Squamous Cell Carcinoma Complicating Lichen planus: A Clinico-Pathological Study of Three Cases

Abstract

Squamous cell carcinoma complicating lichen planus is described in 3 patients. In 2, the cancers developed on the lower leg in chronic and hypertrophic lichen planus. In the other case, the cancer complicated lichen planus of the lip mucosa in a smoker. In the two cutaneous cases, the tumour and the adjacent skin showed features of lichen planus, including hypergranulosis, cytoid bodies and a lichenoid infiltrate. The association, though rare with cutaneous lichen planus when it tends to affect chronic hypertrophic lesions on the lower legs, is now well recognized with oral lichen planus. Patients with oral involvement warrant long-term follow-up, especially if they have other risk factors such as smoking or excessive ultraviolet exposure. Chronicity of lichen planus at other skin sites may also be a risk factor.

Hypertrophic Lichen Planus–Like Reactions Combined With Infundibulocystic Hyperplasia

“…In 2 of our patients, infiltrating cords of atypical keratinocytes were present in the deep dermis and were masked by overlying lichenoid infundibulocystic follicular hyperplasia. Although squamous cell carcinoma may develop in the setting of classic hypertrophic lichen planus, this usually emerges in the background of long-standing lichen planus, 12,13 in contrast to the short history and early lichenoid reactions seen in our patients.…”

Squamous cell carcinoma as a complication of long‐standing hypertrophic lichen planus

“…Hypertrophic lichen planus is a subacute chronic variant of lichen planus characterized by hypertrophic or warty lesions most often found on the pretibial area of the lower limbs 1–3 . In the literature, 41 cases of lichen planus, mainly of hypertrophic or verrucous type, with consecutive carcinoma have been described 4–8 . X‐ray and arsenic treatment of lichen ruber often precedes malignant transformation by many years 5 .…”

Evaluation of premalignant potential in oral lichen planus using interphase cytogenetics

“…gations that found that OSCC developed in lesions previously diagnosed as OLP (11)(12)(13)(14)(15). OSCC develops in 0.5% to 2.5% of OLP according to reports (16,17).…”