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

Abstract

Prevalence of squamous cell carcinoma in patients with chronic hidradenitis suppurativa A review of the articles found 85 cases of SCC arising from HS reported in the English literature to date (6-13). A 2016 report by Jourabchi et al. (6) described 80 of these cases, and we found five additional cases published since that time (Table 2). Among these five new cases, the mean history of HS prior to SCC diagnosis was 26 years. The mean age at diagnosis was 52 years. SCC developed from longstanding HS of predominately the gluteal and perianal areas. A biopsy of malignant tissue was tested for human papillomavirus (HPV) in two of the five cases, and was negative in both cases. A history of tobacco use was reported in two cases (9, 10). The diagnosis of SCC in chronic HS is particularly challenging because painful and inflammatory HS lesions may be difficult to distinguish from malignant transformation (6). Thus, a low threshold for biopsy is often recommended by clinicians to diagnose

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.…”

“…Both lesions were removed surgically with security field of~1 cm (Figure 1b HS is a chronic, often impairing, skin disorder, manifested with forming of painful subdermal abscesses, sinus tracts and scarring in the areas with high apocrine glands count (axillae, gluteal area and anogenital area). 1 Complication of HS include: infection, scarring, limitations in movement and lymph drainage, but also malignisation. In 3.2% to 4.6% of the patients with HS a developing of squamous cell carcinoma (SCC) is seen.…”

“…2 On the other hand, the highly malignant nature of this carcinoma determines its poor prognosis. 1,3 The wide surgical excision has an excellent therapeutic result, showing a recurrence rate of only 2.5%, mainly in advanced forms. 5 Complications are relatively mild such as bleeding and forming of hematoma.…”

Lymphedema in patients with hidradenitis suppurativa: a systematic review of published literature

“…It has been previously reported that patients with chronic HS have a 50% increased risk in the overall incidence of malignancy . In particular, the relative risk for squamous cell carcinoma is 4.6 with HS with most squamous cell carcinomas presenting on the perineal or buttock areas …”

Fatal outcome of malignant transformation of hidradenitis suppurativa: A case report and literature review

“…A paper in 2016 by Jourabchi et al and in 2018 by Chapman et al described 80 and five cases, respectively, on SCC in patients with HS cases in the English literature. We found five additional cases of SCC arising from HS reported in the literature since the last updated review by Chapman et al (Table ). Among these five new cases, the mean history of HS prior to SCC diagnosis was 16 years, and the mean age at diagnosis was 51.2 years.…”