A case of basal cell carcinoma which occurred on chemical burn scar frequently.

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A 64-year-old Japanese male presented multiple lesions of basal cell carcinoma (BCC) on the face on a poikilodermic basis. The lesions numbered nine, and two were reddish, erosive, dome-shaped, thumb-finger-sized tumors located on the nose and left upper eyelid and the other seven were blackish flecks, one of them had ulceration. Histological examinations revealed nodular BCC, a part of which was differentiated into sebaceous glands, and the flecks showed either adenoid or superficial BCC. Although the tumoral lesion of the eyelid was complicated by MRSA infection, calcification, foreign body granuloma and infiltration with plasma cells and lymphocytes were found around the tumor nests and a local immunodeficiency was not confirmed.The poikiloderma on the face was probably due to a single exposure to poisonous gas, composed of yellow mustard gas (Yperite), difenylcyanarsine, hydrocyanicacid and chloracetophenone, and resulting chemical burn at age of 18 or some therapy (probably radiation therapy) for psoriasis vulgaris at age 32.Multiple BCC was, therefore, probably due to the combination of the poisonous effects of the gas, chemical burn scar and radiation therapy for psoriasis, but the true cause could not be determined.Wide excision of the lesions and skin grafting were performed. For the prevention of developement of new lesions and the treatment of psoriasis, an aromatic retinoid is being given.
日本皮膚悪性腫瘍学会の論文