clobetasol and Carcinoma-in-Situ

Topics: Acitretin; Carcinoma in Situ; Clobetasol; Female; Humans; Lichen Sclerosus et Atrophicus; Precancerous Conditions; Randomized Controlled Trials as Topic; Treatment Outcome; Vulva; Vulvar Neoplasms

Topics: Acitretin; Carcinoma in Situ; Clobetasol; Female; Humans; Lichen Sclerosus et Atrophicus; Precancerous Conditions; Vulva; Vulvar Neoplasms

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Betamethasone; Carcinoma in Situ; Carcinoma, Squamous Cell; Clobetasol; Desonide; Female; Humans; Hydrocortisone; Methylprednisolone; Middle Aged; Neoplasm Recurrence, Local; Vulvar Lichen Sclerosus; Vulvar Neoplasms

The cosmetic use of bleaching products is common among women from sub-Saharan Africa. The most frequently used products are highly potent corticosteroids (clobetasol propionate) and hydroquinone. Herein, we report 8 cases of SCC in women using skin bleaching products for cosmetic purposes. Our aim is to describe the epidemiological, clinical and pathological aspects of the carcinomas observed during the course of skin lightening.. We conducted a descriptive multicentre study from August 2005 to January 2016 in three dermatology units in Senegal. We included all patients consulting for cutaneous squamous cell carcinoma associated with skin bleaching. Sociodemographic, clinical, paraclinical and therapeutic data were recorded.. A total of 8 female patients were included. The mean age was 48.1 years (37-63 years). Topical hydroquinone and highly potent corticosteroids were the main products used over the whole body, for an average duration of 20.3 years. No pre-neoplastic skin disease was found in our patients. The clinical aspects of tumours were as follows: cauliflower-like (n=4), ulcerated (n=3) and nodular (n=1). The average development time before consultation was 6.75 months. All the cutaneous squamous cell carcinomas were localized to lichenoid lesions or exogenous ochronotic lesions on photo-exposed areas: face (n=1), neck (n=3) or upper back (n=4). The most common histopathological type was the infiltrating form and there was one case of in situ carcinoma. The outcome was favourable in six of eight patients after surgical resection. Two deaths occurred: one through tumour recurrence and the other through haemorrhagic shock.. From 2005 to 2016, eight cases of cutaneous squamous cell carcinomas associated with cosmetic use of bleaching products were reported in Senegal. The mechanism was not fully elucidated and further studies are necessary. These observations provide an additional argument for combating this practice and including skin bleaching among known risk factors for squamous cell carcinoma.

Topics: Adult; Back; Carcinoma in Situ; Carcinoma, Squamous Cell; Clobetasol; Face; Female; Humans; Hydroquinones; Middle Aged; Neoplasm Recurrence, Local; Senegal; Shock, Hemorrhagic; Skin Lightening Preparations; Skin Neoplasms

Topics: Carcinoma in Situ; Clobetasol; Diagnosis, Differential; Glucocorticoids; Humans; Lasers, Gas; Male; Penile Neoplasms

Topics: Administration, Topical; Anti-Inflammatory Agents; Biopsy; Carcinoma in Situ; Clobetasol; Diagnosis, Differential; Female; Humans; Middle Aged; Plasma Cells; Vulvar Neoplasms; Vulvitis

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Aminoquinolines; Antineoplastic Agents; Carcinoma in Situ; Clobetasol; Contraceptives, Oral; Female; Humans; Imiquimod; Papillomavirus Infections; Pemphigus; Treatment Outcome; Vulvar Diseases; Vulvar Neoplasms

Histological changes of lichen sclerosus (LS)--a chronic inflammatory disease--are frequently found in association with squamous cell carcinoma (SCC) of the vulva, suggesting that women with this disorder are at increased risk. However, follow-up studies have been less convincing, showing that the vast majority of these patients do not go on to develop cancer. In this study, a series of 211 women affected by histologically demonstrated vulval LS were treated with topical therapy (testosterone, clobetasol) and followed prospectively by repetitive vulval examination. Three patients developed SCC of the vulva (two invasive, one in situ) at the sites affected by LS during an average follow-up period of 1 year and 8 months. Compared with the reference population, the number of cases of invasive SCC detected significantly exceeded the number estimated to occur in a comparable age-matched group. The standardized incidence rate of vulval SCC in the LS cohort was 317 (95% CI 35.7-1146.2). Cumulative risk was 14.8% (0.06% in the general female population), with a relative risk of 246.6. In conclusion, these data support the view that LS is a precursor of SCC, although characterized by slight tendency to evolve to carcinoma. Medical treatment of LS, although useful in the control of severity of disease, did not seem to be able to prevent the evolution to malignancy.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Carcinoma in Situ; Carcinoma, Squamous Cell; Case-Control Studies; Clobetasol; Cohort Studies; Female; Follow-Up Studies; Glucocorticoids; Humans; Incidence; Italy; Lichen Sclerosus et Atrophicus; Longitudinal Studies; Middle Aged; Neoplasm Invasiveness; Precancerous Conditions; Prospective Studies; Risk Factors; Testosterone; Vulvar Diseases; Vulvar Neoplasms