Giant cutaneous squamous cell carcinoma of the scalp arising in the setting of folliculitis decalvans. Issue 3 (8th March 2022)

• Record Type: Journal Article
• Authors: Ding, Liang; DeGiovanni, Jason C; Bogner, Paul; Soofi, Yousef
• Is Part Of: BMJ case reports. Volume 15:Issue 3(2022)
• Publication Date: 2022-03-08
• Subjects: pathology -- head and neck surgery -- surgical oncology -- head and neck cancer -- skin cancer; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2021-247932
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Squamous cell carcinoma (SCC) is uncommon in African Americans (AAs), with an incidence of approximately 0.003%. However, it is the most common skin cancer in that patient population. In AAs, SCC typically arises in sun-protected areas and mainly affects patients older than 50 years. We report a case of giant SCC in an AA man in his 40s with long-standing folliculitis decalvans on the scalp. Three previous skin biopsies were inconclusive. A wide excision was performed and the defect was reconstructed with an anterolateral thigh free flap. Histological analysis of the resected specimen revealed a well-moderately differentiated keratinising SCC with clear cell changes, severe mixed inflammation, folliculitis and dermal scar. He was discharged 2 weeks later and has been followed up closely. Four months later, the patient presents with metastatic SCC to an occipital lymph node.