Journal of Clinical and Aesthetic Dermatology

AUG 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

Issue link: http://jcadonline.epubxp.com/i/870497

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44 JCAD JouRnal oF CliniCal and aesthetiC deRMatology august 2017 • Volume 10 • number 8 C a s e r e P o r t Immunosuppressed host. a suppressed immune system is a risk factor for the development of nmsCs. immunosuppression may be congenital or acquired; the latter can be associated with infection (such as human immunodeficiency virus [HiV]) or iatrogenic (following organ transplant). a cardiac transplant patient developed sCC in situ of the finger and bowenoid papulosis of the perianal area. HPV type 16 was detected from both the tumor and the perianal lesion. the investigators hypothesized contact transmission of the viral-associated cancer of the finger. 15 Infection. Chronic bacterial or viral infection has also been observed to precede the development of ventral digit sCC. recurrent bacterial infections preceded the eventual diagnosis of sCC in a 60-year-old man following wood splinter injury to his left palmar thumb 16 and in a 33-year-old man who sustained a small wound to the ventral aspect of his right index finger while working with wet concrete without gloves. 17 our patient's sCC demonstrated viral changes and is therefore likely to be associated with a preceding HPV infection. FiguRe 4. mohs histology showing distant (a) and close (b) views of squamous cell carcinoma with associated viral changes: koilocytic features are noted within the keratinocytes (hematoxylin & eosin: a, ×4; b, ×10) a B FiguRe 3. mohs histology showing squamous cell carcinoma characterized by atypical keratinizing epithelium throughout the epidermis and invading into the dermis (hematoxylin & eosin, x4) t aBle 1. squamous cell carcinoma of the ventral hand digits: causes with associated risk factors Cause Risk FaCtoR Carcinogen exposure • arsenic 6,7 • Grease and oil 8 • soluble oil 9 Congenital c ondition • epidermolysis bullosa 10,11 • Huriez syndrome 12,13 • syndactyly 14 immunosuppressed host • Post transplant 15 infection • bacterial -osteomyelitis 16 -soft tissue 17 • Viral (human papillomavirus- related) (current report) 1 5,18,19 radiation exposure • radiopharmaceutical exposure 20 • radiotherapy exposure 21–23 • ultraviolet a and psoralen 7 trauma • amputation stump 24 • Hammer blow 25 • Friction-associated 14 • laceration 26 • Wood splinter injury 16 • Wound while working with wet concrete 17

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