Squamous cell carcinoma of the skin in both palms, axillary node, donor skin graft site and both soles—associated hyperkeratosis and porokeratosis

Abstract

A 74-year-old woman presented with skin squamous cell carcinomas on both palms, ankles and soles. The patient also had biopsy-proven porokeratosis. There was hyperkeratosis of the palms and soles. The left palm cancer was excised and skin grafted, but recurred. A nodule in the scar of the donor site of the skin graft in the left upper arm was biopsy-proven squamous cell carcinoma. A metastatic left axillary lymph node was excised. There were no palpable metastatic lymph nodes in either the groin or right axilla. All cancers were irradiated and disappeared, as did the incidentally irradiated hyperkeratosis. Porokeratosis may be associated with skin squamous cell carcinoma, yet in this case porokeratosis could not be identified in the heavily hyperkeratotic palms and soles. Despite poor prognostic signs, i.e. the location in the palm, and metastasis, the patient has done well so far.

Gene expression profiling of porokeratosis demonstrates similarities with psoriasis

“…This and other studies have suggested that linear PK cases are at higher risk for malignant change in that eight of 42 (19%) developed SCC 5 . In addition, a number of reports demonstrate metastatic SCC arising in PK lesions 31–36 …”

“…5 In addition, a number of reports demonstrate metastatic SCC arising in PK lesions. [31][32][33][34][35][36] Despite the number of clinical reports that purport a link between PK and SCC, little is known regarding the molecular events that regulate how PK lesions transform into SCC. The first efforts to characterize the molecular phenotype of PK lesions have consisted of immunohistochemical studies.…”

Carcinoma Cuniculatum Arising in Focal Plantar Keratoderma

“…The development of an SCC in keratodermatous skin is a rare event previously reported in severe, extensive areas of keratoderma, e.g., Huriez syndrome, 6 mutilating keratoderma, 7 Clouston's syndrome, 8 porokeratosis, 9 and Unna-Thost hyperkeratosis. 10 We are not aware of an SCC developing in focal plantar keratoderma.…”

Squamous cell carcinoma of the palm in Nigeria

“…Apparently, his lesions signified some cutaneous abnormality. Cutaneous abnormalities like porokeratosis[1819] are of interest. Some such lesions are associated with SCC as a long-term complication.…”