Squamous cell carcinoma arising in acne conglobata

A squamous cell carcinoma was found on the back of a man who had had acne conglobata for more than forty years. Squamous cell carcinomas called Marjolin's ulcers may arise in the sites of chronic inflammation and scarring such as thermal burn scars, discoid lupus erythematosus, leg ulcerations, and foci of osteomyelitis. Squamous cell carcinoma has also been reported in all three diseases included in the so-called "follicular occlusion triad": acne conglobata, dissecting cellulitis of the scalp, and hidradenitis suppurativa.     

Squamous cell carcinoma of the penis arising on lichen sclerosus et atrophicus

Squamous cell carcinoma of the penis arising on lichen sclerosus et atrophicus is rarely reported. A case is described in a 63-year-old man who had been diagnosed of lichen sclerosus et atrophicus 3 years before. The previously reported cases, the association of these diseases in women and men, and the possible pathogenesis are discussed.     

Subungual squamous cell carcinoma presenting with minimal nail changes: A factor in delayed diagnosis?

Squamous cell carcinoma of the nail bed is a relatively uncommon tumour that may be diagnosed only after considerable delay. The first case presented is a 79-year-old man with a history of discomfort and discoloration affecting the right thumbnail of 3 years duration. The second case is a 70-year-old man who presented with a recurrent, offensive discharge from beneath the left thumbnail of 40 years duration. Clinical examination of the affected digits revealed minor nail abnormalities. The presence of tumour was fully apparent only after removal of the nail plate and inspection and biopsy of the nail bed. The cases demonstrate that subungual squamous cell carcinoma may present with prolonged symptoms and a deceptively benign appearance. The importance of consideration of the possibility of malignancy, removal of the nail plate for inspection of the nail bed and appropriate biopsy is emphasized.     

Squamous cell carcinoma with hypercalcemia and leukocytosis

Squamous cell carcinoma with hypercalcemia and leukocytosis arising from burn scars in a 45-year-old man is reported. Hypercalcemia and leukocytosis improved with pepleomycin treatment and worsened with recurrence of the tumor. Serum levels of parathyroid hormone, prostaglandin E and 25-OH-Vitamin D were within normal limits. Autopsy did not disclose any bone metastases or abnormalities of the parathyroid glands. It is suggested that hypercalcemia and leukocytosis were due to factors produced by the squamous cell carcinoma. This is the fifth reported case of cutaneous squamous cell carcinoma associated with hypercalcemia in the absence of bone metastasis or parathyroid gland abnormalities.     

银屑病伴发多发Bowen病及鳞状细胞癌1例

患者女,50岁。周身反复出现鳞屑性红斑伴瘙痒30年,右臀出现菜花状肿物1年。有银屑病病史30年,予UVA照射治疗70余次。手术切除右臀肿物,组织病理示鳞状细胞癌和Bowen病。诊断:银屑病;鳞状细胞癌;Bowen病(多发)。     

Squamous Cell Carcinoma Developing within Lesions of Disseminated Superficial Actinic Porokeratosis

Disseminated superficial actinic porokeratosis (DSAP) consists of multiple annular, hyperkeratotic lesions that have a bilateral distribution on sun-exposed areas, particularly the extremities. DSAPs have a wider distribution than porokeratosis of Mibelli and usually develop during the 3rd or 4th decade of life. Squamous cell carcinoma that arises in the classical type of porokeratosis of Mibelli is well-documented, but there are only a few reports of squamous cell carcinoma in DSAP. Here, we describe a 62-year-old man with DSAP who developed squamous cell carcinoma on his right forearm.     

A case of pachyonychia congenita with unusual manifestations: an unusual type or a new syndrome?

