ABSTRACT
We describe a rare case of atypical pyoderma gangrenosum of the dorsal hand in a patient who presented with the histopathologic diagnosis of squamous cell carcinoma (SCC). Atypical pyoderma gangrenosum is a rare variant of pyoderma gangrenosum that occurs on the upper extremities, presenting as a cutaneous ulcer. The correct treatment is nonsurgical, and surgical intervention often results in trauma-induced expansion of lesions. Pyoderma gangrenosum, most commonly mistaken for infection, has resulted in amputation. Histologic and clinical presentation 1 month after onset of symptoms in the patient reported here mimicked SCC. Awareness by hand surgeons of the possible histologic misdiagnosis of SCC at an early stage in the disease evolution and a high index of suspicion in the face of biopsy-proven SCC may prevent unnecessary digit amputation.
Subject(s)
Carcinoma, Squamous Cell/diagnosis , Hand Dermatoses/diagnosis , Pyoderma Gangrenosum/diagnosis , Skin Neoplasms/diagnosis , Aged , Amputation, Surgical , Anti-Infective Agents/administration & dosage , Anti-Inflammatory Agents/administration & dosage , Biopsy , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Cooperative Behavior , Dapsone/administration & dosage , Diagnosis, Differential , Drug Therapy, Combination , Hand Dermatoses/pathology , Hand Dermatoses/surgery , Humans , Interdisciplinary Communication , Male , Prednisone/administration & dosage , Pyoderma Gangrenosum/pathology , Pyoderma Gangrenosum/surgery , Referral and Consultation , Skin/pathology , Skin Neoplasms/pathology , Skin Neoplasms/surgeryABSTRACT
Electron beam radiation is a commonly used and effective treatment modality for cutaneous malignancies. Secondary cutaneous malignancies arising in electron beam treatment sites are rarely reported. We report on seven patients who developed multiple secondary tumours arising within and immediately around electron beam radiation treatment sites in the setting of treatment for diffuse primary disease or as adjunctive therapy for aggressive cutaneous malignancies.
