What are the recommended referral criteria for a keratoacanthoma to a dermatologist?

Keratoacanthoma referral criteria: Keratoacanthoma is a rapidly growing skin lesion that can resemble squamous cell carcinoma (SCC). The UK NICE guideline NG12 does not explicitly mention keratoacanthoma by name, but it advises that any skin lesion that raises suspicion of squamous cell carcinoma should be referred urgently via a suspected cancer pathway referral to a dermatologist for assessment.

Therefore, if a keratoacanthoma is suspected clinically, especially if the lesion is rapidly growing, ulcerated, or has features concerning for SCC, an urgent suspected cancer pathway referral to dermatology is recommended.

Routine referral may be considered if the lesion is less suspicious, but given the difficulty in clinically distinguishing keratoacanthoma from SCC, urgent referral is prudent when there is suspicion.