Vol 10, No 1 (2024)
Review paper
Published online: 2024-03-06

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Discoid lupus erythematosus and cutaneous squamous cell carcinoma

Michał Dec1, Hubert Arasiewicz1
Forum Dermatologicum 2024;10(1):18-23.

Abstract

Discoid lupus erythematosus (DLE) is a chronic autoimmune skin disorder characterized by inflammatory skin lesions. Patients with DLE often exhibit photosensitivity, scarring, and a higher susceptibility to skin cancers. This systematic review aims to comprehensively evaluate the existing literature to better understand the relationship between DLE and cutaneous squamous cell carcinoma (cSCC). A systematic search of major medical databases was conducted to identify relevant studies published between 1978 and 2023. Studies were included if they explored the association between DLE and cSCC and reported epidemiological data, clinical features and outcomes. Evidence shows a correlation between DLE and squamous cell carcinoma. The study aimed to find literature about DLE and squamous cell carcinoma (SCC) and analyse potential risk factors. Healthcare providers should be aware of the increased cancer risk in DLE patients, emphasizing the importance of regular skin examinations and sun protection.

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References

  1. Motswaledi MH, Khammissa RAG, Wood NH, et al. Discoid lupus erythematosus as it relates to cutaneous squamous cell carcinoma and to photosensitivity. SADJ. 2011; 66(7): 340–343.
  2. Fernandes MS, Girisha BS, Viswanathan N, et al. Discoid lupus erythematosus with squamous cell carcinoma: a case report and review of the literature in Indian patients. Lupus. 2015; 24(14): 1562–1566.
  3. Yendo TM, Gabbi TV, Nico MM. Squamous cell carcinoma arising in discoid lupus erythematosus of the nail unit. Skin Appendage Disord. 2023; 9(3): 221–223.
  4. Melikoglu MA, Melikoglu M, Demirci E, et al. Discoid lupus erythematosus-associated cutaneous squamous cell carcinoma in systemic lupus erythematosus. Eurasian J Med. 2022; 54(2): 204–205.
  5. Harper JG, Pilcher MF, Szlam S, et al. Squamous cell carcinoma in an African American with discoid lupus erythematosus: a case report and review of the literature. South Med J. 2010; 103(3): 256–259.
  6. McEnery-Stonelake ME, Polly S, Phillips CB, et al. Eruptive hypertrophic discoid lupus erythematosus mimicking squamous cell carcinoma: a clinical and histopathological diagnostic challenge. J Clin Rheumatol. 2021; 27(8S): S368–S370.
  7. Makita E, Akasaka E, Sakuraba Y, et al. Squamous cell carcinoma on the lip arising from discoid lupus erythematosus: a case report and review of Japanese patients. Eur J Dermatol. 2016; 26(4): 395–396.
  8. Saxena S, Arora P, Misra S, et al. Squamous cell carcinoma arising in lesions of discoid lupus erythematosus in a patient with overlap syndrome: a chronic rare complication. Indian Dermatol Online J. 2022; 14(2): 287–289.
  9. Tao J, Zhang X, Guo N, et al. Squamous cell carcinoma complicating discoid lupus erythematosus in Chinese patients: review of the literature, 1964-2010. J Am Acad Dermatol. 2012; 66(4): 695–696.
  10. Molomo EM, Bouckaert M, Khammissa RAG, et al. Discoid lupus erythematosus-related squamous cell carcinoma of the lip in an HIV-seropositive black male. J Cancer Res Ther. 2015; 11(4): 1036.
  11. Bhat MR, Hulmani M, Dandakeri S, et al. Disseminated discoid lupus erythematosus leading to squamous cell carcinoma. Indian J Dermatol. 2012; 57(2): 158–161.
  12. Pradhan P, Samal S, Sable M. Basal cell carcinoma arising over lesion of discoid lupus erythematosus: a rare occurrence. Lupus. 2020; 29(2): 210–212.
  13. El Eu, Zakraoui H, Ben Ja, et al. Lupus discoïde et carcinome épidermoide. A propos de deux cas. Tunis Med. 2004; 82(10): 980–983.
  14. Paschos A, Lehmann P, C Hofmann S. Cutaneous squamous cell carcinoma as a complication of discoid lupus erythematosus. J Dtsch Dermatol Ges. 2019; 17(10): 1054–1056.
  15. Kim DY, Rha EY, Yoo G, et al. Squamous cell carcinoma on the upper lip of a patient with discoid lupus erythematosus. Arch Plast Surg. 2013; 40(2): 155–157.
