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SCC with keratoacanthoma lesions found on tattooed lips

A woman developed multiple eruptive squamous cell carcinomas with features of keratoacanthoma beginning approximately 2 months after a red ink tattoo of the vermilion lips, according to recently published study results.

“The majority of reported [squamous cell carcinomas (SCCs)] and [keratoacanthomas] have been observed within red ink tattoos, whereas most reported cases of melanoma and basal cell carcinoma have been noted on black, dark blue or dark ink tattoos,” the researchers wrote. “However, the link between tattooing and skin cancer remains unclear.”

The researchers, based in New Hampshire, reported on a 56-year-old woman with no prior personal or family history of skin cancer who had presented with a 4-mm papule on the vermilion approximately 2 months after her upper and lower vermilion lips were tattooed with red ink in Canada. A biopsy showed well-differentiated SCC with features of keratoacanthoma and exogenous pigment, with biopsy edges involved.

Multiple new 2-mm to 3-mm papules on the upper and lower lips were present approximately 1 month later.

A well-healed scar was present at the original biopsy site, with no recurrence, and no further treatment performed.

The woman underwent photodynamic therapy for three lesions on the upper and lower lips after biopsy of one of the new papules of the left upper vermilion lip showed an SCC with features of keratoacanthoma. Photodynamic therapy response was incomplete, and the remaining lesion treated with pulsed dye laser, 595 nm, combined with photodynamic therapyfor resolution of the lesion.

Shave excision was used to treat a new 3-mm keratotic papule on the right lower vermilion lip 6 weeks later, as well as a new 2-mm keratotic papule on the right upper vermilion lip, which developed 5 weeks following.

At follow-up 1 year after the original biopsy, there were well-healed scars and no clinical recurrence of the lesions.

“Follow-up at one year demonstrated no recurrent lesions after treatment with shave excision, despite positive biopsy edges,” the researchers wrote.  – By Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.