If you live with Hidradenitis Suppurativa (HS), you are no stranger to painful, non-healing wounds. Research has shown that people living with HS have a higher chance of developing skin cancer, specifically squamous cell carcinoma (SCC), in the areas where these non-healing wounds typically occur. It is important to keep in mind that HS can occur anywhere on the body where there is a hair follicle, meaning you can get HS anywhere other than the lips, palms, and soles of the feet. In those living with HS, SCC most commonly occurs in the groin and perineum areas. This risk of developing SCC is rare, but significant. As a patient it can be difficult to distinguish SCC from a typical non-healing HS wound, which is why it’s important to have your skin checked at least every year by a dermatologist.
What is SCC?
Squamous cell carcinoma, or SCC, is a form of non-melanoma skin cancer that starts in the outermost layer of the skin. It can affect up to 30% of the general population and is usually caused by ultraviolet radiation from the sun. For those living with HS, it can look very similar to a typical non-healing HS wound.
Why are people living with HS at a higher risk for skin cancer?
How can SCC develop in areas that don’t get much sun exposure? In those living with HS, ongoing skin inflammation can lead to damage at the cellular level, increasing the risk of SCC. As a result, this type of skin cancer can develop in the areas most affected by HS.
Why does early detection matter?
SCC can be aggressive, causing damage to the surrounding tissues if left untreated. In rare cases, it can even spread to other parts of the body. If detected early, SCC is highly treatable. It is recommended that those living with HS schedule yearly full skin checks with their dermatologist.
How do I tell the difference between SCC and HS?
It can be difficult to tell the difference since many of the characteristics sound just like our normal HS abscesses. Key features of SCC that those living with HS should be aware of:
● An open sore that doesn’t heal for months, even with your regular HS treatment
● Irritated flat lesions that have asymmetrical or irregular borders, bleed for no reason, or continuously form a crust
● Painful nodules that change colour or shape
● Growing wart-like lesions which do not respond to wart treatment
● Lesions that otherwise behave differently from your typical HS
If you notice any changes, consider speaking to your healthcare provider about a referral to a dermatologist or to your dermatologist directly. You might say to your healthcare provider, "I know that HS puts me at a higher risk of squamous cell carcinoma. I’ve noticed some changes in my skin, and I’d like to be evaluated by a dermatologist." This clear and informed approach can help guide the conversation and ensure your concerns are addressed!
References:
Racanelli E, Jfri A, Gefri A, O’Brien E, Litvinov I.V, Zubarev A, Savin E, Netchiporouk E. Cutaneous Squamous Cell Carcinoma in Patients with Hidradenitis Suppurativa. Cancers 2021, 13, 1153. https://doi.org/10.3390/cancers13051153
Huang S, