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Squamous Cell Carcinoma
Primary cutaneous squamous cell carcinoma: the appearance of this lesion alone suggests the proper diagnosis.
A 63-year-old woman with long-standing psoriasis and decades-long history of methotrexate ingestion presents with a solitary, hard, slightly tender nodule on the hand. A review of her past medical history also revealed extensive phototherapy. The patient was of Irish ancestry, with a very fair complexion, who sunburned easily.
Key point: The appearance of the skin lesion alone should strongly suggest the proper diagnosis: primary cutaneous squamous cell carcinoma.
Treatment: The lesion was excised under histologic control by Moh’s surgery. The resulting large defect was closed via split-thickness skin graft. Radiation therapy might be another treatment option.
Note: Although the patient learned early in life to avoid the sun, she was nonetheless exposed to therapeutic ultraviolet irradiation for many years, as well as to a known tumorigenic immunosuppressive (methotrexate). There is an element of iatrogenic etiology in this case.
Biden Administration Announces First 10 Prescription Drugs Slated for Price Negotiations
August 29th 2023The first 10 drugs identified for negotiations under the Inflation Reduction Act include several well advertised agents indicated to treat diabetes, heart failure, and other chronic diseases.
