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Verrucuous carcinoma may arise in the skin, the oral cavity and the genitalia. In this blog only cutaneous tumors are described. Oral & genital tumors will be discussed in separate blogs. Clinical features •Predilection for middle-aged males but either sex may be affected at any age including exceptionally in children •Sole of the foot, wrists, fingers…
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Lichenoid keratosis (lichen planus, lichen planus-like keratosis): the older literature sometimes uses the term “solitary lichen planus”, this is confusing as lichenoid keratosis is quite different from lichen planus. Clinical features •Fairly common, erythematous or brown, scaly macule or plaque with a predilection for the chest & upper extremities •Sometimes pruritic •Generally solitary •F>M •Caucasians++ •Wide…
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Clinical features •Essentially, a clinical diagnosis •Presents as an erythematous scaly or crusted plaque clinically mimicking psoriasis & presenting on the head, neck & extremities; often affecting sun-exposed surfaces •Anogenital Bowen’s disease is discussed in a seperate blog •Single or multiple lesions, often many cm in diameter •Middle-aged or elderly •No significant sex predilection •Pigmented variant •Immunosuppression related cases •5% develop invasive tumor with significant…
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Variants of keratoacanthoma •Solitary •Multiple •Giant (>3.0 cm diameter) •Agglomerate keratoacanthoma (aggregation of multiple lesions) •Keratoacanthoma centrifugum marginatum- large expansile lesion many cm in diameter •Subungual keratoacanthoma . Oral keratoacanthoma •Association with Muir-Torre syndrome •Arising in a nevus sebaceus •Fergusson-Smith syndrome; familial, autosomal dominant associated with a male predominance and development of innumerable lesions •Grzybowski syndrome characterized by development of very large numbers of…
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Clinical features •This variant shows a predilection for the head & neck of the elderly; less often on the limbs, genitalia & elsewhere •Sometimes arises in an acantholytic actinic keratosis •Presents as a frequently ulcerated nodule or plaque •Intraoral variant •Although previously thought to represent an aggressive variant of SCC with high recurrence and metastasis rate, this is has largely been disproven Histological…
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Clinical features •Rare variant •Sun-damaged skin of the head & neck •M>>F Histological features •Clear cell change results from cytoplasmic glycogen accumulation •Can be focal or involve most of the tumor •Exceptionally, this can present with a signet ring-like appearance Differential diagnosis If obvious squamous differentiation is not apparent, then metastatic clear cell carcinoma is an important differential diagnosis. Clear cell…
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Clinical features •Common, often multiple, dry, scaly erythematous or yellow brown lesions (up to 1.0 cm diameter) on sun-damaged skin of the middle-aged or elderly Caucasians •Face, neck, forearms & hands •M>F •Fair complexion with a tendency to sunburn •Associated keratin horn •Pigmented variant •Represent a strong indicator of risk of developing SCC (up to…
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Clinical features •Extremely rare cutaneous tumor •Variably considered a variant of squamous cell carcinoma or an entity sui generis representing the cutaneous equivalent of nasopharyngeal lymphoepithelioma-like carcinoma; lastly is the possibility of an adnexal carcinoma •Head & neck with predilection for sun-damaged skin; solitary flesh colored or erythematous, firm nodule or plaque •Exceptionally presents elsewhere e.g., trunk & arm •Elderly (39-96 years; mean 70 years) •M=F…
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Currently classified as a variant of mycosis fungoides overlapping with granulomatous mycosis fungoides. It has been postulated by some that the entity is a reflection of the site of involvement (axiallae & groins) rather than indicating a separate disease. Due to its rarity, further larger series are needed to substantiate this hypophysis. Clinical features •Exceedingly…
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Dystrophic epidermolysis bullosa (DEB) develops as a consequence of mutations in COL7A1. This results in defective or absent anchoring fibrils. As a consequence the skin is susceptible to shearing blisters with even minor trauma. Repeated blistering and ulceration complicated by severe scarring results. Squamous cell carcinoma (SCC) is most often encountered on the extremities. Current…
McKee Derm 