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Keratoacanthoma usually resolves spontaneously. There have been case reports of classical keratoacanthoma changing into squamous cell carcinoma; either there has been a misdiagnosis of the original tumour or a genuine neoplastic change has occurred. When in doubt about diagnosis or recurrence in a presumed keratoacanthoma, the best course is excision biopsy. However, it must not be assumed that a keratoacanthoma that has rapid growth, or recurred after surgery, has turned malignant. Rapid growth may be a feature of the normal natural history. In animal models, recurrence has been seen when the original lesion was incompletely eradicated.

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