{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:49:33Z","timestamp":1787028573711,"version":"build-2736575974"},"reference-count":122,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Associazione Italiana per la Ricerca sul Cancro, AIRC, Italy","award":["IG 2021-ID. 25899"],"award-info":[{"award-number":["IG 2021-ID. 25899"]}]},{"name":"EU funding","award":["PE00000007, INF-ACT"],"award-info":[{"award-number":["PE00000007, INF-ACT"]}]},{"name":"Ministero dell\u2019Universit\u00e0 e della Ricerca, Italy","award":["PRIN 2022-cod. 20223RYYFC"],"award-info":[{"award-number":["PRIN 2022-cod. 20223RYYFC"]}]},{"name":"Ministero dell\u2019Universit\u00e0 e della Ricerca, Italy","award":["PRIN 2022 PNRR-cod. P20222YKP8"],"award-info":[{"award-number":["PRIN 2022 PNRR-cod. P20222YKP8"]}]},{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Keratoacanthoma (KA) is a rapidly growing epithelial neoplasm characterized by clinical and histopathological features that often overlap with well-differentiated squamous cell carcinoma (SCC), posing diagnostic challenges. This review provides a comprehensive overview of KA, emphasizing advances in non-invasive diagnostic techniques such as dermoscopy, reflectance confocal microscopy (RCM), and line-field confocal optical coherence tomography (LC-OCT), which improve lesion characterization and differentiation from SCC. We discuss the histopathological phases of KA and highlight key features aiding in diagnosis. Furthermore, we explore the emerging role of human papillomavirus (HPV), particularly \u03b2-genus types, as a cofactor in KA carcinogenesis through modulation of apoptosis and DNA damage response pathways, especially under ultraviolet (UV) radiation exposure. Therapeutic strategies remain centered on complete surgical excision; however, alternative treatments, including radiotherapy, cryotherapy, topical agents, and systemic retinoids, are discussed with their respective benefits and limitations. Finally, we review current HPV vaccines and novel vaccine candidates targeting a broad spectrum of mucosal and cutaneous HPV types. This review underscores the importance of integrated diagnostic and therapeutic approaches to optimize KA management and highlights future directions in understanding its pathogenesis and treatment.<\/jats:p>","DOI":"10.3390\/ijms262010040","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T14:04:02Z","timestamp":1760537042000},"page":"10040","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["New Insights into Pathogenesis and Management of Keratoacanthoma: A Narrative Review"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9376-5974","authenticated-orcid":false,"given":"Mariafrancesca","family":"Hyeraci","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine, University of Padua, 35122 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6119-1870","authenticated-orcid":false,"given":"Dario","family":"Didona","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damiano","family":"Abeni","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Magri","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, 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35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Di Lella","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0117-346X","authenticated-orcid":false,"given":"Antonio","family":"Di Guardo","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annarita","family":"Panebianco","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Chello","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5126-8873","authenticated-orcid":false,"given":"Claudio","family":"Conforti","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"},{"name":"Department of Life Science, Health and Health Professions, Link University of Rome, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4329-3312","authenticated-orcid":false,"given":"Elena","family":"Dellambra","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Fania","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Dermopatico dell\u2019Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy"},{"name":"Department of Life Science, Health and Health Professions, Link University of Rome, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e100","DOI":"10.1111\/j.1365-2230.2009.03668.x","article-title":"Severe exacerbation of multiple self-healing squamous epithelioma (Ferguson\u2013Smith disease) with radiotherapy, which was successfully treated with acitretin","volume":"35","author":"Robertson","year":"2010","journal-title":"Clin. 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