Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany.
J Dtsch Dermatol Ges. 2020 Jul;18(7):669-673. doi: 10.1111/ddg.14096. Epub 2020 May 4.
Scleroderma is a heterogeneous group of fibrosing connective tissue disorders of unknown etiology. Morphea is a localized form of scleroderma that occasionally leads to chronic erosions and ulcerations of the skin. Fibrosis, inflammation and chronic ulcerations may eventually promote skin neoplasms; morphea is therefore a rare but established risk factor for cutaneous squamous cell carcinoma (cSCC). We present a review of 16 scleroderma patients: 15 case reports from the literature (identified by a PubMed search) and one case from our clinic of a patient who had developed cSCC, and we discuss potential underlying mechanisms. Statistical analysis revealed that the lower extremities were the body site most commonly affected by cSCC in these scleroderma patients. The mean time interval between the onset of scleroderma and the development of cSCC was ten to twenty years. In patients with morphea, we recommend checking for skin tumors during follow-up examinations as well as a careful risk-benefit analysis when considering the application of immunosuppressants or phototherapy in view of their potential carcinogenic side effects.
硬皮病是一种病因不明的纤维性结缔组织疾病的异质性群体。硬斑病是局限性硬皮病，偶尔会导致皮肤慢性侵蚀和溃疡。纤维化、炎症和慢性溃疡最终可能会促进皮肤肿瘤的发生；因此，硬斑病是皮肤鳞状细胞癌（cSCC）的一个罕见但已确立的危险因素。我们回顾了 16 例硬皮病患者：15 例来自文献的病例报告（通过 PubMed 搜索确定）和 1 例来自我们诊所的患者发生 cSCC 的病例，并讨论了潜在的潜在机制。统计分析显示，下肢是这些硬皮病患者中最常发生 cSCC 的身体部位。硬皮病发病和 cSCC 发展之间的平均时间间隔为 10 到 20 年。对于硬斑病患者，我们建议在随访检查中检查皮肤肿瘤，并在考虑应用免疫抑制剂或光疗时进行仔细的风险效益分析，因为它们可能具有致癌的副作用。
