Squamous-cell carcinoma developing within anal lichen planus: report of a case.
OBJECTIVE
We present a case of squamous-cell carcinoma developing within perianal lichen planus. This is a chronic or recurrent cutaneous and/or mucosal dermatosis affecting less than 1 percent of the population. Neoplastic degeneration of cutaneous lichen planus is rare; only one case of squamous-cell carcinoma developing within perianal lichen planus has been described up until now in the international literature.


METHODS
Our case involved a 68-year-old woman with chronic, long-term lichen planus spreading all over the vulva and perianal region and the mucosa of the anal canal, where squamous-cell carcinoma developed within the perianal lichen planus. Treatment consisted of wide, circular excision of the perianal skin and mucosectomy of the anal canal up to as far as 1 cm above the dentate line. Reconstruction was performed by means of two V-Y bilateral subcutaneous flaps.


CONCLUSIONS
Wide excision was performed not only to remove the squamous-cell carcinoma but also the lichen planus to prevent recurrence of metachronous or synchronous squamous-cell carcinoma. Follow-up at one year after surgery showed no local recurrence of either lichen planus or squamous-cell carcinoma, which suggests that surgical removal should be the therapy of choice for long-term, chronic perianal lichen planus that has proved to be resistant to medical therapy.
Fundarò
S
S
Department of Surgery, University of Modena, Italy.
Spallanzani
A
A
Ricchi
E
E
Carriero
A
A
Perrone
S
S
Giusti
G
G
Giannetti
A
A
De Bernardinis
G
G
D000368:Aged; D001004:Anus Diseases / Q000150:complications* / Q000473:pathology / Q000601:surgery; D001005:Anus Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008010:Lichen Planus / Q000150:complications* / Q000473:pathology / Q000601:surgery