Verrucous Carcinoma Arising Secondary to Diabetic Foot Lesions: A Systematic Review of the Literature

Kayla Neville,Aleksandar Z Obradovic

doi:10.25251/skin.5.3.3

Abstract

Verrucous carcinoma is classically considered a variant of squamous cell carcinoma, most commonly occurring in the oral cavity in association with snuff and chewed tobacco. However, the association between verrucous carcinoma of the foot and diabetes is less well known. This study presents a systematic review of all articles containing the search term “verrucous carcinoma” and “diabetic foot ulcer” in the abstract or title that have been published in PubMed before September 2020. The requirement for inclusion in our report were that the patient data had been documented in a case‐related manner and the patient diagnosed with verrucous carcinoma secondary to diabetic foot lesion. Seven descriptions of verrucous carcinoma presenting in patients with diabetic foot ulcers were presented across six case reports, and clinical case descriptions are collected here along with treatment outcomes, where available, and discussion of common mimics of verrucous carcinoma of the foot. Due to treatability and potential for extensive invasion of local structures requiring resection with wide margins, verrucous carcinoma should be carefully considered in the differential diagnosis of a warty foot lesion in the setting of the diabetic foot.

Highlights

Diabetic foot ulcers are a common complication of chronic uncontrolled diabetes, and the lifetime incidence of foot ulcers is estimated to affect 19% to 34% of people with diabetes.[1]
This article presents a comprehensive review of the literature to date describing malignant transformation of diabetic foot ulcers into verrucous carcinoma, and provides important insights into the presentation and treatment of this rare diabetic complication
Descriptions of verrucous carcinoma in the literature have been sparse and potentially misleading in the context of diabetes, describing a classic clinical presentation of painful ulcers most often localized in the throat.[6,7,8]

Summary

INTRODUCTION

Diabetic foot ulcers are a common complication of chronic uncontrolled diabetes, and the lifetime incidence of foot ulcers is estimated to affect 19% to 34% of people with diabetes.[1]. We have conducted a systematic review of literature describing verrucous carcinoma developing secondary to a diabetic foot ulcer. This is an important item on differential diagnosis of dermatologic deformity secondary to diabetic foot ulceration, as the warty appearance of these carcinomas may mimic more common foot pathology. This article represents the most comprehensive review to date of published cases describing verrucous carcinoma arising secondary to diabetic foot ulcers, and provides important insights into the presentation and management of this rare complication of diabetes. That the patient data had been documented in a case‐related manner and the patient diagnosed with verrucous carcinoma secondary to diabetic foot lesion. A quantitative meta‐analysis of outcomes to treatment was not possible based on the limited number of total reported cases in the literature and variations in longitudinal follow-up

RESULTS

DISCUSSION

Findings

Ackerman LV