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• W2044293882 abstract "To the Editor: Squamous cell carcinoma (SCC) is the most frequent cancer in individuals of dark skin. We describe two cases of SCC and one case of actinic keratoses in three African American women. All three cases presented with scaly, hyperpigmented plaques and mottled pigmentation on the legs. We also reviewed the literature to examine the distribution of SCC in the patients of African descent. In most of these studies, SCC most commonly occurred on the lower legs. A summary of the data from these studies is depicted in Table I.1Fleming I.D. Barnawell J.R. Burlison P.E. Rankin J.S. Skin cancer in black patients.Cancer. 1975; 35: 600-605Crossref PubMed Scopus (102) Google Scholar, 2Mora R.G. Perniciaro C. Cancer of the skin in blacks. I. A review of 163 black patients with cutaneous squamous cell carcinoma.J Am Acad Dermatol. 1981; 5: 535-543Abstract Full Text PDF PubMed Scopus (104) Google Scholar, 3Rosen T. Tucker S.B. Tschen J. Bowen's disease in blacks.J Am Acad Dermatol. 1982; 7: 364-368Abstract Full Text PDF PubMed Scopus (20) Google Scholar, 4Bang K.M. Halder R.M. White J.E. Sampson C.C. Wilson J. Skin cancer in black Americans: a review of 126 cases.J Natl Med Assoc. 1987; 79: 51-58PubMed Google Scholar, 5Halder R.M. Bang K.M. Skin cancer in blacks in the United States.Dermatol Clin. 1988; 6: 397-405PubMed Google Scholar, 6Datubo-Brown D.D. Primary malignant skin tumors in Nigerians.J Natl Med Assoc. 1991; 83: 345-348PubMed Google Scholar, 7Amir H. Mbonde M.P. Kitinya J.N. Cutaneous squamous cell carcinoma in Tanzania.Cent Afr J Med. 1992; 38: 439-443PubMed Google Scholar, 8Yakubu A. Mabogunje O.A. Squamous cell carcinoma of the skin in Africans.Trop Geogr Med. 1995; 47: 91-93PubMed Google Scholar, 9Singh B. Bhaya M. Shaha A. Har-El G. Lucente F.E. Presentation, course, and outcome of head and neck skin cancer in African Americans: a case-control study.Laryngoscope. 1998; 108: 1159-1163Crossref PubMed Scopus (13) Google Scholar, 10McCall C.O. Chen S.C. Squamous cell carcinoma of the legs in African Americans.J Am Acad Dermatol. 2002; 47: 524-529Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar, 11Dieng M.T. Diop N.N. Déme A. Sy T.N. Niang S.O. Ndiaye B. Squamous cell carcinoma in black patients: 80 cases [in French].Ann Dermatol Venereol. 2004; 131: 1055-1057Crossref PubMed Google Scholar, 12Ochicha O. Edino S.T. Mohammed A.Z. Umar A.B. Atanda A.T. Pathology of peripheral lymph node biopsies in Kane, Northern Nigeria.Ann Afr Med. 2007; 6: 104-108Crossref PubMed Scopus (5) Google Scholar, 13Adigun I.A. Buhari M.O. Ayorinde R.O. Malignant skin tumor in blacks: experience in a teaching hospital.West Afr J Med. 2006; 25: 276-278PubMed Google Scholar, 14Mulwafu W.K. Fagan J.J. Jessop S. Squamous cell carcinoma in black patients with discoid lupus erythematosus.S Afr J Surg. 2006; 44: 144-146PubMed Google Scholar, 15Ribeiro A.M. Curado M.P. Filho J.B. Cutaneous squamous cell carcinoma of the lower limbs in Goiânia, Goiás.Brazil. Int J Dermatol. 2006; 45: 1039-1042Crossref PubMed Scopus (6) Google Scholar, 16Adegbidi H. Yedomon H. Atadokpede F. Balley-Pognon M.C. do Ango-Padonou F. Skin cancers at the National University Hospital of Cotonou from 1985 to 2004.Int J Dermatol. 2007; 46: 26-29Crossref PubMed Scopus (15) Google ScholarTable ISquamous cell carcinoma in patients of African descentStudyYearLocationStudy resultsSites of predilectionFleming et al1Fleming I.D. Barnawell J.R. Burlison P.E. Rankin J.S. Skin cancer in black patients.Cancer. 