  16. Grover S, Murthy PS, Rajagopal R, et al. Discoid lupus erythematosus leading to squamous cell carcinoma. Med J Armed Forces India. 2007; 63(2): 184–185.
  17. Sulica VI, Kao GF. Squamous-cell carcinoma of the scalp arising in lesions of discoid lupus erythematosus. Am J Dermatopathol. 1988; 10(2): 137–141.
  18. Shapera EA, Kim PD. Squamous cell cancer arising in an African American male cheek from discoid lupus: a rare case and review of the literature. Case Rep Surg. 2016: 9170424.
  19. Flower C, Gaskin D, Bhamjee S, et al. High-risk variants of cutaneous squamous cell carcinoma in patients with discoid lupus erythematosus: a case series. Lupus. 2013; 22(7): 736–739.
  20. Gamble M, Tocci E, Venna S, et al. Poorly differentiated squamous cell carcinoma arising within a lesion of discoid lupus erythematosus in an African-American woman. JAAD Case Rep. 2015; 1(3): 138–140.
  21. Alsanafi S, Werth VP. Squamous cell carcinomas arising in discoid lupus erythematosus scars: unusual occurrence in an African-American and in a sun-protected area. J Clin Rheumatol. 2011; 17(1): 35–36.
  22. Arvanitidou IE, Nikitakis NG, Georgaki M, et al. Multiple primary squamous cell carcinomas of the lower lip and tongue arising in discoid lupus erythematosus: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 125(2): e22–e30.
  23. Parikh N, Choi J, Li M, et al. Squamous cell carcinoma arising in a recent plaque of discoid lupus erythematous, in a sun-protected area. Lupus. 2010; 19(2): 210–212.
  24. Keith WD, Kelly AP, Sumrall AJ, et al. Squamous cell carcinoma arising in lesions of discoid lupus erythematosus in black persons. Arch Dermatol. 1980; 116(3): 315–317.
  25. Simpson JK, Medina-Flores R, Deng JS. Squamous cell carcinoma arising in discoid lupus erythematosus lesions of the ears infected with human papillomavirus. Cutis. 2010; 86(4): 195–198.
  26. Ashinoff R, Werth VP, Franks AG. Resistant discoid lupus erythematosus of palms and soles: successful treatment with azathioprine. J Am Acad Dermatol. 1988; 19(5 Pt 2): 961–965.
  27. Ermertcan AT, Gençoglan G, Eskiizmir G, et al. Microinvasive squamous cell carcinoma arising in discoid lupus erythematosus lesions successfully treated with imiquimod 5% cream. Indian J Dermatol Venereol Leprol. 2013; 79(1): 115–117.
  28. Caruso WR, Stewart ML, Nanda VK, et al. Squamous cell carcinoma of the skin in black patients with discoid lupus erythematosus. J Rheumatol. 1987; 14(1): 156–159.
  29. Presser SE, Taylor JR. Squamous cell carcinoma in blacks with discoid lupus erythematosus. J Am Acad Dermatol. 1981; 4(6): 667–669.
  30. Farah FS, Matta MT, Zeinoun S, et al. Squamous cell carcinoma and keratoacanthoma in discoid lupus erythematosus. Dermatologica. 1974; 148(6): 357–361.
  31. Ee HL, Ng PPL, Tan SH, et al. Squamous cell carcinoma developing in two Chinese patients with chronic discoid lupus erythematosus: the need for continued surveillance. Clin Exp Dermatol. 2006; 31(4): 542–544.
  32. Bhari N, Khaitan BK, Gupta P, et al. Neglect leads to extremes: maggots and malignancy in a case of discoid lupus erythematosus. Lupus. 2016; 25(1): 97–101.
  33. Dhingra M, Bhalla M, Thami GP, et al. Metastasizing squamous cell carcinoma arising from chronic discoid lupus erythematosus plaque of recent onset. Indian J Dermatol Venereol Leprol. 2011; 77(5): 626.
  34. Millard LG, Barker DJ. Development of squamous cell carcinoma in chronic discoid lupus erythematosus. Clin Exp Dermatol. 1978; 3(2): 161–166.
  35. Miyagawa S, Minowa R, Yamashina Y, et al. Development of squamous cell carcinoma in chronic discoid lupus erythematosus: a report of two patients with anti-Ro/SSA antibodies. Lupus. 1996; 5(6): 630–632.
  36. Cyriac MJ, Gopinath T. Squamous cell carcinoma in discoid lupus erythematosus. Indian J Dermatol Venereol Leprol. 1982; 48(4): 218–220.
  37. Dabski K, Stoll HL, Milgrom H. Squamous cell carcinoma complicating late chronic discoid lupus erythematosus. J Surg Oncol. 1986; 32(4): 233–237.
  38. Sherman RN, Lee CW, Flynn KJ. Cutaneous squamous cell carcinoma in black patients with chronic discoid lupus erythematosus. Int J Dermatol. 1993; 32(9): 677–679.
