A Case of Squamous Cell Carcinoma Arising in Disseminated Superficial Porokeratosis

Abstract

Porokeratosis (PK), characterized by keratotic lesions with an atrophic center and a prominent peripheral ridge, with a typical histological hallmark, namely, the cornoid lamella, has two forms: disseminated and localized. While PK often converts into squamous cell carcinoma (SCC), conversion from disseminated superficial porokeratosis (DSP) alone is rarely reported except for one case in which DSP and LP coexisted and converted to SCC. Here, we report the case of a patient with SCC converted from DSP alone, presenting with coin-sized macules on the bottom right of his waist that developed into an ulcer at the center. The patient underwent radiation therapy, which effectively treated the SCC but did not resolve the PK. This article highlights regular follow-up and undergo comprehensive diagnosis, both of which are beneficial to enable early detection and management of DSP that has converted to into SCC; in addition, standardized medical treatment may help improve the treatment therapeutic effect of in similar diseases.

Keywords: disseminated superficial porokeratosis; porokeratosis; squamous cell carcinoma.

Figure 1

Clinical manifestations of the patient. There is a coin-sized macules at the bottom right of his waist, which developed into an ulcer at the center. The bottom of the ulcer was uneven and infiltrative, with a few shallow erosions in the surrounding rash. The ulcer was hard on touch.

Figure 2

Histopathological findings in the vertical section. The brown macules exhibited hyperkeratosis with columnar parakeratosis. Dyskeratotic cells are observed in the epidermis beneath the parakeratosis column. Additionally, mild hyperplasia and hypertrophy of the spinous layer and slight lymphocytes infiltration in the superficial dermis were observed. (HE×200). Columnar parakeratosis: .

Figure 3

Plaque biopsy results. The epidermis proliferates irregularly, mainly as squamous cells, with some cell clumps growing infiltratively in the dermis. Infiltration of inflammatory cells into superficial and middle dermal layers (HE×200). Squamous cells: . Inflammatory cell infiltration: .

Figure 4

Atypia of tumor cells with pathological karyokinesis is evident. (HE x 400). Pathological karyokinesis: .