Clinical Case Of Rdeb And Scc

Anne Lucky, MD

Before beginning her PowerPoint presentation, Dr Anne Lucky apologized on beforehand   for the shocking images this presentation would show; especially the impression the images would made on the EB patients among the audience.

A 19 year old girl was presented with a non-healing, tender ulcer in the left shin in 2005. Although she was treated with silver dressings, the ulcer continued to enlarge. At surgery one found that the young girl had much more invasive and more extensive squamous cell carcinoma than was expected, and below the knee an amputation had to be performed.

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But after that, in more ulcers at the left upper thigh, which contained also staphylococcus   and streptococcus, a biopsy showed that the thigh also was threatened by invasive SCC. Finally the young woman refused further evaluation and treatment; because therapies were not successful. In 2006 the patient was removed to a hospice, where she died peacefully but much too early, 14 months after the diagnosis with SCC.

Summary

  • Squamous cell carcinoma often occurs in the 3rd decade of life.
  • It is rapidly progressive both to locally and to distant metastases, often at the time of presentation.
  • It is poorly responsive to therapy, but there have been very few trials.
  • Patients may choose to refuse further diagnostic and therapeutic intervention except for comfort care, especially pain management.

More information

annelucky@fuse.net

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