Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk Factors
A 19-year-old female with a history of pre-B cell acute lymphocytic leukemia (ALL) presented with two aggressive cutaneous squamous cell carcinomas (C-SCC) in the right hand. The patient was diagnosed with pre-B cell ALL at four years of age. She underwent chemotherapy with initial remission. Howeve...
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MDPI AG
2022-03-01
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Online Access: | https://www.mdpi.com/2296-3529/9/2/15 |
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author | Gehan A. Pendlebury Michelle A. Bongiorno Jeffrey N. Lackey |
author_facet | Gehan A. Pendlebury Michelle A. Bongiorno Jeffrey N. Lackey |
author_sort | Gehan A. Pendlebury |
collection | DOAJ |
description | A 19-year-old female with a history of pre-B cell acute lymphocytic leukemia (ALL) presented with two aggressive cutaneous squamous cell carcinomas (C-SCC) in the right hand. The patient was diagnosed with pre-B cell ALL at four years of age. She underwent chemotherapy with initial remission. However, recurrence of the pre-B cell ALL required an unrelated allogeneic cord hematopoietic stem cell transplant (alloHSCT). Post-transplant, the patient developed Graft-Versus-Host Disease (GVHD), which was treated with immunosuppressant therapy for six years until resolution. Fourteen years following the transplant, the patient developed a morbilliform drug eruption secondary to clindamycin. She consequently received prednisone treatment. During the treatment period, the patient developed a new ulcerated and tender nodule on the dorsal aspect of her right hand. Further histopathological biopsy confirmed the diagnosis of C-SCC, which required excision. Ten months following the excision, the patient developed an additional C-SCC nodule on the same right hand, separated by 2.6 cm from the prior C-SCC. She was referred for a ray resection procedure. This case illustrates a patient with multiple risk factors that may have contributed to the continued development of C-SCC. Such risk factors include: a prolonged course of immunosuppressant medications and voriconazole treatment. Additional research is needed to investigate the etiologies and risks of C-SCC development in patients who require a transplant and long-duration immunosuppressive therapy. |
first_indexed | 2024-03-10T00:01:50Z |
format | Article |
id | doaj.art-ec28e826394749aa8752a2730ea63835 |
institution | Directory Open Access Journal |
issn | 2296-3529 |
language | English |
last_indexed | 2024-03-10T00:01:50Z |
publishDate | 2022-03-01 |
publisher | MDPI AG |
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series | Dermatopathology |
spelling | doaj.art-ec28e826394749aa8752a2730ea638352023-11-23T16:15:19ZengMDPI AGDermatopathology2296-35292022-03-019212213010.3390/dermatopathology9020015Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk FactorsGehan A. Pendlebury0Michelle A. Bongiorno1Jeffrey N. Lackey2College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33314, USADepartment of Dermatology, Walter Reed National Military Medical Center, Bethesda, MD 20814, USADepartment of Dermatology, Tulane University School of Medicine, New Orleans, LA 70112, USAA 19-year-old female with a history of pre-B cell acute lymphocytic leukemia (ALL) presented with two aggressive cutaneous squamous cell carcinomas (C-SCC) in the right hand. The patient was diagnosed with pre-B cell ALL at four years of age. She underwent chemotherapy with initial remission. However, recurrence of the pre-B cell ALL required an unrelated allogeneic cord hematopoietic stem cell transplant (alloHSCT). Post-transplant, the patient developed Graft-Versus-Host Disease (GVHD), which was treated with immunosuppressant therapy for six years until resolution. Fourteen years following the transplant, the patient developed a morbilliform drug eruption secondary to clindamycin. She consequently received prednisone treatment. During the treatment period, the patient developed a new ulcerated and tender nodule on the dorsal aspect of her right hand. Further histopathological biopsy confirmed the diagnosis of C-SCC, which required excision. Ten months following the excision, the patient developed an additional C-SCC nodule on the same right hand, separated by 2.6 cm from the prior C-SCC. She was referred for a ray resection procedure. This case illustrates a patient with multiple risk factors that may have contributed to the continued development of C-SCC. Such risk factors include: a prolonged course of immunosuppressant medications and voriconazole treatment. Additional research is needed to investigate the etiologies and risks of C-SCC development in patients who require a transplant and long-duration immunosuppressive therapy.https://www.mdpi.com/2296-3529/9/2/15squamous cell carcinomaGraft-Versus-Host Diseasevoriconazolehematopoietic stem cell transplantimmunosuppressive therapymorbilliform drug eruption |
spellingShingle | Gehan A. Pendlebury Michelle A. Bongiorno Jeffrey N. Lackey Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk Factors Dermatopathology squamous cell carcinoma Graft-Versus-Host Disease voriconazole hematopoietic stem cell transplant immunosuppressive therapy morbilliform drug eruption |
title | Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk Factors |
title_full | Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk Factors |
title_fullStr | Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk Factors |
title_full_unstemmed | Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk Factors |
title_short | Aggressive Cutaneous Squamous Cell Carcinomas Following Treatment for Graft-versus-Host Disease: A Case Report and Review of Risk Factors |
title_sort | aggressive cutaneous squamous cell carcinomas following treatment for graft versus host disease a case report and review of risk factors |
topic | squamous cell carcinoma Graft-Versus-Host Disease voriconazole hematopoietic stem cell transplant immunosuppressive therapy morbilliform drug eruption |
url | https://www.mdpi.com/2296-3529/9/2/15 |
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