Concomitant hypertrophic lichen planus and squamous cell carcinoma: Clinical features and treatment outcomes

Background: Patients with hypertrophic lichen planus (HLP) and squamous cell carcinoma (SCC) diagnoses present clinicians with diagnostic and disease management challenges. Objective: To better define the clinical and treatment outcomes of patients with concomitant diagnoses of HLP and SCC. Methods and Materials: A retrospective review was performed from January 1, 2008, to July 31, 2015, at Mayo Clinic. Patients with a histologic diagnosis of HLP and SCC were included. Patient demographics, associated comorbidities, histopathologic characteristics, treatment, and outcomes were evaluated. Results: Thirty-three patients were identified; 79% were female, and mostly the lower extremities were involved. Most of the SCCs were well-differentiated and in situ with the majority treated with destruction or excision. There were no cases of local recurrence, metastasis, or disease-specific death during the follow-up period (mean 55.8 months). Conclusion: Patients with diagnoses of both HLP and SCC appear to be a distinct population that is predominantly female with lesion predilection for the lower extremities. However, regardless of treatment modality or tumor size, there were no adverse outcomes. An initial trial of more conservative treatment measures with close follow-up may be reasonable with biopsy of lesions unresponsive to conventional treatment.