New Report Highlights the development of Non-melanoma Skin Cancer In Erosive Pustular Dermatosis

Case Series of Six Patients Describe 4 Cases of SCC and 2 Cases of BCC

A new report in the journal Dermatologic Therapy described 6 patients with erosive pustular dermatosis of the scalp (EPDS) who developed non melanoma skin cancer. These cases were identified following retrospective review of patients in the authors’ practices with EPDS.

The mean age of the 6 patients was 82 (range 65-92). 5 of the 6 patients had lighter skin types (Fitzpatrick type 1 or 2). Four patients had prior histories of non-melanoma skin cancer as well. 4 patients developed squamous cell carcinoma and 2 developed basal cell carcinoma.

Comments

Many chronic inflammatory scalp conditions are associated with an increased risk for skin cancer. In addition to erosive pustular dermatosis of the scalp, discoid lupus, folliculitis decalvans, lichen planopilaris and dissecting cellulitis are examples of inflammatory scalp conditions that are associated with a risk of skin cancer. Of course, the risk is not all the same for all these conditions.

This report by Negbenebor et al is interesting. It reminds us that patients with erosive pustular dermatosis may have some degree of increased risk of developing nonmelanoma skin cancer. Several prior studies have also reported this association of SCC and BCC developing in the setting of EPDS.

The authors propose that a morphologic change in a lesion of erosive pustular dermatosis, such as a crusted plaque becoming nodular or an area on the scalp growing significantly within a relatively short period of time - should prompt the clinician to consider a biopsy to rule out nonmelanoma skin cancer.

The authors propose that further studies are needed to better understand the risk of non-melanoma arising in the setting of erosive pustular dermatosis of the scalp.

REFERENCE

Negbenebor NA et al. Nonmelanoma skin cancer in the setting of erosive pustular dermatosis of the scalp: A case series and comment on management implications. Dermatol Ther. 2022 Jul;35(7):e15584. doi: 10.1111/dth.15584. Epub 2022 May 28.

Barilla S et al. Squamous Cell Carcinoma Arising in Chronic Erosive Pustular Dermatosis. Dermatol Surg. 2022 Feb 1;48(2):250-251.

Lovell CR et al. Cutaneous carcinoma arising in erosive pustular dermatosis of the scalp. Br J Dermatol. 1980 Sep;103(3):325-8.

Curry SS et al. Squamous cell carcinoma arising in dissecting perifolliculitis of the scalp. A case report and review of secondary squamous cell carcinomas. J Am Acad Dermatol 1981 Jun;4(6):673-8.

Mufti A et al. Squamous cell carcinoma arising within discoid lupus erythematous lesions: A systematic review. JAAD Int. 2020 Nov 30;2:1-4.

Colmenero  CG et al. Squamous cell carcinoma in lichen planopilaris. J Dermatol Case Rep . 2013 Sep 30;7(3):84-7.

Pahalyants V et al. Rapidly progressive squamous cell carcinoma in a patient with longstanding history of folliculitis decalvans. JAAD Case Rep. 2021 Jul 10;15:42-45.