Skin tumors in xeroderma pigmentosum: Evaluation of a large series and a literature review

Abstract

Xeroderma pigmentosum (XP) is a rare genodermatosis with a lifelong propensity to develop malignant skin tumors. In this retrospective study, 24 XP patients were evaluated with regard to frequency and clinicopathological features of benign and malignant skin tumors. Seventeen patients had at least one malignant skin tumor diagnosed: basal cell carcinoma (BCC) in 13 patients (n=72), basosquamous carcinoma in three patients (n=4), squamous cell carcinoma in six patients (n=13), keratoacanthoma in three patients (n=15), and melanoma in six patients (n=18). Most melanomas (n=15) were in situ lesions. Several benign skin tumors were noted such as tricholemmoma (n=1), trichoepithelioma (n=1), trichoblastoma (n=1), follicular infundibulum tumor (n=1), keratoacanthoma-like follicular lesion (n=1), adnexal tumors with folliculosebaceous (n=1) and tricholemmal differentiation (n=1), and neurofibroma (n=1). Benign vascular proliferations including pyogenic granulomas (n=8), widespread telangiectasias, and senile angioma-like lesions were also observed in 3, 5, and 5 patients, respectively. Similar to many reports, BCC was found to be the most common malignant skin tumor. The high prevalence of benign adnexal tumors of follicular differentiation, some of them showing mixed histopathological features and various vascular proliferations in our series raises the question of whether they indicate a formerly undescribed association with XP.