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To the Editor:—
In reference to the article published in The Journal of June 5, 1954, page 562, entitled "Keratoacanthoma," I should like to point out certain discrepancies between the method of treatment cited and the possibility of histological diagnosis. Apparently, in this lesion, the differentiation from a low-grade squamous cell carcinoma rests on the criterion of invasion. Therefore, from a pathological standpoint, the practice of shaving the lesion flush with the surrounding skin and then electrodesiccating the base does not furnish the pathologist with an adequate specimen for this differential diagnosis. I personally have run across this problem in the last few weeks, and I strongly feel that, if any tissue is to be submitted for an examination, the entire lesion should be excised.
Thomas R. Cox. KERATOACANTHOMA. JAMA. 1954;156(14):1351. doi:10.1001/jama.1954.02950140051023