Longstanding hypertrophic lichen planus may be complicated by the development of a squamous cell carcinoma.
Patient selection: hypertrophic lichen planus
Risk factors:
(1) longstanding lichen planus
(2) sun-exposed skin
Clinically hypertrophic lichen planus and squamous cell carcinoma may overlap. A change in a chronic skin lesion with proliferative change or ulceration would be of concern.
On histology a very well-differentiated squamous cell carcinoma can be difficult to diagnose conclusively.
Features of a squamous cell carcinoma:
(1) marked nuclear atypia
(2) invasive growth
(3) lymphovascular or perineural invasion
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