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Year : 2020  |  Volume : 11  |  Issue : 3  |  Page : 473-474  

Cutaneous squamous cell carcinoma in background of chronic arsenicosis


1 Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL, United States
2 Department of Dermatology and Venereology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India

Date of Submission01-Aug-2019
Date of Decision23-Oct-2019
Date of Acceptance19-Nov-2019
Date of Web Publication10-May-2020

Correspondence Address:
Soniya Mahajan
Department of Dermatology and Venereology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 049
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/idoj.IDOJ_366_19

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How to cite this article:
Subhadarshani S, Mahajan S. Cutaneous squamous cell carcinoma in background of chronic arsenicosis. Indian Dermatol Online J 2020;11:473-4

How to cite this URL:
Subhadarshani S, Mahajan S. Cutaneous squamous cell carcinoma in background of chronic arsenicosis. Indian Dermatol Online J [serial online] 2020 [cited 2020 May 27];11:473-4. Available from: http://www.idoj.in/text.asp?2020/11/3/473/284117



A 44-year-old woman from Varanasi presented with numerous rough, skin-colored hard papules and plaques on bilateral palms and soles present for 25 years. She also noticed a rapidly growing ulcer on the left palm extending onto the distal aspect of the wrist for the past 3 months [Figure 1]a and [Figure 1]b. Biopsy of the small keratotic lesion on palm revealed severe hyperkeratosis, acanthosis, and reticulated prolonged rete pegs suggestive of arsenical keratosis [Figure 2]a while that of the ulcer revealed a large cell non-keratinizing carcinoma deeply infiltrating the fat and striated muscles [Figure 2]b, which was confirmed on magnetic resonance imaging [Figure 2]c and d]. On clinicopathological correlation, a diagnosis of arsenical keratosis with invasive squamous cell carcinoma was made.[1]
Figure 1: (a) Skin colored papules on bilateral palms with a large necrotic ulcer on the left palm (b) Similar rough papules on bilateral soles

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Figure 2: (a) Skin biopsy of keratotic papule (H and E 10×) shows hyperkeratosis, acanthosis, and reticulated prolonged rete pegs suggestive of arsenical keratosis (b) Biopsy of ulcer edge (H and E 10×) shows collections of atypical squamous cells with pleomorphism, necrosis and large nuclei compatible with squamous cell carcinoma (c) Higher magnification (H and E 100×) demonstrating atypical squamous cells. (d) MRI reveals a mass lesion infiltrating skin, subcutaneous tissue and adjacent medial part of the thenar muscle without any evidence of neurovascular invasion

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   References Top

1.
Paul PC, Chattopadhyay A, Dutta SK, Mazumder DN, Santra A. Histopathology of skin lesions in chronic arsenic toxicity-grading of changes and study of proliferative markers. Indian J Pathol Microbiol 2000;43:257-64.  Back to cited text no. 1
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