Giant porokeratosis with overlying cutaneous horn and squamous cell carcinoma

Rajesh Kumar Mandal¹ , Anupam Das² , Piyush Kumar³

¹ Department of Dermatology, STD and Leprosy, North Bengal Medical College, Darjeeling, West Bengal, India
² Department of Dermatology, STD and Leprosy, KPC Medical College, Kolkata, West Bengal, India
³ Department of Dermatology, STD and Leprosy, Katihar Medical College, Katihar, Bihar, India

Correspondence Address:
Rajesh Kumar Mandal
Department of Dermatology, STD and Leprosy, North Bengal Medical College, Darjeeling, West Bengal
India

A 35-year-old man presented with a solitary, large, 15 cm × 25 cm, oval annular plaque with a characteristic peripheral keratotic ridge with a central groove on his back [Figure - 1]. Besides, there were two round ulcerated overgrowths with a verrucous surface present along the inferior margin of the plaque. Further, there were multiple hyperkeratotic elongated horny eruptions distributed on the primary lesion. Biopsy from the margin of the primary plaque showed cornoid lamella (column of parakeratotic cells overlying a zone of hypogranulosis) confirming porokeratosis while a biopsy from the ulcerated lesion showed keratin pearls, atypical keratinocytes with hyperchromatic nucleus and numerous mitotic figures suggestive of squamous cell carcinoma.

Figure 1: Giant porokeratosis with overlying cutaneous horn and squamous cell carcinoma

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