Lin Li, Huang Zeyu, Xi Bangsheng, Qin Xiaoming, Yang Kongchao, Zhang Ruzhi
Department of Dermatology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, People's Republic of China.
Department of Dermatology, The Third Affiliated Hospital of Soochow University, Changzhou, People's Republic of China.
Clin Cosmet Investig Dermatol. 2024 Aug 5;17:1757-1762. doi: 10.2147/CCID.S476845. eCollection 2024.
Cutaneous squamous cell carcinoma (SCC) is a common non-melanoma skin cancer (NMSC). Although most cutaneous SCC in people with lighter skin pigmentation as a result of sun damage, patients with underlying conditions such as skin ulcers and chronic inflammation-including conditions such as lupus vulgaris (LV) and chronic discoid lupus erythematosus-are also predisposed to developing SCC. Here we report a case of secondary SCC diagnosed in a 54-year-old patient with 20 years of lupus vulgaris without prior formal systemic treatment, a rarity in clinical practice. Two months ago, the patient developed papules on the right cheek that ulcerated and discharged purulent fluid. Laboratory tests revealed a positive TSPOT result and histopathological examination confirmed granulomatous lesions, supporting the diagnosis of SLE. However, a tissue biopsy unexpectedly revealed a moderately differentiated SCC of the keratinizing type. In this case, we performed surgical excision of the lesion followed by cosmetic closure and adjuvant photodynamic therapy (PDT). Concurrently, the patient underwent systemic anti-tuberculosis treatment. At 6 months post-treatment, no tumour recurrence was observed and the rash associated with lupus erythematosus had also resolved. The patient was satisfied with the treatment outcome.
皮肤鳞状细胞癌（SCC）是一种常见的非黑色素瘤皮肤癌（NMSC）。虽然大多数皮肤色素较浅的人的皮肤SCC是由阳光损伤引起的，但患有皮肤溃疡和慢性炎症等基础疾病的患者——包括寻常狼疮（LV）和慢性盘状红斑狼疮等疾病——也易患SCC。在此，我们报告一例在一名患有20年寻常狼疮且未接受过正规系统治疗的54岁患者中诊断出的继发性SCC病例，这在临床实践中较为罕见。两个月前，该患者右侧脸颊出现丘疹，随后溃疡并排出脓性液体。实验室检查显示TSPOT结果呈阳性，组织病理学检查证实为肉芽肿性病变，支持系统性红斑狼疮（SLE）的诊断。然而，组织活检意外发现为角化型中分化SCC。在本病例中，我们对病变进行了手术切除，随后进行了美容缝合和辅助光动力疗法（PDT）。同时，该患者接受了全身抗结核治疗。治疗后6个月，未观察到肿瘤复发，与红斑狼疮相关的皮疹也已消退。患者对治疗结果感到满意。
