Infiltrative squamous cell carcinoma in hidradenitis suppurativa: A case report for early surgical intervention

•Hidradenitis suppurativa is a morbid disease and can resist medical management.•Squamous cell carcinoma may develop within a chronic hidradenitis suppurativa lesion.•Early surgical intervention with skin grafting offers relief from disease morbidly.•Early skin grafting eliminates risk of untreatabl...

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Published inInternational journal of surgery case reports Vol. 55; pp. 50 - 53
Main Authors Juviler, Peter G., Patel, Ankit P., Qi, Yanjie
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.01.2019
Elsevier
Subjects
Fatal outcome
Hidradenitis suppurativa
Malignant transformation
Skin neoplasm
Squamous cell carcinoma
Surgical management
Skin neoplasm
Surgical management
Squamous cell carcinoma
Hidradenitis suppurativa
Malignant transformation
Fatal outcome
Online AccessGet full text
ISSN2210-2612
2210-2612
DOI10.1016/j.ijscr.2019.01.006

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Abstract •Hidradenitis suppurativa is a morbid disease and can resist medical management.•Squamous cell carcinoma may develop within a chronic hidradenitis suppurativa lesion.•Early surgical intervention with skin grafting offers relief from disease morbidly.•Early skin grafting eliminates risk of untreatable cancer discovery. Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that has potential for malignant transformation into squamous cell carcinoma (SCC). The pathogenesis of HS is poorly understood but thought to be from follicular keratinization, occlusion, and rupture of the pilosebaceous unit, followed by an infiltration of inflammatory cells into the dermis. Treatment is challenging due to a lack of effective medical therapies. In this case report, we describe a patient with chronic HS that developed into SCC who underwent late surgical intervention after failing medical management. At the time malignant transformation was discovered, the SCC was beyond resectability and ultimately fatal. Based on the morbidity and mortality of chronic HS illustrated in our case and presented in the literature, we advocate for early surgical intervention. Wide surgical excision offers a near definitive intervention and should at least be considered for all chronic HS patients due to high morbidity and malignant transformation risk.
AbstractList Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that has potential for malignant transformation into squamous cell carcinoma (SCC). The pathogenesis of HS is poorly understood but thought to be from follicular keratinization, occlusion, and rupture of the pilosebaceous unit, followed by an infiltration of inflammatory cells into the dermis. Treatment is challenging due to a lack of effective medical therapies.INTRODUCTIONHidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that has potential for malignant transformation into squamous cell carcinoma (SCC). The pathogenesis of HS is poorly understood but thought to be from follicular keratinization, occlusion, and rupture of the pilosebaceous unit, followed by an infiltration of inflammatory cells into the dermis. Treatment is challenging due to a lack of effective medical therapies.In this case report, we describe a patient with chronic HS that developed into SCC who underwent late surgical intervention after failing medical management. At the time malignant transformation was discovered, the SCC was beyond resectability and ultimately fatal.PRESENTATION OF CASEIn this case report, we describe a patient with chronic HS that developed into SCC who underwent late surgical intervention after failing medical management. At the time malignant transformation was discovered, the SCC was beyond resectability and ultimately fatal.Based on the morbidity and mortality of chronic HS illustrated in our case and presented in the literature, we advocate for early surgical intervention.DISCUSSIONBased on the morbidity and mortality of chronic HS illustrated in our case and presented in the literature, we advocate for early surgical intervention.Wide surgical excision offers a near definitive intervention and should at least be considered for all chronic HS patients due to high morbidity and malignant transformation risk.CONCLUSIONWide surgical excision offers a near definitive intervention and should at least be considered for all chronic HS patients due to high morbidity and malignant transformation risk.
•Hidradenitis suppurativa is a morbid disease and can resist medical management.•Squamous cell carcinoma may develop within a chronic hidradenitis suppurativa lesion.•Early surgical intervention with skin grafting offers relief from disease morbidly.•Early skin grafting eliminates risk of untreatable cancer discovery. Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that has potential for malignant transformation into squamous cell carcinoma (SCC). The pathogenesis of HS is poorly understood but thought to be from follicular keratinization, occlusion, and rupture of the pilosebaceous unit, followed by an infiltration of inflammatory cells into the dermis. Treatment is challenging due to a lack of effective medical therapies. In this case report, we describe a patient with chronic HS that developed into SCC who underwent late surgical intervention after failing medical management. At the time malignant transformation was discovered, the SCC was beyond resectability and ultimately fatal. Based on the morbidity and mortality of chronic HS illustrated in our case and presented in the literature, we advocate for early surgical intervention. Wide surgical excision offers a near definitive intervention and should at least be considered for all chronic HS patients due to high morbidity and malignant transformation risk.
• Hidradenitis suppurativa is a morbid disease and can resist medical management. • Squamous cell carcinoma may develop within a chronic hidradenitis suppurativa lesion. • Early surgical intervention with skin grafting offers relief from disease morbidly. • Early skin grafting eliminates risk of untreatable cancer discovery.
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that has potential for malignant transformation into squamous cell carcinoma (SCC). The pathogenesis of HS is poorly understood but thought to be from follicular keratinization, occlusion, and rupture of the pilosebaceous unit, followed by an infiltration of inflammatory cells into the dermis. Treatment is challenging due to a lack of effective medical therapies. In this case report, we describe a patient with chronic HS that developed into SCC who underwent late surgical intervention after failing medical management. At the time malignant transformation was discovered, the SCC was beyond resectability and ultimately fatal. Based on the morbidity and mortality of chronic HS illustrated in our case and presented in the literature, we advocate for early surgical intervention. Wide surgical excision offers a near definitive intervention and should at least be considered for all chronic HS patients due to high morbidity and malignant transformation risk.
Author Juviler, Peter G.
Patel, Ankit P.
Qi, Yanjie
AuthorAffiliation b Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642-0001, USA
a University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642-0001, USA
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  givenname: Ankit P.
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  givenname: Yanjie
  surname: Qi
  fullname: Qi, Yanjie
  organization: Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14642-0001, USA
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Keywords Skin neoplasm
Surgical management
Squamous cell carcinoma
Hidradenitis suppurativa
Malignant transformation
Fatal outcome
Language English
License This is an open access article under the CC BY-NC-ND license.
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Snippet •Hidradenitis suppurativa is a morbid disease and can resist medical management.•Squamous cell carcinoma may develop within a chronic hidradenitis suppurativa...
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the skin that has potential for malignant transformation into squamous cell carcinoma (SCC)....
• Hidradenitis suppurativa is a morbid disease and can resist medical management. • Squamous cell carcinoma may develop within a chronic hidradenitis...
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SubjectTerms Fatal outcome
Hidradenitis suppurativa
Malignant transformation
Skin neoplasm
Squamous cell carcinoma
Surgical management
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Title Infiltrative squamous cell carcinoma in hidradenitis suppurativa: A case report for early surgical intervention
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https://dx.doi.org/10.1016/j.ijscr.2019.01.006
https://www.ncbi.nlm.nih.gov/pubmed/30685629
https://www.proquest.com/docview/2179464908
https://pubmed.ncbi.nlm.nih.gov/PMC6351348
Volume 55
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