carcinoma

Keratoacanthomas (KAs) resemble squamous cell carcinomas (SCCs) except thar, unlike SCCs, after a period of rapid growth over a few months they involute completely. The basis of their regressing natural history is not known. We have examined keratoacanthomas and another benign cutaneous tumour, the basal cell papilloma (BCP), for loss of heterozygosity (LOH) at a number of loci that are frequently lost in SCCs and other skin tumours. The frequency of LOH for both KAs and BCPs was low, with only isolated losses identified at 9p, 9q and 10q in KAs [fractional allelic loss (FAL) was 1.3%] and at 9p and 17p in BCPs (FAL was 0.4%). This contrasts with previous work showing a FAL of 32% in SCC and 46% in actinic keratoses. The results show a clear difference between KA and SCC and do not support the hypothesis that KAs are SCCs that regress as a result of external (host) influences but rather suggest that KAs and SCCs are different de novo. LOH around the locus implicated in the multiple self-healing epitheliomata of Ferguson-Smith (9q22-q31) was shown in only 1 of 11 KAs.