Squamous cell carcinoma complicating late chronic discoid lupus erythematosus

Abstract

Two cases of squamous cell carcinoma developing in lesions of chronic cutaneous discoid lupus erythematosus are presented. One of the patients was white and the other was black. The squamous cell carcinoma in the black patient proved to be rapidly metastatic and eventually fatal. The white patient developed seven squamous cell carcinomas over 8 years with no evidence of metastatic spread. The role of ultraviolet light in inducing skin cancer in these patients is discussed.

Squamous cell carcinoma in discoid lupus erythematosus: Reconstruction with a free forearm fasciocutaneous flap

“…Dabski et al [9] and Martin and Rosen [10] reported that there was high metastatic potential in squamous cell carcinomas that arise in DLE. Most of the authors preferred excision as treatment if a squamous cell carcinoma complicated DLE [1].…”

“…Exposure to actinic radiation [1], and carcinogenic agents such as cytotoxics or radiation [8] were the main causes in this case. Reports of squamous cell carcinoma on a DLE lesion are common [9]. In recent years, the reduction in the incidence of squamous cell carcinoma with DLE was explained by changes in the treatment of the DLE, with the omission of carcinogenic agents [8].…”

“…Recurrences after inadequate excision and reconstruction may be prevented by wide excision and free flaps. The flaps use for reconstruction were usually pedicled flaps such as forehead or deltopectoral [8,9]. Our forearm fasciocutaneous flap was used because it was large enough to close the defect; easy to harvest; there was little donor site morbidity; there was a good colour match; and it was thin.…”

“…These have been treated by excision [6], cryosurgery [6], dermabrasion [7], skin grafting [8], local flaps [8,9], and laser [5] for scarred areas and tumours until now.…”

Cutaneous lupus erythematosus simulating squamous neoplasia: The clinicopathologic conundrum and histopathologic pitfalls

“…[4][5][6][7] Confusion with squamous cell carcinoma may be especially troublesome, for the occurrence of indubitable squamous cell carcinoma arising in lesions of DLE is well described. [8][9][10][11][12][13][14][15][16][17] Nonhypertrophic and atrophic lesions of CLE can exhibit similar atypical changes and may also mimic squamous neoplasia. When keratinocytic atypia and dyskeratosis are present in such lesions, actinic keratosis, lichen planuselike keratosis, and squamous cell carcinoma must be included in the differential diagnosis.…”