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Journal of the American Academy of Dermatology
Volume 61, n° 5
pages 892-897 (novembre 2009)
Doi : 10.1016/j.jaad.2009.01.037
Case Reports

Eruptive postoperative squamous cell carcinomas exhibiting a pathergy-like reaction around surgical wound sites
 

Suleman J. Bangash, DO a, W. Harris Green, MD b, David J. Dolson, MD c, Armand B. Cognetta, MD d,
a private practice, Elgin, Illinois 
b Division of Dermatology, The Brody College of Medicine at East Carolina University, Greenville, North Carolina 
c Ketchem, Wood, and Bergert Pathology Associates, Tallahassee, Florida 
d Dermatology Associates of Tallahassee, Tallahassee, Florida 

Reprint requests: Armand B. Cognetta, Jr, MD, Dermatology Associates of Tallahassee, 1707 Riggins Rd, Tallahassee, FL 32317.
Abstract
Background

The isomorphic response of Koebner and the pathergy skin reaction have not classically been associated with neoplastic processes such as cutaneous squamous cell carcinoma (SCC).

Objective

We report 5 patients who developed postoperative eruptive SCCs within and around the healed or healing sites of excised nonmelanoma skin cancers. The original cancers were all excised with histologically tumor-free margins and the subsequent eruptive SCCs were sometimes multiple.

Methods

We performed follow-up examinations of patient’s wounds after the treatment of skin cancer with Mohs micrographic surgery. Keratotic nodules that developed acutely in the margins of healing wound sites of these patients were examined histologically by a single dermatopathologist.

Results

The tumors presented as rapidly growing keratotic nodules within the sites of previously excised cancers. The mean time of clinical appearance was approximately 6 weeks and histologic examination of the nodules demonstrated well-differentiated SCC.

Limitations

This study is limited by its relatively small number of cases.

Conclusion

Acutely eruptive SCC is a rare but significant postoperative complication of skin cancer surgery. Furthermore, this case series suggests that some individuals appear to be predisposed to this recurrent, pathergy-like reaction involving SCC.

The full text of this article is available in PDF format.

Key words : Mohs micrographic surgery, pathergy, squamous cell carcinoma



 Funding sources: None.
 Conflicts of interest: None declared.
 Presented as a poster at the American College of Mohs Micrographic Surgery Annual Meeting in Naples, Florida, May 4-7, 2007.



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