Surgical Excision Combined with Photodynamic Therapy for Squamous Cell Carcinoma Arising in Lupus Vulgaris

Cutaneous squamous cell carcinoma (SCC) is a common non-melanoma skin cancer, often related to sun damage in lighter skin. However, chronic inflammatory conditions such as lupus vulgaris (LV) also predispose patients to SCC. We report a rare case of secondary SCC in a 54-year-old patient with a 20-year history of untreated LV. Two months prior, the patient developed papules on the right cheek that ulcerated with purulent discharge. Although laboratory tests and histopathology initially supported a diagnosis of lupus erythematosus, tissue biopsy unexpectedly revealed a moderately differentiated keratinizing SCC. The lesion was surgically excised, followed by cosmetic closure and adjuvant photodynamic therapy (PDT), alongside systemic anti-tuberculosis treatment. At 6 months follow-up, no recurrence was observed and the inflammatory rash had resolved. This case highlights the importance of considering SCC in chronic LV patients. Early detection and comprehensive management are essential.