Successful surgical treatment for squamous cell carcinoma arising from hidradenitis suppurativa

Abstract

Rationale:Hidradenitis suppurativa (HS) is a disabling inflammatory disease mainly affecting apocrine glands. Marjolin ulcer (MU) is a term used to describe a rare type of squamous cell carcinoma (SCC) arising within sites of chronic wounds or preexisting scars. Chronic HS may result in a rare type of SCC, MU, which has a poor prognosis due to its high metastatic rate.Concerns of the patient:Here we reported a 60-year-old male who developed SCC on the right buttock after suffering from HS for 15 years.Interventions:Radical resection with clear margin was performed, after which topical negative pressure (TNP) was applied followed by split-thickness skin grafting.Outcomes:In a 1-year follow-up, there was no recurrence of malignancy.Lessons:Cases reported in English literature since 1991 were reviewed to get a general grasp of status quo. The authors conclude that chronic HS lesion especially in the gluteal region should be cautiously observed. Once tumor arisen from HS lesion, immediate radical excision should be performed. With assured clear margin, TNP could be chosen to offer a favorable environment for the survival of skin grafting.

Cutaneous squamous cell carcinoma complicating hidradenitis suppurativa: a review of the prevalence, pathogenesis, and treatment of this dreaded complication

“…When SCC does arise in HS it is usually well differentiated; however, despite the theoretical good prognosis, the combination of SCC and HS is often associated with early metastasis and high mortality rates (8). The development of SCC is likely multifactorial, and may be explained by the chronic irritation and inflammation characteristic of HS in association with other risk factors such as tobacco use (6,9).…”

Multiple SCCs arising in the gluteal area from patient with short disease duration of hidradenitis suppurativa (hurley I‐II): Surgical approach with favorable outcome

“…2,3 It develops three times more often in males, probably due to the more frequent gluteal and perineal localization in males and is highly associated with smoking. [1][2][3][4] The average period between HS onset and SCC developing is estimated of 27 ± 9.9 years, 1,4 significantly longer than in the presented case (~2.5 years). In addition, cases in medical literature report SCC developing in advanced HS, whereas in the presented case the condition is assessed as hurley I-II.…”

“…2 However in cases of ulceration, more aggressive and earlier approach is advisable, given the fact that ulceration is noted as a risk factor for malignisation. 4 In case of SCC developing the disease management should include a wide excision of the tumor and a screening for metastasis. 1 The presented case is interesting because of the unusual rapid development of SCC in place of chronic inflammatory lesion of HS and the fact that malignisation in hurley I-II is observed, to the best of our knowledge for the first time.…”

Letter to the Editor referring to Hessam et al. – Squamous cell carcinoma arising in hidradenitis suppurativa: subclinical lymphedema may have favored the tumor onset

“…Thus, taking the described concept of Ruocco et al into conclusion, the development of SCC would most likely be expected in the areas of most severe lymphedema. However, genital SCC is only reported in the minority of cases [ 14 ] . Regarding male HS/ AI patients scrotal SCC is only described in three cases and penile SCC is not described in the literature [ 14 ] .…”

“…However, genital SCC is only reported in the minority of cases [ 14 ] . Regarding male HS/ AI patients scrotal SCC is only described in three cases and penile SCC is not described in the literature [ 14 ] .…”