[Squamous cell carcinoma in localized scleroderma].

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Localized scleroderma (morphea) is a chronic inflammatory condition affecting the skin and subcutaneous tissue.
• Malignant transformation of morphea is exceptionally rare, typically occurring in long-standing cases on lower extremities.

Observation:

• A 26-year-old woman with a 15-year history of morphea developed an ulcerated lesion on her foot.
• Initial diagnosis suggested ulcerative osteomyelitis based on imaging, treated with antibiotics.
• Histopathology revealed granulomatous tissue and chronic inflammation with pseudoepitheliomatous hyperplasia.

Findings:

• The patient's condition worsened, necessitating a below-knee amputation.
• Metastatic squamous cell carcinoma was subsequently found in the inguinal lymph node.
• Despite multimodal therapy, the cancer progressed, leading to the patient's death.

Implications:

• This case underscores the critical need for vigilant monitoring and comprehensive histopathological evaluation in chronic morphea, especially with ulcerative lesions.
• Squamous cell carcinoma can present insidiously, mimicking other conditions like osteomyelitis.
• Early detection and aggressive management are crucial for improving outcomes in rare malignant transformations of morphea.