Abstract
A 90 years female diagnosed as a case of Discoid lupus erythematosus (DLE) developed Squamous cell carcinoma from the lesions over a period of 5 years due to treatment gap and late follow up. Diagnosis was based on clinical aspects (erythematous, nodular and scanty bleeding), dermoscopic features and histopathological examination, the absence of systemic involvement and routine laboratory parameters, which registered all within normal range.SCC in a patient with DLE is rare in Nepalese patients. It is every essential to counsel the diagnosed cases of DLE and warn all patients about all the possible outcomes and compliance with medications should be ensured.Nepal Journal of Dermatology, Venereology & Leprology, Vol.14(1) 2016, pp.51-55
Highlights
Discoid lupus erythematosus (DLE) is a benign, autoimmune disorder of the skin, clinically characterized by red scaly patches which heal with atrophy, scarring and pigmentary changes, and histopathologically by stratum corneum hyperkeratosis and follicular plugging, thinning and fla ening of stratum malpigii, hydropic degenera on of the basal layer referred to as liquiefac on degenera on, which is characterised by vacuolar spaces beneath and between basilar kera nocytes which shows individual cell necrosis and acquire elongated contours like their superficial counterparts rather than their normal columnar appearance
Squamous cell carcinoma usually arises in skin damaged by ac nic rays
Due to muta on in p53 tumor suppressor gene, there will be defect in apoptosis of kera nocytes that have sustained UV-radia on-induced DNA damage which ul mately lead to squamous cell carcinoma (SCC).[6]
Summary
Discoid lupus erythematosus (DLE) is a benign, autoimmune disorder of the skin, clinically characterized by red scaly patches which heal with atrophy, scarring and pigmentary changes, and histopathologically by stratum corneum hyperkeratosis and follicular plugging, thinning and fla ening of stratum malpigii, hydropic degenera on of the basal layer referred to as liquiefac on degenera on, which is characterised by vacuolar spaces beneath and between basilar kera nocytes which shows individual cell necrosis (apoptosis) and acquire elongated contours like their superficial counterparts rather than their normal columnar appearance (squama sa on). This is a case of squamous cell carcinoma (SCC) developing over lesions of disseminated DLE. DLE of the lips, scalp, ears or nose may eventually progress to squamous cell carcinoma (SCC).
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