1975; 35: 600-605Crossref PubMed Scopus (102) Google Scholar1975USNMSC: 58; SCC: 3823/38 (61%) SCC cases on non-sun exposed areas, including the legsMora and Perniciaro2Mora R.G. Perniciaro C. Cancer of the skin in blacks. I. A review of 163 black patients with cutaneous squamous cell carcinoma.J Am Acad Dermatol. 1981; 5: 535-543Abstract Full Text PDF PubMed Scopus (104) Google Scholar1981LouisianaSCC: 176The most common sites of involvement were the face and the lower extremityRosen et al3Rosen T. Tucker S.B. Tschen J. Bowen's disease in blacks.J Am Acad Dermatol. 1982; 7: 364-368Abstract Full Text PDF PubMed Scopus (20) Google Scholar1982HoustonSCC in situ (Bowens): 7Not specifiedBang et al4Bang K.M. Halder R.M. White J.E. Sampson C.C. Wilson J. Skin cancer in black Americans: a review of 126 cases.J Natl Med Assoc. 1987; 79: 51-58PubMed Google Scholar1987Washington, DCNMSC: 126; SCC: 75Not specifiedHalder et al5Halder R.M. Bang K.M. Skin cancer in blacks in the United States.Dermatol Clin. 1988; 6: 397-405PubMed Google Scholar1988USSCC: 4328/43 (63%) of SCC cases on non–sun exposed areas, including the legsDatubo-Brown6Datubo-Brown D.D. Primary malignant skin tumors in Nigerians.J Natl Med Assoc. 1991; 83: 345-348PubMed Google Scholar1991NigeriaNMSC: 11; SCC: 7Not specifiedAmir et al7Amir H. Mbonde M.P. Kitinya J.N. Cutaneous squamous cell carcinoma in Tanzania.Cent Afr J Med. 1992; 38: 439-443PubMed Google Scholar1992TanzaniaNMSC: Not available; SCC: not availableSCC most common NMSC reported in the study, with lower limbs the most affected siteYakubu et al8Yakubu A. Mabogunje O.A. Squamous cell carcinoma of the skin in Africans.Trop Geogr Med. 1995; 47: 91-93PubMed Google Scholar1995NigeriaSCC: 524283/524 (54%) SCC cases on the lower extremitiesSingh et al9Singh B. Bhaya M. Shaha A. Har-El G. Lucente F.E. Presentation, course, and outcome of head and neck skin cancer in African Americans: a case-control study.Laryngoscope. 1998; 108: 1159-1163Crossref PubMed Scopus (13) Google Scholar1998USNMSC: 67; SCC: 4134/41 (83%) SCC cases on non–head and neck, including the lower legsMcCall and Chen10McCall C.O. Chen S.C. Squamous cell carcinoma of the legs in African Americans.J Am Acad Dermatol. 2002; 47: 524-529Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar2002USSCC: 3516/35 (46%) SCC cases on the lower legs of elderly womenDieng et al11Dieng M.T. Diop N.N. Déme A. Sy T.N. Niang S.O. Ndiaye B. Squamous cell carcinoma in black patients: 80 cases [in French].Ann Dermatol Venereol. 2004; 131: 1055-1057Crossref PubMed Google Scholar2004SenegalSCC: 80Not specifiedOchicha et al12Ochicha O. Edino S.T. Mohammed A.Z. Umar A.B. Atanda A.T. Pathology of peripheral lymph node biopsies in Kane, Northern Nigeria.Ann Afr Med. 2007; 6: 104-108Crossref PubMed Scopus (5) Google Scholar2004NigeriaNMSC: 82; SCC: 5034/50 (68%) the lower limbs were the most frequent sitesAdigun et al13Adigun I.A. Buhari M.O. Ayorinde R.O. Malignant skin tumor in blacks: experience in a teaching hospital.West Afr J Med. 2006; 25: 276-278PubMed Google Scholar2006NigeriaNMSC: 146; SCC: 138Authors reported most of the cases resulted on the legs from leg ulcers and burn scarsMulwafu et al14Mulwafu W.K. Fagan J.J. Jessop S. Squamous cell carcinoma in black patients with discoid lupus erythematosus.S Afr J Surg. 2006; 44: 144-146PubMed Google Scholar2006South AfricaSCC: 2Discoid lupus erythematosusRebeiro et al15Ribeiro A.M. Curado M.P. Filho J.B. Cutaneous squamous cell carcinoma of the lower limbs in Goiânia, Goiás.Brazil. Int J Dermatol. 2006; 45: 1039-1042Crossref PubMed Scopus (6) Google Scholar2006BrazilSCC: Not available7 cases on the lower limbsAdegbidi et al16Adegbidi H. Yedomon H. Atadokpede F. Balley-Pognon M.C. do Ango-Padonou F. Skin cancers at the National University Hospital of Cotonou from 1985 to 2004.Int J Dermatol. 