Squamous cell carcinoma arising in vulval lichen planus

We report two cases of squamous cell carcinoma arising in vulval lichen planus. Patients with lichen planus should be examined for evidence of genital involvement. If this is present, such patients should be closely monitored, and any atypical lesions biopsied.     

Metastatic cutaneous squamous cell carcinoma arising from a previous area of chronic hypertrophic lichen planus

Malignant transformation of cutaneous lichen planus is a rare event. We report a 34 year old Caucasian male who presented with an exophytic tumor on the right foreleg. The tumor gradually developed within previous areas of histologically proven hypertrophic lichen planus that had existed for about 10 years. However, the current histological examination of the excised tumor revealed highly differentiated squamous cell carcinoma with a depth of tumor invasion of 10 mm. At that time, neither sentinel lymph node biopsy nor further imaging diagnostics revealed evidence for metastatic spreading. Nevertheless, five months after surgery inguinal lymph node metastases were detected. Initial chemotherapy and inguinal lymph node dissection were unable to stop the spread of the tumor. One year later, parailiacal lymph node metastases were detected by computed tomography. Further cycles of chemotherapy resulted in significant reduction of the parailiacal tumor masses. This report indicates that the long-standing hypertrophic form of lichen planus seems to have a considerable propensity for malignant transformation, even in young patients.     

Giant keratoacanthoma arising in hypertrophic lichen planus

A 45-year-old man presented with a rapidly enlarging tumour in an area of long-standing hypertrophic lichen planus of the lower leg. Histological examination of the resected specimen showed it to be a giant keratoacanthoma measuring 37 x 57 mm. Neoplastic change is a rarely reported complication of chronic variants of cutaneous lichen planus. To date there have been only two reports of keratoacanthoma development in association with lichen planus.     

Squamous carcinoma following lichen planus of the vulva

A 58-year-old woman presented with typical cutaneous features of lichen planus (LP). She had suffered from vulval pruritus for 3 years, and examination showed lesions suggestive of LP on the vulva. Three months later a plaque developed on the clitoral hood, and biopsy showed an invasive squamous carcinoma. After vulvectomy, features of LP were found in the excised specimen. Vulval LP should be carefully monitored for possible malignant transformation.     

Verrucous carcinoma in association with hypertrophic lichen planus

Neoplastic transformation of lichen planus is a rare event. However, squamous cell carcinoma may develop in 0.3%–3% of patients with the oral form of the disease. On the other hand, less than 30 cases arising in cutaneous lichen planus have been reported, and only four cases of verrucous carcinoma in association with either form, one with an oral lesion and three with cutaneous lesions (one hypertrophic and one ulcerative).
This report describes the unusual progression of a hypertrophic lichen planus plaque of the right leg to a verrucous carcinoma in a 40-year-old woman.     

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.     

足跟部扁平苔藓继发鳞状细胞癌一例

皮肤鳞状细胞癌是起源于表皮或附属器角质形成细胞的一种恶性肿瘤,常由各种癌前期疾病演变而来,其中扁平苔藓继发鳞状细胞癌临床上较为少见。本文报道了足跟部扁平苔藓继发鳞状细胞癌1例。     

Hypertrophic lichen planus mimicking squamous cell carcinoma

An 87-year-old female presented with a 3 month history of hyperkeratotic nodules on her left shin. An initial clinical and histological diagnosis of multiple squamous cell carcinomas on the left shin was made. Review of the biopsy, however, showed hypertrophic lichen planus with pseudoepitheliomatous hyperplasia. Typical lichen planus was seen affecting the oral mucosa, nails and skin elsewhere.