Digital Pigmented Squamous Cell Carcinoma In-situ: A Case Report

Main Article Content

Jordan Lamb
Colleen Beatty
Nancy House
Alaina James

Keywords

pigmented squamous cell carcinoma in-situ, Bowen's disease, corticosteroid, immunosuppressed, skin cancer, skin of color

Abstract

Pigmented squamous cell carcinoma in-situ (SCCIS) is a rare variant of cutaneous SCC that can clinically mimic malignant melanoma. This variant is more commonly seen in patients with brown and black skin and often presents in sun-protected areas. We report a case of a 38-year-old man with a dark brown, expanding lesion on the lateral aspect of the left middle finger and history of immunosuppression secondary to chronic corticosteroid treatment for systemic sarcoidosis. Histologic examination of the lesion was consistent with a diagnosis of pigmented SCCIS. This report highlights a unique association between iatrogenic immunosuppression for inflammatory disease and development of pigmented SCCIS. Additionally, the case emphasizes the importance of surveillance for pigmented SCC in patients with skin of color, particularly those who may be at higher risk due to immunosuppression.

References

1. Ragi G, Turner MS, Klein LE, Stoll HL, Jr. Pigmented Bowen's disease and review of 420 Bowen's disease lesions. J Dermatol Surg Oncol. Jul 1988;14(7):765-9. doi:10.1111/j.1524-4725.1988.tb01161.x

2. Cameron A, Rosendahl C, Tschandl P, Riedl E, Kittler H. Dermatoscopy of pigmented Bowen's disease. J Am Acad Dermatol. Apr 2010;62(4):597-604. doi:10.1016/j.jaad.2009.06.008

3. Stewart TJ, Farrell J, Crainic O, Rosen RH. A large series of pigmented Bowen's disease. Int J Dermatol. Sep 2020;59(9):e316-e317. doi:10.1111/ijd.14977

4. Hogue L, Harvey VM. Basal Cell Carcinoma, Squamous Cell Carcinoma, and Cutaneous Melanoma in Skin of Color Patients. Dermatol Clin. Oct 2019;37(4):519-526. doi:10.1016/j.det.2019.05.009

5. Rocha-Méndez LE, Salazar-Torres F, Martínez-Jaramillo B, Tarango-Martínez V, Solís-Ledesma G. An interdigital case of pediatric pigmented Bowen's disease associated with human papillomavirus antibodies: A location not previously reported in this age group. JAAD Case Rep. Jul 2020;6(7):666-668. doi:10.1016/j.jdcr.2020.05.016

6. Que SKT, Zwald FO, Schmults CD. Cutaneous squamous cell carcinoma: Incidence, risk factors, diagnosis, and staging. J Am Acad Dermatol. Feb 2018;78(2):237-247. doi:10.1016/j.jaad.2017.08.059

7. Pirie K, Beral V, Heath AK, et al. Heterogeneous relationships of squamous and basal cell carcinomas of the skin with smoking: the UK Million Women Study and meta-analysis of prospective studies. Br J Cancer. Jul 2018;119(1):114-120. doi:10.1038/s41416-018-0105-y

8. Herman S, Rogers HD, Ratner D. Immunosuppression and squamous cell carcinoma: a focus on solid organ transplant recipients. Skinmed. Sep-Oct 2007;6(5):234-8. doi:10.1111/j.1540-9740.2007.06174.x

9. Collins L, Quinn A, Stasko T. Skin Cancer and Immunosuppression. Dermatol Clin. Jan 2019;37(1):83-94. doi:10.1016/j.det.2018.07.009

10. Fernández-Sánchez M, Charli-Joseph Y, Domínguez-Cherit J, Guzman-Herrera S, Reyes-Terán G. Acral and Multicentric Pigmented Bowen's Disease in HIV-Positive Patients: Report on Two Unusual Cases. Indian J Dermatol. Nov-Dec 2018;63(6):506-508. doi:10.4103/ijd.IJD_47_17

11. Shimizu A, Kuriyama Y, Hasegawa M, Tamura A, Ishikawa O. Nail squamous cell carcinoma: A hidden high-risk human papillomavirus reservoir for sexually transmitted infections. J Am Acad Dermatol. Dec 2019;81(6):1358-1370. doi:10.1016/j.jaad.2019.03.070

12. Serret CA, Wang S, Marsch A, Hernandez C. Pigmented squamous cell carcinoma presenting as longitudinal melanonychia in a transplant recipient. Cutis. May 2018;101(5):375-377.