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Author: Dr David Veitch, Dermatology Registrar, Department of Dermatology, Leicester Royal Infirmary, Leicester, United Kingdom. DermNet NZ Editor in Chief: Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell/Maria McGivern. August 2018.
Carcinoma cuniculatum is a rare, slow-growing variant of cutaneous squamous cell carcinoma (SCC). It tends to affect the sole of the foot, but it can occur at other sites, such as the oral cavity and genitals.
Carcinoma cuniculatum is also known as:
Risk factors for carcinoma cuniculatum include viral warts due to human papillomavirus infection (HPV), tobacco (smoking or snuff), chemical mutagens, and in the vulva, lichen sclerosus . The genital variant tends to affect older people.
The above risk factors give rise to a variant of low–grade SCC. The genetic factors are unknown.
Carcinoma cuniculatum is a solitary, slow growing, warty, papillomatous plaque.
In rare cases, carcinoma cuniculatum can metastasise.
Although the diagnosis of carcinoma cuniculatum may be suspected clinically, biopsy is essential to confirm the diagnosis.
The differential diagnosis for carcinoma may include:
Carcinoma cuniculatum is usually treated by surgical excision. Oral retinoids, methotrexate, laser surgery, and topical imiquimod have been reported to be effective where surgery is contraindicated [2,3].
Radiotherapy is to be avoided, as this can trigger the development of an anaplastic form of SCC.
The prognosis of carcinoma cuniculatum is very good if treated with surgical excision. Distant or local lymph node metastases are rare.
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