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SHORT COMMUNICATION
Year : 1990  |  Volume : 56  |  Issue : 1  |  Page : 64-65

Squamous cell carcinoma on a patch of mucosal vitiligo




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S Ravi


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How to cite this article:
Ravi S, Ramesh V, Misra R S. Squamous cell carcinoma on a patch of mucosal vitiligo. Indian J Dermatol Venereol Leprol 1990;56:64-5

How to cite this URL:
Ravi S, Ramesh V, Misra R S. Squamous cell carcinoma on a patch of mucosal vitiligo. Indian J Dermatol Venereol Leprol [serial online] 1990 [cited 2019 Aug 25];56:64-5. Available from: http://www.ijdvl.com/text.asp?1990/56/1/64/3488


Skin malignancies of non-melanocytec origin are surprisingly rare in patients having vitiligo, possibly because such people strictly avoid sun­light or some unknown factor affords protection.[1] We describe a patient who developed squamous cell carcinoma on a patch of mucosal vitiligo involving the glans penis and inner prepuce.

A 75-year-old un-circumcised widower had an asymptomatic verrucous growth on the inner prepuce of 1 year's duration. He had kept proper genital hygiene and was not a diabetic. His wife had expired 5 years ago and he firmly denied extra-marital sexual contact in the past. The lesion was a depigmented macule on the distal part of the glans penis extending along the ventral surface to encircle the inner prepuce. At places the inner prepuce retained the normal colour. Urethral orifice appeared normal and there was - no difficulty in micturition. This lesion had been present for 6 years and he had sought no treatment. At the 3 O'clock position on the inner prepuce, a little away from its attachment to the glans, a faint pink verrucous growth 1.5 cm in diameter, soft and well circum­scribed, resembling condyloma acuminatum was seen on the depigmented site. There was no regional lymph adenopathy. Other systems were normal. Routine blood and urinalysis and X-ray of the chest were normal. The growth was excised and a biopsy including the margin of the depigmented macule revealed marked hyperkeratosis, patchy parakeratosis, marked papillomatosis and the acanthotic rete ridges composed of varying groups of normal and atypical squamous cells extended to the deep dermis. The atypical cells showed great varia­tion in shape and size with abnormal mitotic figures. The nuclei were hyperplastic and hyper. chromatic. A fairly large number of horn pearls, most of them fully keratinised were seen. The basal cell layer was disrupted at places. A dense inflammatory infiltrate was present in the dermis. Mucosa adjacent to the warty lesion showed mild acanthosis and a dense dermal infiltrate. There were no dopa positive melano­cytes on staining for dopa oxidase and tyrosinase. Histopathology of the depigmented macule revealed a normal epidermis with the absence of melanocytes and a mild dermal infiltrate: the marginal zone showed highly dendritic melano­cytes. Collagen appeared normal.

Cutaneous tumours such as seborrheic keratoses, keratoacanthoma, basal cell carcinoma and squamous cell carcinoma have been reported in vitiligo macules repeatedly exposed to sun­light[2] and in patients with widespread vitiligo.[3] Sarcoma of the skin occurring in association with vitiligo has also been recorded.[4] In our patient, the squamous cell carcinoma was situated on a localised lesion of vitiligo involving the genital mucous membrane, an area never exposed to sunlight. The association may be fortuitous.

 
  References Top

1.Ortonne JP, Mosher DB and Fitzpatrick TB Vitiligo and Other Hypomelanoses of Hair and Skin, Plenum Medical, New York, 1983; p 218-219,  Back to cited text no. 1    
2.Lisi P : Vitiligo cancro cutaneo proposito di due casi clinici, G Minerva Dermatol, 1972; 113 : 427-429.  Back to cited text no. 2    
3.Lassos A, Apajalahati A, Blomqvist K et al Vitiligo and neoplasms, Acta Dermato-Venereol (Stockh), 1972; 52 : 229-232.  Back to cited text no. 3    
4.Wright PD : Vitiligo and sarcomatosis cutis (letter), Arch Dermatol, 1928; 17 :280.  Back to cited text no. 4    


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