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Clinical Images  |   September 2014
Hypertrophic Lichen Planus Mimicking Squamous Cell Carcinoma of Skin
Author Notes
  • From the Division of Hematology and Oncology at the University of New Mexico Cancer Center in Albuquerque 
  • Address correspondence to Waheed Murad, MD, University of New Mexico Cancer Center, 1201 Camino de Salud NE, Albuquerque, NM 87131-0001. E-mail: wmurad@salud.unm.edu  
Article Information
Imaging / Pain Management/Palliative Care / Clinical Images / Headache
Clinical Images   |   September 2014
Hypertrophic Lichen Planus Mimicking Squamous Cell Carcinoma of Skin
The Journal of the American Osteopathic Association, September 2014, Vol. 114, 735. doi:10.7556/jaoa.2014.144
The Journal of the American Osteopathic Association, September 2014, Vol. 114, 735. doi:10.7556/jaoa.2014.144
A purple pruritic plaque of the right leg developed in a 56-year-old woman with migraine headaches. Similar lesions appeared subsequently on all extremities within 3 months. At presentation, numerous plaques with scales (pictured) were observed overlying both upper and lower extremities and plantar surfaces but without nail bed, mouth, or palmer surface involvement. Laboratory tests revealed normal complete blood cell count, liver function, viral hepatitis and HIV serology, and CD4 count; however, positron emission tomography revealed uptake of fludeoxyglucose F 18 in the subcutaneous lesions. Biopsy results (not pictured) demonstrated lichenoid dermatitis with eosinophils consistent with hypertrophic lichen planus but no evidence of squamous cell carcinoma. Intralesional injections of triamcinolone acetonide (40 mg on 3 occasions) and oral prednisone therapy (60 mg for 6 weeks) provided clinical resolution. 
Hypertrophic lichen planus typically causes pruritic plaques on anterior surfaces of lower extremities, and squamous cell carcinoma originating in these lesions has been reported.1 Squamous cell carcinoma is manifested by a change of plaque to wart-like growth and requires confirmatory biopsy. 
   Financial Disclosures: None reported.
 
   Support: None reported.
 
Reference
Reference
Manz B, Paasch U, Sticherling M. Squamous cell carcinoma as a complication of long-standing hypertrophic lichen planus. Int J Dermatol. 2005;44(9):773-774. [CrossRef] [PubMed]