A novel case of cutaneous squamous cell carcinoma at the site of previous sporotrichosis

Abstract

| INTRODUC TI ONCutaneous squamous cell carcinoma (cSCC), a malignant tumor of epithelial keratinocytes, is characterized by relatively reduced instances of lymph node metastases. The incidence of cSCC is on the rise, despite this cancer type being highly preventable. A vast majority of cSCC cases are a result of precancerous lesions pertaining to specific skin diseases; however, cSCC has also been reported as a primary cancer. In addition, pathogen infection, especially human papillomavirus infection, has been reported as one of the most important causative factors of cSCC. In this report, we describe a novel case of cSCC which was caused by sporothrix infection. | C A S E REP ORTInformed consent was obtained from the patient for inclusion in the study, and all methods were carried out in accordance with relevant guidelines and regulations. In mid-2017, a 72-year-old healthy male patient consulted our Department of Dermatology in relation to a dermatosis condition that had manifested itself two months prior to the consultation. The condition was first recognized as a dull red bean-sized papule on the left zygomatic arch region with slight pruritus. Gradually, this developed into a nail-sized plaque with a keratinized surface. A skin biopsy revealed epidermal hyperplasia and granulomatous inflammation of the dermis (Figure 1). Fungal culture Abstract Background: Cutaneous squamous cell carcinoma (cSCC) is a malignant tumor of epithelial keratinocytes, with a relatively reduced frequency of lymph node metastasis.Despite the fact that this tumor type is largely preventable, the incidence of cSCC is rising every year. Ultraviolet exposure is a major cause of cSCC and directly contributes to cSCC. Other known environmental risk factors include ionizing radiation, cigarette smoking, and certain chemical exposures. Aims:In this study, we report a clinical case of cSCC with a novel causative factor. Patient/Methods: The report describes a 72-year-old male who was seen for a dermatosis condition initially. Later, epidermal hyperplasia and granulomatous inflammation of the dermis was diagnosed based on skin biopsy. Fungal culture revealed the presence of Sporothrix schenckii which led to the diagnosis of fixed-type sporotrichosis.Results: Four months of oral terbinafine (250 mg once a day) administration partially resolved the lesions. Patient was subsequently diagnosed with cSCC, and surgical resection with wider margins was performed. Conclusion:After a careful and rigorous exclusion of known risk factors, we confirmed that this incidence of cSCC was caused by chronic inflammation which followed fixed-type sporotricosis. K E Y W O R D Sbiopsy, pathogenesis, Sporothrix schenckii, sporotrichosis, squamous cell carcinoma