Squamous Cell Carcinomas in Two Cases of Nail Lichen Planus: Is There a Real Association?

Nail lichen planus: A review of clinical presentation, diagnosis and therapy

Lichen planus is a multifaceted disease of complex etiopathogenesis. Nails are involved in up to 10% of patients with lichen planus. Although most cases are mild, serious consequences may occur due to rapid progression of the disease, the high risk of scarring, and the resulting irreversible damage to the nail structure. Permanent damage of at least one nail occurs in approximately 4-12% of patients with nail lichen planus. In this narrative review, we emphasize the pathophysiology of nail lichen planus, the emergent nature of the disease, and the spectrum of different clinical manifestations. Diagnosis of nail disease in general, and of nail lichen planus in particular, is rapidly evolving. This review provides a comprehensive account of the non-invasive and invasive diagnostic techniques and treatment options reported in the literature, with emphasis on the efficacy and safety of the drugs used, the associated evidence, and the factors to be taken into account in planning and providing adequate treatment. The role of aesthetic and camouflage options is also summarized.

Squamous Cell Carcinoma Arising in Ungual Lichen Planus: Report and Review

Background

Lichen planus (LP) can lead to severe scarring of the nail unit leading to anonychia. There are very few reports of squamous cell carcinoma (SCC) occurring in the lesions of ungual LP.

Objective

The aim of this study was to revise the previously reported cases of SCC appearing in ungual LP and to present a new case.

Methods

A PubMed search was performed with the terms "nail lichen planus" and "squamous cell carcinoma." Reported cases as well as a new case were depicted in a table.

Results

Only 2 indexed articles reporting 3 cases were found. All patients suffered of long-lasting scarring ungual LP.

Conclusions

The occurrence of SCC in nail LP is rare. LP is not "premalignant" per se, but SCC might rarely arise in LP scars.

Review of Nail Lichen Planus: Epidemiology, Pathogenesis, Diagnosis, and Treatment

Nail lichen planus is an inflammatory disorder of the nails with potential for significant cosmetic disfigurement and functional impairment. Nail manifestations may be isolated or appear concurrently with other forms of lichen planus. Longitudinal ridging is the most common clinical finding, but progressive disease may result in irreversible scarring (dorsal pterygium) or permanent nail loss (anonychia). Data on treatment are limited to retrospective studies and case reports. The mainstays of treatment are intralesional and intramuscular corticosteroid injections and oral retinoids. There is a need for randomized controlled trials on nail lichen planus to more rigorously assess efficacy and outcomes.

Cutaneous Bowen's Disease: an Analysis of 182 Cases according To Age, Sex, and Anatomical Site from an Italian Center

Bowen’s disease (BD), also known as squamous cell carcinoma in situ, is a type of non-melanocytic intraepidermal malignancy characterised by a slowly enlarging erythematous to pink, scaly patch or plaque with irregular and well-demarcated borders. These lesions are usually persistent and progressive; it has been estimated that in general population around 3% to 5% of Bowen’s disease transform into invasive squamous cell carcinoma. This report describes our experience with cutaneous BD and assesses the differences found about age, sex and anatomical site. Bowen’s disease was seen more frequently in male patients rather than in female patients in contrast to what confirmed in literature - this difference is probably because being head-neck an exposed region, patients are more easily induced to autoexam and to consult the dermatologist.