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).