Cutaneous Squamous Cell Carcinoma in Black Patients With Chronic Discoid Lupus Erythematosus

Abstract

A 43-year-old African-American man with a 20-year history of discoid lupus erythematosus presented to the Veterans Administration Hospital in New Orleans for evaluation of tumors of the scalp and arm. He was using a topical steroid ointment and sunscreens daily. The medical records indicated that he had a long history of noncompliance with medical therapy including antimalarials and oral corticosteroids. Examination of the scalp showed a cutaneous horn of the left parietal region measuring 3 x 4 cm at the base and 5 cm in height and cicatricial alopecia. The lateral aspect of the right arm showed an exophytic mass measuring 8 x 10 cm arising within an atrophic scarred plaque. The patient also had disseminated atrophic, hyperkeratotic, depigmented plaques in a photodistribution. No palpable adenopathy suggestive of metastatic disease was found. Review of systems was significant only for photosensitivity. The following laboratory studies were negative or within normal limits: ANA (Hep-2 substrate), ssA, ssB, dsDNA, RNP, CBC, biochemical profile, urine analysis, lupus band, RPR, rheumatoid factor, and chest x-ray. Erythrocyte sedimentation rate was elevated at 32. Skin biopsies of the cutaneous horn and exophytic arm lesion showed invasive sec. The patient was referred for excision and full-thickness skin grafts. Following excision, he remained noncompliant with medical therapy and was lost to follow-up. DiseussiON

Skin cancer risk perceptions: A comparison across ethnicity, age, education, gender, and income

“…26, 50–51, 54 Compared to SCC in whites, these are more often associated with scarring, trauma, or inflammation. 24, 26, 50, 53, 55–56 Such potentially preventable SCCs are more aggressive, with substantially greater mortality (approximately 20 to 30%). 26, 50, 53 …”

Metastasizing squamous cell carcinoma arising from chronic discoid lupus erythematosus plaque of recent onset

“…CDLE lesions may develop malignant transformation; an incidence of 3.3% was reported by Millard and Barker, with a delay of 26-41 years (mean 30.8 years) between initiation of the CDLE and the appearance of SCC. [1] In another review of 10 African-American patients by Sherman et al, [2] it was observed that SCC in depigmented CDLE lesions occurred only in sunexposed areas with a male predisposition and a history of CDLE for an average of approximately 18 years (range 7-30 years). Although the above-mentioned studies [1,2] indicate a long latent period, Parikh et al [3] have reported a case of SCC in a CDLE plaque over sunprotected area of only 1 year duration.…”

Discoid lupus erythematosus leading to squamous cell carcinoma: a case report

“…6 In a review by Sherman et al, the interval between development of DLE and SCC has varied from 4-20 years. 7 However, there have been reports of shorter duration of up to four years between the onset of the disease and development of SCC, but our case developed SCC within few months of appearance of DLE lesions. This could be explained by the high risk factors in this case.…”