Squamous Cell Carcinoma Arising in Ungual Lichen Planus: Report and Review

Abstract

<b><i>Background:</i></b> Lichen planus (LP) can lead to severe scarring of the nail unit leading to anonychia. There are very few reports of squamous cell carcinoma (SCC) occurring in the lesions of ungual LP. <b><i>Objective:</i></b> The aim of this study was to revise the previously reported cases of SCC appearing in ungual LP and to present a new case. <b><i>Methods:</i></b> A PubMed search was performed with the terms “nail lichen planus” and “squamous cell carcinoma.” Reported cases as well as a new case were depicted in a table. <b><i>Results:</i></b> Only 2 indexed articles reporting 3 cases were found. All patients suffered of long-lasting scarring ungual LP. <b><i>Conclusions:</i></b> The occurrence of SCC in nail LP is rare. LP is not “premalignant” per se, but SCC might rarely arise in LP scars.

Oral lichen planus: case series and experience in a tertiary dermatology service in Brazil

“…SCC will only appear in cases of long-term OLP and the presence of intense cicatricial sequelae in the mucosa; hence, the importance of long-term follow-up. SCC is very rare in association with cutaneous LP, as the latter rarely develops cicatricial sequelae, but it can occasionally occur 12 .…”

Porokeratosis of the Nail Unit: Case Series and Review

“…No such case has been reported so far, probably due to the extreme rarity of ungual PK. The occurrence of SCC in scars of ungual LP (a rare complication of a much more common entity) has been recently reviewed [13].…”

“…Longitudinal nail biopsies were not obtained, given the presence of many typical lesions elsewhere, where simple punch biopsies were more easily performed. Squamous cell carcinomas (SCC) can arise at areas of chronic and intense scarring such as burns, morphea, discoid lupus erythematosus, LP, lupus vulgaris, epidermolysis bullosa dystrophica, hidradenitis, nonhealing ulcers, and, very rarely rarely, PK [13]. These diseases should not be considered "pre-malignant," nonetheless SCC truly can arise in their chronic scars (Marjolin's ulcer) [1,13].…”

“…Squamous cell carcinomas (SCC) can arise at areas of chronic and intense scarring such as burns, morphea, discoid lupus erythematosus, LP, lupus vulgaris, epidermolysis bullosa dystrophica, hidradenitis, nonhealing ulcers, and, very rarely rarely, PK [13]. These diseases should not be considered "pre-malignant," nonetheless SCC truly can arise in their chronic scars (Marjolin's ulcer) [1,13]. In theory, then, SCC can occur in a cicatricial anonychia due to PK.…”