Scalp Squamous Cell Carcinoma in Xeroderma Pigmentosum
A three-year-old boy, known case of XP, presented to our clinic with an ulcerating mass in the scalp []. The ulcer was round in shape, measured about 10 × 15 cm, with punched out edges. There was no discharge or bleeding. At presentation, he was irritable and photophobic. There were diffuse hyperpigmented lesions over the face, trunk, and extensor surface of the upper extremities. The skin was unnaturally dry and rough all over the previously mentioned areas. Hyperpigmented hyperkeratotic changes were observed over some lesions. There was a congestion of conjunctivae of both eyes. Neurological examination was normal. He has a family history of thalassemia major in two siblings, but no similar case. There is a positive history of consanguinity. Biopsy showed moderately differentiated squamous cell carcinoma. The patient presented with a late diagnosis of SCC that has been progressing for 2 years. At age of three months, he started to develop rashes and hyperpigmentation (freckles) on the face and extremities. Previously, he sought medical advice that has poor diagnostic facilities near his town. Computerized Tomography (CT) scan of the brain demonstrates evidence of erosion of the outer and inner plate of scalp exposing the dura with no intracranial extension. Excision of the lesion with 1 cm safety margin circumferentially was done. Scalp reconstruction was performed using local flaps and skin graft. A written informed consent was obtained from the parents for publication of this case report and any supplementary image.