Case report
A 42-year-old woman presented to our clinic with a 1.8 x 1.8 cm red nodule on the nose tip (Figure 1A). It had been present for the past 8 months and was slightly itchy, painless, and progressively increasing in size. No other associated symptoms or history of trauma to the nose or prolonged exposure to sunlight was reported. A skin biopsy revealed histopathological architecture, suggestive of KA (Figure 2A). The patient did not treat the nodule earlier, but occasionally squeezed it. Owing to the cosmetic issues involved, she refused surgery. Thus, superficial radiotherapy (SXRT; Sensus Healthcare, Boca Raton, FL, USA) was performed. SXRT was administered at one fraction of 3.8 Gy every 4 days for 12 fractions, for a total dose of 45.6 Gy. The irradiation field included a 0.6-cm adequate margin of normal skin around the lesion. The lesion was completely removed after radiotherapy (Figure 1B). After 1 month of radiotherapy, she noted two red nodules arising from the bridge of her nose at 1 cm and 3.4 cm away from the primary focus (Figure 1C). The nodule did not absorb after 15 days of treatment with mupirocin ointment and amoxicillin. Therefore, the pathological examination was performed, and the results confirmed the same pathological type of KA as that recorded earlier (Figure 2B).