A 30‐year‐old man presented with lesions on his oral mucosa and soles. There were no similar complaints in his family members. The dermatological examination revealed follicular hyperkeratosis on his trunk and upper extremities and flesh‐colored, firm cystic lesions on his axillae. He had focal, painful, hyperkeratotic areas sited particularly on both his soles and palms. In addition to these, leukokeratosis and ulcerative areas on buccal, labial mucosa, tongue, and at corners of the mouth, and complete loss of teeth was observed. The proximal layering was revealed on all of his nails. The laboratory investigations produced normal results except the deficiency of immunoglobulin A. The psychiatric examination revealed mild mental retardation. Keratin gene (KRT6a, KRT6b, KRT16, and KRT17) mutations for pachyonychia congenita were negative. He got removable dental prosthesis because of inadequate alimentation. Squamous cell cancer developed on lower lip mucosa during follow‐up. We present an individual who had different nail dystrophy, epidermal cysts, mental retardation, blepharitis, complete loss of teeth, and negative keratin gene mutations for pachyonychia congenita and developed squamous cell cancer on the oral leukokeratosis lesions. We think that the present case may be an unusual new type of pachyonychia congenita.     

Squamous cell carcinoma arising in long-standing necrobiosis lipoidica

Necrobiosis lipoidica (NL) is a disease of collagen. Squamous cell carcinomas developing in areas of chronic ulceration and scarring have been well documented in a variety of skin diseases but rarely in areas of necrobiosis lipoidica. The case history of a 76-year-old female is presented, whose squamous cell carcinoma appeared 30 years after the diagnosis of necrobiosis lipoidica. The clinical and histopathological picture is described, stressing the importance of the unusual association of the two pathologies in the prognostic.     

Pachyonychia Congenita: A Clinical Study of 12 Cases and Review of the Literature

Twelve cases of pachyonychia congenita were reviewed. The mode of inheritance was autosomal dominant. The clinical features of these patients included thickened nails, hyperkeratosis of the palms and soles, thinning of hair or alopecia, painful bullae or ulcerations of the palms and soles, leukokeratosis oris, verrucous lesions of the extremities, hyperhidrosis, premature eruption of teeth, paronychial infections, epidermal cysts with milia, and corneal dyskeratosis at times associated with cataracts. Biopsy from the plantar lesions usually revealed marked hyperkeratosis, acanthosis, moderate hypergranulosis, and minimal dermal inflammatory infiltration. Treatment with keratolytic agents and lubricants is indicated to areas of palmar and plantar hyperkeratosis but usually produces only transient benefit. Squamous cell carcinoma developed in one of the patients over the site of chronic plantar ulcerations. Areas of chronic bullous formation or ulceration should be observed for possible skin malignancy.     

Development of neuroendocrine (Merkel cell) carcinoma mixed with squamous cell carcinoma in erythema ab igne

Squamous cell carcinoma and neuroendocrine (Merkel cell) carcinoma are cutaneous neoplasms that have only occasionally been reported to coexist. Squamous cell carcinoma, but not neuroendocrine (Merkel cell) carcinoma, is a rare complication of erythema ab igne. This report describes the development of both neoplasms arising within the same tumor mass in an area of erythema ab igne.     

Squamous cell carcinoma arising in transplanted skin

Squamous cell carcinoma arising in a skin graft is rare. Previous reports concern the use of skin in heterotopic locations namely the vagina and oral cavity. We report a case of squamous cell carcinoma, which arose in a skin graft used for resurfacing a scalp defect. The defect followed the excision of a basal cell carcinoma 11 years previously. The excision was incomplete and radiotherapy had been given. The possible pathological mechanisms for the development of a squamous cell carcinoma in transplanted skin are discussed.     

Development of squamous cell carcinoma in chronic discoid lupus erythematosus

Squamous cell carcinoma was seen in five patients with chronic discoid lupus erythematosus during a review of 120 cases seen originally in the years 1958–1962.     

Subungual squamous cell carcinoma in Darier's disease

We report the first case of subungual squamous cell carcinoma in a patient with Darier's disease (keratosis follicularis). The presence of human papiliomavirus DNA was confirmed, consistent with its probable role in carcinogenesis at this site. The role of an altered immune state is discussed as an additional factor. Squamous cell carcinomas may be overlooked when they occur among the other cutaneous manifestations and complications of Darier's disease. A solitary, ulcerating nail bed lesion warrants biopsy to exclude squamous cell carcinoma.     

Squamous cell carcinoma on rubeosis steroidica

Squamous cell carcinoma developed on the erythematous right cheek of a 79-year-old woman where she had used corticosteroid ointments for 20 years. This condition, also known as rubeosis steroidica, might have predisposed the patient to squamous cell carcinoma, although the possibility of its being a coincidental association cannot be excluded.     

