{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T00:36:13Z","timestamp":1770510973634,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T00:00:00Z","timestamp":1383609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Keratoacanthoma (<jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content>), an epithelial neoplasm occurring in sun\u2010exposed skin of the elderly, is considered a well\u2010differentiated form of conventional squamous cell carcinoma (<jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>) that often follows a course of spontaneous regression. Distinguishing <jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content> from conventional <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content> or pseudocarcinomatous epithelial hyperplasia ensures proper diagnosis, treatment and management. For some time, perforating elastic fibers have been utilized in differentiating <jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>. This phenomenon may also occur in association with scars and hypertrophic lupus erythematosus (<jats:styled-content style=\"fixed-case\">LE<\/jats:styled-content>). To assess the diagnostic utility of perforating elastic fibers, we compared their incidence in <jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>, scars with overlying pseudocarcinomatous hyperplasia, hypertrophic <jats:styled-content style=\"fixed-case\">LE<\/jats:styled-content>, hypertrophic lichen planus (<jats:styled-content style=\"fixed-case\">LP<\/jats:styled-content>) and lichen simplex chronicus (<jats:styled-content style=\"fixed-case\">LSC<\/jats:styled-content>). A retrospective case search identified 359 lesions and the presence of perforating elastic fibers was evaluated using routinely stained sections. This phenomenon was documented in all studied groups except hypertrophic <jats:styled-content style=\"fixed-case\">LP<\/jats:styled-content>. The incidence was found to be 71% in <jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content>, 37% in <jats:styled-content style=\"fixed-case\">SCC<\/jats:styled-content>, and was lowest in inflammatory conditions with associated pseudocarcinomatous hyperplasia (hypertrophic <jats:styled-content style=\"fixed-case\">LP<\/jats:styled-content> 0%, hypertrophic <jats:styled-content style=\"fixed-case\">LE<\/jats:styled-content> 5.9% and <jats:styled-content style=\"fixed-case\">LSC<\/jats:styled-content> 28.2%). The observed frequency in pseudocarcinomatous hyperplasia overlying scars (57.8%) vs. <jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content> (71%) was not statistically different. Although elastic fiber trapping has potential value as a diagnostic criterion for <jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content>, dermatopathologists should consider its limitations. Its diagnostic utility was greatest in distinguishing <jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content> from hypertrophic <jats:styled-content style=\"fixed-case\">LE<\/jats:styled-content> and hypertrophic <jats:styled-content style=\"fixed-case\">LP<\/jats:styled-content>. Conversely, elastic trapping is not helpful differentiating pseudocarcinomatous hyperplasia from recurrent\/persistent <jats:styled-content style=\"fixed-case\">KA<\/jats:styled-content> following surgery.<\/jats:p>","DOI":"10.1111\/cup.12247","type":"journal-article","created":{"date-parts":[[2013,10,18]],"date-time":"2013-10-18T16:40:47Z","timestamp":1382114447000},"page":"108-112","source":"Crossref","is-referenced-by-count":17,"title":["Perforating elastic fibers (\u2018elastic fiber trapping\u2019) in the differentiation of keratoacanthoma, conventional squamous cell carcinoma and pseudocarcinomatous epithelial hyperplasia"],"prefix":"10.1111","volume":"41","author":[{"given":"Kabeer","family":"Shah","sequence":"first","affiliation":[{"name":"Rocky Vista University College of Osteopathic Medicine Parker CO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktoryia","family":"Kazlouskaya","sequence":"additional","affiliation":[{"name":"Ackerman Academy of Dermatopathology New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karan","family":"Lal","sequence":"additional","affiliation":[{"name":"New York College of Osteopathic Medicine New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Molina","sequence":"additional","affiliation":[{"name":"Department of Pathology Memorial Sloan Kettering Cancer Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk M.","family":"Elston","sequence":"additional","affiliation":[{"name":"Ackerman Academy of Dermatopathology New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,5]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semdp.2009.09.003"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.104"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000372-199308000-00007"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.1991.tb00132.x"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.1980.tb01192.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1827.2004.01667.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2011.01834.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0560.2003.00082.x"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1984.tb04677.x"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000018276"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.2.2.85"},{"key":"e_1_2_5_13_1","first-page":"80","article-title":"Topical treatment with imiquimod may induce regression of facial keratoacanthoma","volume":"13","author":"Dendorfer M","year":"2003","journal-title":"Eur J Dermatol"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.12.017"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/229255031101900209"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-200044010-00015"},{"key":"e_1_2_5_17_1","first-page":"329","article-title":"Aggressive giant keratoacanthoma of the face treated with intramuscular methotrexate and triamcinolone acetonide","volume":"59","author":"Santoso\u2010Pham JC","year":"1997","journal-title":"Cutis"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220(83)90101-9"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcup.12247","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.12247","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T13:35:54Z","timestamp":1696340154000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.12247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11,5]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2014,2]]}},"alternative-id":["10.1111\/cup.12247"],"URL":"https:\/\/doi.org\/10.1111\/cup.12247","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"value":"0303-6987","type":"print"},{"value":"1600-0560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11,5]]}}}