Giant Squamous Cell Carcinoma on Chronic Lichen Planus on the Ankle - A Case Report and Short Literature Review

Abstract

BACKGROUND: Cutaneous squamous cell carcinoma (SCC) is the second most common malignancy of skin. Although a major risk factor is a chronic exposure to ultraviolet radiation, preexistent chronic inflammatory disorders may also possess an increased risk for SCC. That is not the case for cutaneous lichen planus in contrast to oral lichen planus and oral SCC.  CASE REPORT: We report the case of an 87-year-old Caucasian woman presenting with a giant verrucous tumour on the left ankle. She suffered from long-standing disseminated lichen planus. Histology confirmed the diagnosis of SCC on partly verrucous lichen planus. The course was complicated due to sepsis. An emergency transfemoral amputation became necessary. The patients survived and could be released into her nursery. A literature review underlined the rarity of SCC on lichen planus of the skin. Most of these rare cases were in patients in their second half of life on the lower legs. Hypertrophic lichen plnaus was overrepresented.   CONCLUSIONS: Although very rare by number, SCC can complicate lichen planus and lead to the life-threatening situation. Atypical verrucous lesions on lichen planus warrant a histologic analysis. Surgery is the treatment of choice for cutaneous SCC.