What is the prevalence of squamous cell carcinoma (SCC) in hidradenitis suppurativa (HS)?

Updated: Aug 30, 2019
  • Author: Marina Jovanovic, MD, PhD; Chief Editor: William D James, MD  more...
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Answer

Squamous cell carcinoma (SCC) is a rare but serious consequence. Most SCCs occur in men and in the anogenital region, perhaps because these tumors are hard to detect. SCC tumors show endophytic growth along the sinus tracts once they occur. Most patients with SCC have a history of hidradenitis suppurativa for 10 years or longer; the prevalence of SCC among patients with perianal hidradenitis suppurativa lasting 20-30 years is approximately 3.2%. [76] The diagnosis of perianal SCC is often delayed owing to chronic scarring and the endophytic nature of its growth pattern. Metastases and death may result.

The first case of vulvar SCC as a complication of hidradenitis suppurativa was reported in the English-language literature in 1999. [55] All 5 previously reported cases of SCC with hidradenitis suppurativa in women involved the buttocks or the perianal region. Maclean and Coleman suggest that hidradenitis suppurativa arising in extra-axillary sites is a premalignant condition and that it should not be treated conservatively. [77] SCC that arises in chronically scarred and inflamed skin (Marjolin ulcer) tends to be more aggressive than that resulting from actinic damage, and it is associated with local invasion or recurrence after excision, distant metastasis, and a higher mortality rate. [78]

Attention should also be given to the development of anal cancer.


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