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LETTER TO EDITOR
  
Year : 1995  |  Volume : 61  |  Issue : 5  |  Page : 326-327

Occurrence of squamous cell carcinoma and multiple cutaneous horns in porokeratosis

Devakar P Yesudian, SGS Krishnan, M Jayaraman, Jan 
 

Correspondence Address:
Devakar P Yesudian





How to cite this article:
Yesudian DP, Krishnan S, Jayaraman M, Jan. Occurrence of squamous cell carcinoma and multiple cutaneous horns in porokeratosis.Indian J Dermatol Venereol Leprol 1995;61:326-327


How to cite this URL:
Yesudian DP, Krishnan S, Jayaraman M, Jan. Occurrence of squamous cell carcinoma and multiple cutaneous horns in porokeratosis. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2020 Jan 18 ];61:326-327
Available from: http://www.ijdvl.com/text.asp?1995/61/5/326/4261


Full Text

 To the Editor,



A 75-year-old male presented with multiple atrophic plaques over the upper limbs, trunk and lower limbs of 4 years duration. The lesion in the upper limbs extended from the forearm to the arm. The plaque in the lower limbs involved the knee, ankle and thigh regions. The plaques showed central atrophy with a raised peripheral keratotic edge. Using a hand lens, a furrow could clearly be made out in the edge. Multiple small atrophic lesions with a keratotic edge could also be seen in the trunk. A depressed plaque was also made out in the tongue. GHair, nail and teeth were normal. The plaque over the right forearm showed an ulcerated growth [Figure 1]. The plaque in the left lower limb showed in its upper border, a large hyperkeratotic horny projection about 4 cm in height and having a diameter of about 3 cm in the base [Figure 2]. A similar projection was seen in the lower end of the same plaque, routine investigations were normal. Biopsy of the plaque in the left forearm from the raised edge showed the typical features of porokeratosis. Another biopsy was done from the ulcerated area on the right forearm. This revealed a squamous cell carcinoma (SCC). a wide excision of the SCC was done. Follow up over a period of 1 years showed no recurrence. Biopsy of the cutaneous horns showed no evidence of any malignant degeneration.

This case, ah elderly male who has manifest porokeratosis for several decades presents a unique combination of both cutaneous horns and SCC over different plaques of porokeratosis. Malignant degeneration is more common in the giant, linear and plaque types of porokeratosis. Many mechanisms have been suggested for the malignant change in these lesions. One is the presence of an instability in the short arm of chromosome 3 as seen in cultured fibroblast studies.[1] Immunological factors may also contribute. Earli erreports have documented the occurrence of cutaneous horns in porokeratotic lesions.[2] The clinical significance of these lesions is that they can represent forerunners of malignant change. We report this case to emphasize the need for careful surveillance of all lesions of porokeratosis as they represent potential premalignant lesions.

References

1Scappaticci S, Lambiasi S, Orechia G. Clonal chromosome abnormalities with preferential involvement of chromosome 3 in patients with porokeratosis of Mibelli. Cancer Genet Cytogenet 1989;43:89-94.
2Riyaz N, Nair LV. Multiple cutaneous horns arising from porokeratosis. Ind J Dermatol Venereol Leprol 1994;60:150-2.

 

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