2007; 46: 26-29Crossref PubMed Scopus (15) Google Scholar2007BeninNMSC: 11; SCC: 6Lower lip: 1; vertex: 1; back: 1; right elbow: 1; and leg: 2NMSC, Nonmelanoma skin cancer; SCC, squamous cell carcinoma. Open table in a new tab Case 1 was a 69-year-old African American woman who presented with a 1-year history of a hyperpigmented scaly plaque on her left leg. The physical examination revealed a 2-cm black, hyperkeratotic plaque on the patient's left leg (Fig 1). Histology showed a markedly pigmented epidermis with full thickness epidermal atypia, scattered mitotic figures, and overlying parakeratosis consistent with pigmented SCC in situ. The tumor was subsequently excised with Mohs micrographic surgery.Case 2 was a 93-year-old African American woman presented to our clinic with multiple scaly dark brown plaques on the lower limbs of 6 months' duration. The physical examination revealed multiple, dark brown, hyperkeratotic plaques on the lower limbs. Histology was consistent with squamous cell carcinoma. Because of the patient's advanced age, she was treated with 5-flourouracil 5% cream twice daily but was later lost to follow-up.Case 3 was an 82-year-old African American woman presented to our clinic with a hyperpigmented scaly plaque on the anterolateral surface of the right leg. The physical examination revealed a 2-cm, minimally scaly, dark brown plaque on the right anterolateral surface of her leg. A biopsy specimen revealed hyperkeratosis, alternating parakeratosis, disordered epidermal maturation, and mild chronic inflammation consistent with a hyperplastic actinic keratosis. The patient was prescribed 5-flurouracil 5% cream twice daily. At a 3-month follow-up visit, only a residual brown patch was observed.All patients denied a history of skin cancer, excessive sun exposure to their legs, a history of sunburns, or clinically significant occupational exposures.Our first two cases were clinically consistent with the commonly described presentation of SCC in elderly African American women. Our third case of actinic keratosis revealed the importance of early intervention in this patient population. SCC, which represents 30% to 60% of skin cancers in African Americans, is the most common malignancy in black patients.17Byrd-Miles K. Toombs E.L. Peck G.L. Skin cancer in individuals of African, Asian, Latin-American, and American-Indian descent: differences in incidence, clinical presentation, and survival compared to Caucasians.J Drugs Dermatol. 2007; 6: 10-16PubMed Google Scholar, 18Hu S. Soza-Vento R.M. Parker D.F. Kirsner R.S. Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida.Arch Dermatol. 2006; 142: 704-708Crossref PubMed Scopus (75) Google Scholar, 19Gloster Jr., H.M. Neal K. Skin cancer in skin of color.J Am Acad Dermatol. 2006; 55: 741-760Abstract Full Text Full Text PDF PubMed Scopus (398) Google Scholar Numerous studies have shown an increased incidence of SCC on the lower legs of patients of African decent.17Byrd-Miles K. Toombs E.L. Peck G.L. Skin cancer in individuals of African, Asian, Latin-American, and American-Indian descent: differences in incidence, clinical presentation, and survival compared to Caucasians.J Drugs Dermatol. 2007; 6: 10-16PubMed Google Scholar, 18Hu S. Soza-Vento R.M. Parker D.F. Kirsner R.S. Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida.Arch Dermatol. 2006; 142: 704-708Crossref PubMed Scopus (75) Google Scholar, 19Gloster Jr., H.M. Neal K. Skin cancer in skin of color.J Am Acad Dermatol. 