Basal Cell Carcinoma in a Case of Systemic Lupus Erythematosus – A Case Report

Life Sciences-General surgery

Authors

  • Rathnaganapathy T Senior Resident Department of General Surgery, Sree Balaji Medical College and Hospital, Chrompet, Chennai - 44.
  • Manimaran Ramachandran Assistant Professor, Department of General Surgery, Sree Balaji Medical College and Hospital, Chrompet, Chennai - 44.
  • Suruchi Rubina Harinarain Junior Resident Department of General Surgery, Sree Balaji Medical College and Hospital, Chrompet, Chennai - 44. https://orcid.org/0000-0002-2423-8748

DOI:

https://doi.org/10.22376/ijlpr.2024.14.2.L13-L17

Keywords:

Systemic lupus erythematosus, Malignancy, Basal cell carcinoma, Immunosuppression, Wide local excision.

Abstract

Systemic lupus erythematosus (SLE) is a chronic, systemic autoimmune with autoantibody production, complementactivation, and immune complex deposition. SLE patients have higher mortality rates as compared to the general populationEven though there have been improvements in finding and treating diseases, cancer is still a major reason for death in this group.The most common type of cancer is Basal cell carcinoma, and it is widespread. The risk of malignancy in SLE is of considerableinterest because the immune and genetic pathways underlying the pathogenesis of SLE and the immunosuppressant drugs (ISDs)used in its management may mediate this altered risk. Here, we present a case of long-standing SLE in an elderly female who wason treatment for the same. She presented with a chronic ulcer over her scalp. She got checked, and a biopsy showed she hadBasal Cell Carcinoma on her scalp. Doctors removed it with surgery and covered the open area with skin from another part ofher body. At her first checkup, everything looked good, and the new skin was healing well. Even though skin cancers are knownto happen in people with certain skin conditions, getting Basal Cell Carcinoma with lupus is very uncommon. In various cohortstudies of adults with SLE and overall risk of malignancy, ranging from 1992 to 2017, it was found that though cutaneousmalignancies did occur, not a single study reported Basal Cell Carcinoma.

References

Svetlana Topolyanskaya. Squamous Cell Skin Carcinoma in Systemic Lupus Erythematosus: Case Report and Literature Review. Fortune Journal of Rheumatology 2 (2020): 107-117

Kole AK, Ghosh A. Cutaneous manifestations of systemic lupus erythematosus in a tertiary referral center. Indian J Dermatol. 2009;54(2):132-6. doi: 10.4103/0019-5154.53189. PMID: 20101308; PMCID: PMC2807152.

Lerang K, Gilboe IM, Steinar Thelle D, Gran JT. Mortality and years of potential life loss in systemic lupus erythematosus: a population-based cohort study. Lupus. 2014 Dec;23(14):1546-52. doi: 10.1177/0961203314551083. Epub 2014 Sep 10. PMID: 25209070.

For Nieves, C.E., Izmirly, P.M. Mortality in Systemic Lupus Erythematosus: an Updated Review. Curr Rheumatol Rep 18, 21 (2016).

Song L, Wang Y, Zhang J, et al. The risks of cancer development in systemic lupus erythematosus (SLE) patients: a systematic review and metanalysis. Arthritis Research and Therapy 20 (2018): 270

Cao L, Tong H, Xu G, et al. Systemic Lupus Erythematous and Malignancy Risk: A MetaAnalysis. PLoS ONE 10 (201): e0122964.

Björnadal L, Löfström B, Yin L, et al. Increase cancer incidence in a Swedish cohort of patients with systemic lupus erythematosus. Scand J Rheumatol 31(2002): 66-71.

Chen YJ, Chang YT, Wang CB, et al. Malignancy in systemic lupus erythematosus: a nationwide cohort study in Taiwan. Am J Med 123 (2010): 1150-1156.

Zaalberg A, Moradi Tuchayi S, Ameri AH, Ngo KH, Cunningham TJ, Eliane JP, Livneh M, Horn TD, Rosman IS, Musiek A, Anadkat MJ, Demehri S. Chronic Inflammation Promotes Skin Carcinogenesis in Cancer-Prone Discoid Lupus Erythematosus. J Invest Dermatol. 2019 Jan;139(1):62-70. doi: 10.1016/j.jid.2018.06.185. Epub 2018 Jul 17. PMID: 30030152; PMCID: PMC6309656.

Epidemiology and sociodemographics of systemic lupus erythematosus and lupus nephritis among US adults with Medicaid coverage, 2000-2004. Feldman CH, Hiraki LT, Liu J, et al. Arthritis Rheum. 2013; 65:753–763. [PMC free article] [PubMed] [Google Scholar]

Fors Nieves, C.E., Izmirly, P.M. Mortality in Systemic Lupus Erythematosus: an Updated Review. Curr Rheumatol Rep 18, 21 (2016). https://doi.org/10.1007/s11926-016-0571-2

Malignancies in Systemic Lupus Erythematosus – a 2015 Update

Gillian C Goobie, MD,1 Sasha Bernatsky, MD, PhD,2 Rosalind Ramsey-Goldman, MD, DrPH,3 and Ann E. Clarke, MD, MSc4

Systemic Lupus Erythematous and Malignancy Risk: A Meta-Analysis

Lihong Cao ,Hongyan Tong ,Gaixiang Xu,Ping Liu,Haitao Meng,Jinghan Wang,Xiaoying Zhao,Yongmin Tang,Jie Jin

Bernatsky S, Ramsey-Goldman R, Labrecque J, et al. Cancer risk in systemic lupus: An updated international multi-centre cohort study. J Autoimmun. 2013;42:130–135. [PMC free article] [PubMed] [Google Scholar]

Mellemkjér L, Andersen V, Linet MS, et al. Non-Hodgkin’s lymphoma and other cancers among a cohort of patients with systemic lupus erythematosus. Arthritis & Rheumatology. 1997;40(4):761–768. [PubMed] [Google Scholar]

Cao L, Tong H, Xu G, et al. Systemic lupus erythematous and malignancy risk: A meta-analysis. PloS one. 2015;10(4):e0122964. [PMC free article] [PubMed] [Google Scholar]

Hsu CY, Lin MS, Su YJ, et al. Cumulative immunosuppressant exposure is associated with diversified cancer risk among 14 832 patients with systemic lupus erythematosus: A nested case-control study. Rheumatology (Oxford) 2016 Apr [PubMed] [Google Scholar]

Matsushita S, Ishihara T, Kageshita T, Egawa K, Miyake T, Ono T. Multiple squamous cell carcinomas arising in lesions of discoidlupus erythematosus. J Dermatol 2004; 31: 73–75.

Bhat MR, Hulmani M, Dandakeri S, Kambil SM, Gatti Disseminated discoid lupus erythematosus leading to squamouscell carcinoma. Indian J Dermatol 2012; 57: 158–161

Published

2024-03-01

How to Cite

T, R., Ramachandran, M., & Rubina Harinarain, S. . (2024). Basal Cell Carcinoma in a Case of Systemic Lupus Erythematosus – A Case Report: Life Sciences-General surgery. International Journal of Life Science and Pharma Research, 14(2), L13-L17. https://doi.org/10.22376/ijlpr.2024.14.2.L13-L17

Issue

Section

Case Study