“…Above knee amputation was required in another case of non-healing ulcers of the foot with long-standing congenital lymphedema nonresponsive to multiple treatments [ 11 ]. Below knee amputation was done in one case of lymphedema praecox with full-thickness ulceration of the dorsal aspect of her ankle as despite aggressive wound care, negative pressure therapy, as well as surgical debridement and skin grafting wound didn't heal [ 18 ].Pedal amputation was required in a case of SCC in a patient with lymphedema and underlying epidermodysplasia verruciformis, with extensive involvement of the distal foot [ 19 ]. The role of adjuvant radiotherapy was only described in one case for regional lymph nodal metastasis but there is no documentation of role of chemotherapy and immunotherapy in the literature.…”