2006; 55: 741-760Abstract Full Text Full Text PDF PubMed Scopus (398) Google Scholar In conclusion, SCC should be considered in the differential diagnosis of keratotic, hyperpigmented plaques in blacks, particularly when these lesions present on the legs of elderly African American women. To the Editor: Squamous cell carcinoma (SCC) is the most frequent cancer in individuals of dark skin. We describe two cases of SCC and one case of actinic keratoses in three African American women. All three cases presented with scaly, hyperpigmented plaques and mottled pigmentation on the legs. We also reviewed the literature to examine the distribution of SCC in the patients of African descent. In most of these studies, SCC most commonly occurred on the lower legs. A summary of the data from these studies is depicted in Table I.1Fleming I.D. Barnawell J.R. Burlison P.E. Rankin J.S. Skin cancer in black patients.Cancer. 1975; 35: 600-605Crossref PubMed Scopus (102) Google Scholar, 2Mora R.G. Perniciaro C. Cancer of the skin in blacks. I. A review of 163 black patients with cutaneous squamous cell carcinoma.J Am Acad Dermatol. 1981; 5: 535-543Abstract Full Text PDF PubMed Scopus (104) Google Scholar, 3Rosen T. Tucker S.B. Tschen J. Bowen's disease in blacks.J Am Acad Dermatol. 1982; 7: 364-368Abstract Full Text PDF PubMed Scopus (20) Google Scholar, 4Bang K.M. Halder R.M. White J.E. Sampson C.C. Wilson J. Skin cancer in black Americans: a review of 126 cases.J Natl Med Assoc. 1987; 79: 51-58PubMed Google Scholar, 5Halder R.M. Bang K.M. Skin cancer in blacks in the United States.Dermatol Clin. 1988; 6: 397-405PubMed Google Scholar, 6Datubo-Brown D.D. Primary malignant skin tumors in Nigerians.J Natl Med Assoc. 1991; 83: 345-348PubMed Google Scholar, 7Amir H. Mbonde M.P. Kitinya J.N. Cutaneous squamous cell carcinoma in Tanzania.Cent Afr J Med. 1992; 38: 439-443PubMed Google Scholar, 8Yakubu A. Mabogunje O.A. Squamous cell carcinoma of the skin in Africans.Trop Geogr Med. 1995; 47: 91-93PubMed Google Scholar, 9Singh B. Bhaya M. Shaha A. Har-El G. Lucente F.E. Presentation, course, and outcome of head and neck skin cancer in African Americans: a case-control study.Laryngoscope. 1998; 108: 1159-1163Crossref PubMed Scopus (13) Google Scholar, 10McCall C.O. Chen S.C. Squamous cell carcinoma of the legs in African Americans.J Am Acad Dermatol. 2002; 47: 524-529Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar, 11Dieng M.T. Diop N.N. Déme A. Sy T.N. Niang S.O. Ndiaye B. Squamous cell carcinoma in black patients: 80 cases [in French].Ann Dermatol Venereol. 2004; 131: 1055-1057Crossref PubMed Google Scholar, 12Ochicha O. Edino S.T. Mohammed A.Z. Umar A.B. Atanda A.T. Pathology of peripheral lymph node biopsies in Kane, Northern Nigeria.Ann Afr Med. 2007; 6: 104-108Crossref PubMed Scopus (5) Google Scholar, 13Adigun I.A. Buhari M.O. Ayorinde R.O. Malignant skin tumor in blacks: experience in a teaching hospital.West Afr J Med. 2006; 25: 276-278PubMed Google Scholar, 14Mulwafu W.K. Fagan J.J. Jessop S. Squamous cell carcinoma in black patients with discoid lupus erythematosus.S Afr J Surg. 2006; 44: 144-146PubMed Google Scholar, 15Ribeiro A.M. Curado M.P. Filho J.B. Cutaneous squamous cell carcinoma of the lower limbs in Goiânia, Goiás.Brazil. Int J Dermatol. 2006; 45: 1039-1042Crossref PubMed Scopus (6) Google Scholar, 16Adegbidi H. Yedomon H. Atadokpede F. Balley-Pognon M.C. do Ango-Padonou F. Skin cancers at the National University Hospital of Cotonou from 1985 to 2004.Int J Dermatol. 