  39. Martin S, Rosen T, Locker E. Metastatic squamous cell carcinoma of the lip. Occurrence in blacks with discoid lupus erythematosus. Arch Dermatol. 1979; 115(10): 1214.
  40. Sehgal VN, Reddy BS, Koranne RV, et al. Squamous cell carcinoma complicating chronic discoid lupus erythematosus (CDLE). J Dermatol. 1983; 10(1): 81–84.
  41. Matsushita S, Ishihara T, Kageshita T, et al. Multiple squamous cell carcinomas arising in lesions of discoid lupus erythematosus. J Dermatol. 2004; 31(1): 73–75.
  42. Onayemi O, Soyinka F. Squamous cell carcinoma of the scalp following a chemical burn and chronic discoid lupus erythematosus. Br J Dermatol. 1996; 135(2): 342–343.
  43. Ma D, Dai G, Guo C. [Carcinoma of the lips developing in discoid lupus erythematosus]. Zhonghua Kou Qiang Yi Xue Za Zhi. 1999; 34(1): 13–15.
  44. Garrett AB. Multiple squamous cell carcinomas in lesions of discoid lupus erythematosus. Cutis. 1985; 36(4): 313–314, 316.
  45. Baroni A, Brunetti G, Ruocco E. Coexistence of malignancy (skin cancer) and immune disorder (discoid lupus erythematosus) on a burn scar: a concrete example of 'immunocompromised district'. Br J Dermatol. 2011; 164(3): 673–675.
  46. Goh CL, Ang LC, Ho J. Squamous cell carcinoma complicating discoid lupus erythematosus. Int J Dermatol. 1987; 26(2): 110–111.
  47. Mladick RA, Pickrell KL, Thorne FL, et al. Squamous cell cancer in discoid lupus erythematosus. Case report. Plast Reconstr Surg. 1968; 42(5): 497–499.
  48. Samar SK, Panwar KC, Malpani NK, et al. DLE changing into squamous cell carcinoma in an Indian farmer. Indian J Dermatol. 1985; 30(2): 41–43.
  49. Walling HW, Sontheimer RD. Cutaneous lupus erythematosus: issues in diagnosis and treatment. Am J Clin Dermatol. 2009; 10(6): 365–381.
  50. Burge SM, Frith PA, Juniper RP, et al. Mucosal involvement in systemic and chronic cutaneous lupus erythematosus. Br J Dermatol. 1989; 121(6): 727–741.
  51. Zaalberg A, Moradi Tuchayi S, Ameri AH, et al. Chronic inflammation promotes skin carcinogenesis in cancer-prone discoid lupus erythematosus. J Invest Dermatol. 2019; 139(1): 62–70.
  52. Cassarino DS, Derienzo DP, Barr RJ. Cutaneous squamous cell carcinoma: a comprehensive clinicopathologic classification--part two. J Cutan Pathol. 2006; 33(4): 261–279.
  53. Waldman A, Schmults C. Cutaneous squamous cell carcinoma. Hematol Oncol Clin North Am. 2019; 33(1): 1–12.
  54. Kostaki D, Antonini A, Peris K, et al. Skin cancer risk in autoimmune connective tissue diseases. G Ital Dermatol Venereol. 2014; 149(5): 567–572.
  55. Trent JT, Kirsner RS. Wounds and malignancy. Adv Skin Wound Care. 2003; 16(1): 31–34.
  56. Hussein MR. Ultraviolet radiation and skin cancer: molecular mechanisms. J Cutan Pathol. 2005; 32(3): 191–205.
  57. Paschos A, Lehmann P, C Hofmann S. Cutaneous squamous cell carcinoma as a complication of discoid lupus erythematosus. J Dtsch Dermatol Ges. 2019; 17(10): 1054–1056.
  58. Cohen L, Shah V, Chen PL, et al. Cutaneous squamous cell carcinoma causing a rhinophymatous mass in a patient with clinically occult hypertrophic lupus erythematosus. Lupus. 2020; 29(6): 644–648.
  59. Ju T, Ingrasci G, Diaz-Perez JA, et al. Development of squamous cell carcinoma in the setting of chronic discoid lupus erythematosus may be associated with plasmacytoid dendritic cell inflammation. J Cutan Pathol. 2023; 50(1): 19–23.
  60. Gao X, Ma L, Zhou Z, et al. Podoplanin expression is correlated with the progression of chronic discoid lupus erythematosus to lip squamous cell carcinoma. Int J Surg Pathol. 2016; 24(7): 595–599.
  61. Kuhn A, Aberer E, Bata-Csörgő Z, et al. S2k guideline for treatment of cutaneous lupus erythematosus - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol. 2017; 31(3): 389–404.
  62. Chasset F, Arnaud L, Jachiet M, et al. Changing antimalarial agents after inefficacy or intolerance in patients with cutaneous lupus erythematosus: A multicenter observational study. J Am Acad Dermatol. 2018; 78(1): 107–114.e1.
  63. Grossman D, Leffell DJ. Squamous Cell Carcinoma. In: Freeberg IM, Eisen AZ, Wolff K, Auster KF, Goldsmith LA, Katz SI. ed. Fitzpatrick's Dermatology in Internal Medicine. 6th ed. McGraw Hill, New York 2003: 737–747.