Immunohistochemical differentiation of extra-ocular sebaceous carcinoma from other skin cancers

We performed an immunohistochemical study using routinely processed formalin-fixed and paraffin-embedded tissue specimens from 26 cases of extra-ocular sebaceous carcinoma (EOSC) and eight easily available antibodies. They were polyclonal anti-carcinoembryonic antigen (CEA) antibody, monoclonal anti-CEA antibody, anti-breast carcinoma associated antigen-225 antibody (CU18), anti-CA15.3 antibody (CA15.3), anti-CD15 antibody (CD15), anti-breast carcinoma associated antigen antibody (B6.2), anti-gross cystic disease fluid antigen-15 antibody (GCDFP15) and anti-Thomsen-Friedenreich antigen antibody (TFA). Squamous cell carcinoma, porocarcinoma, syringomatous carcinoma, malignant clear cell hidradenoma, apocrine adenocarcinoma, and extramammary Paget's disease with underlying adenocarcinoma were used as controls. EOSC was positive for CU18 and CA15.3 in most cases, and for CD15 in a few cases. Squamous cell carcinoma of the skin was positive for CA15.3 in only one case. Porocarcinoma, syringomatous carcinoma and malignant clear cell hidradenoma were positive for CEA, CU18, CA15.3, and B6.2 in most cases. Apocrine adenocarcinoma and extramammary Paget's disease with underlying adenocarcinoma were positive for CEA, CU18, CD15, GCDFP15, CA15.3, and B6.2 in most cases. TFA was positive not only in EOSC but also in other skin cancers. Immunohistochemical examinations using these seven of eight antibodies except for TFA and routinely processed formalin-fixed and paraffin-embedded tissue specimens are beneficial in differentiating EOSC from other skin cancers.     

Metastatic Bowen carcinoma

A 72-year-old man presented with basaloid squamous cell carcinoma metastatic to both lungs that was morphologically similar to recurrent, invasive moderately to poorly differentiated carcinoma arising from persistent Bowen's disease of the right cheek. The original lesion of invasive moderately differentiated squamous cell carcinoma arising in Bowen's disease had been excised 11 years previously. Mohs' surgery was performed for the recurrent lesion on the cheek 12 months prior to detection of lung metastases. He died of respiratory failure 19 months following diagnosis of his metastatic disease. Our case reflects the potentially aggressive nature of invasive squamous cell carcinoma arising from Bowen's disease and highlights the importance of approaching this entity with a view to complete surgical excision with adequate margins.     

Squamous cell carcinoma antigen in patients with cutaneous disorders

Serum levels of the tumor marker squamous cell carcinoma antigen (TA-4) were examined in patients with nonneoplastic dermatologic diseases. The majority of patients with significant disease had elevated levels of this antigen. The percentage of involved skin surface area correlated with serum squamous cell carcinoma antigen levels. Psoriasis and atopic dermatitis have different effects on squamous cell carcinoma antigen levels. Kidney failure also causes elevated levels. Squamous cell carcinoma antigen is not a reliable tumor marker in patients with squamous cell carcinoma at any site when these patients also have a cutaneous disorder that involves more than 2% of the skin surface area or when they have kidney failure.     

Special concern about squamous cell carcinoma of the scalp in organ transplant recipients

BACKGROUND: Several risk factors are generally accepted to portend more aggressive behavior of cutaneous squamous cell carcinoma. These include tumor size, tumor depth, histologic subtype, location on the lip or ear, tumor arising in scar, recurrent tumor, and tumor demonstrating perineural invasion. Organ transplant recipients can have significant morbidity and mortality from squamous cell carcinoma. OBSERVATIONS: Four organ transplant recipients developed metastatic disease from squamous cell carcinoma of the scalp. CONCLUSIONS: Squamous cell carcinoma of the scalp in organ transplant recipients should be considered a high-risk tumor because of its anatomic location. Margin-controlled tumor extirpation, sentinel lymph node biopsy, and adjuvant radiation therapy should all be considered in the organ transplant recipient population.