2007; 46: 26-29Crossref PubMed Scopus (15) Google Scholar NMSC, Nonmelanoma skin cancer; SCC, squamous cell carcinoma. Case 1 was a 69-year-old African American woman who presented with a 1-year history of a hyperpigmented scaly plaque on her left leg. The physical examination revealed a 2-cm black, hyperkeratotic plaque on the patient's left leg (Fig 1). Histology showed a markedly pigmented epidermis with full thickness epidermal atypia, scattered mitotic figures, and overlying parakeratosis consistent with pigmented SCC in situ. The tumor was subsequently excised with Mohs micrographic surgery. Case 2 was a 93-year-old African American woman presented to our clinic with multiple scaly dark brown plaques on the lower limbs of 6 months' duration. The physical examination revealed multiple, dark brown, hyperkeratotic plaques on the lower limbs. Histology was consistent with squamous cell carcinoma. Because of the patient's advanced age, she was treated with 5-flourouracil 5% cream twice daily but was later lost to follow-up. Case 3 was an 82-year-old African American woman presented to our clinic with a hyperpigmented scaly plaque on the anterolateral surface of the right leg. The physical examination revealed a 2-cm, minimally scaly, dark brown plaque on the right anterolateral surface of her leg. A biopsy specimen revealed hyperkeratosis, alternating parakeratosis, disordered epidermal maturation, and mild chronic inflammation consistent with a hyperplastic actinic keratosis. The patient was prescribed 5-flurouracil 5% cream twice daily. At a 3-month follow-up visit, only a residual brown patch was observed. All patients denied a history of skin cancer, excessive sun exposure to their legs, a history of sunburns, or clinically significant occupational exposures. Our first two cases were clinically consistent with the commonly described presentation of SCC in elderly African American women. Our third case of actinic keratosis revealed the importance of early intervention in this patient population. SCC, which represents 30% to 60% of skin cancers in African Americans, is the most common malignancy in black patients.17Byrd-Miles K. Toombs E.L. Peck G.L. Skin cancer in individuals of African, Asian, Latin-American, and American-Indian descent: differences in incidence, clinical presentation, and survival compared to Caucasians.J Drugs Dermatol. 2007; 6: 10-16PubMed Google Scholar, 18Hu S. Soza-Vento R.M. Parker D.F. Kirsner R.S. Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida.Arch Dermatol. 2006; 142: 704-708Crossref PubMed Scopus (75) Google Scholar, 19Gloster Jr., H.M. Neal K. Skin cancer in skin of color.J Am Acad Dermatol. 2006; 55: 741-760Abstract Full Text Full Text PDF PubMed Scopus (398) Google Scholar Numerous studies have shown an increased incidence of SCC on the lower legs of patients of African decent.17Byrd-Miles K. Toombs E.L. Peck G.L. Skin cancer in individuals of African, Asian, Latin-American, and American-Indian descent: differences in incidence, clinical presentation, and survival compared to Caucasians.J Drugs Dermatol. 2007; 6: 10-16PubMed Google Scholar, 18Hu S. Soza-Vento R.M. Parker D.F. Kirsner R.S. Comparison of stage at diagnosis of melanoma among Hispanic, black, and white patients in Miami-Dade County, Florida.Arch Dermatol. 2006; 142: 704-708Crossref PubMed Scopus (75) Google Scholar, 19Gloster Jr., H.M. Neal K. Skin cancer in skin of color.J Am Acad Dermatol. 2006; 55: 741-760Abstract Full Text Full Text PDF PubMed Scopus (398) Google Scholar In conclusion, SCC should be considered in the differential diagnosis of keratotic, hyperpigmented plaques in blacks, particularly when these lesions present on the legs of elderly African American women." @default.
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• W2044293882 title "Squamous cell carcinomas of the lower limbs in African American women" @default.
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