Keratoacanthoma (KA) is a common tumoral lesion which arises from the pilosebaceous glands. Although conjunctival keratoacanthoma had been primarily described in 1961, diagnosis and treatment guidelines are still controversial. In this study we report a novel way on treatment of conjunctival keratoacanthoma.

A 33 year-old male, referred to ocular surface department due to a rapidly growing lesion conjunctival lesion. The protruding lesion which was grown in about 2 weeks on the nasal conjunctiva was shiny, fleshy, and white. Due to typical history of the disease, patient was diagnosed as keratoacanthoma. Treatment with Interferon α-2b 1 million units four times per day was started and after one and a half months of treatment the lesion started to regress and about 2 months after starting Interferon α-2b, complete resolution of the lesion was seen.

There are several treatment choices such as surgical excision, topical therapy, and intralesional injection of 5-fU. Although there is information about keratoacanthomas of skin, data about conjunctival keratoacanthomas is limited to several case reports. To date, there are no published reports of topical treatment of conjunctival KA and almost all cases reported about conjunctival keratoacanthoma were treated by surgical excision. Topical interferon alfa-2b is effective in the management of ocular surface squamous neoplasia and keratoacanthoma is pathologically similar to squamous neoplasia, so we intended to use topical interferon α-2b for treatment of keratoacanthoma in order to find a novel and non-invasive way of treatment.

This novel way of treatment of keratoacanthoma should be investigated on more cases in order to confirm its effectiveness. Keratoacanthoma has spontaneous resolution which happens in about 27 weeks in skin lesions and there is no data about resolution time of conjunctival keratoacanthoma so further studies should be done to establish this way of treatment as a standard guideline in treatment of keratoacanthoma.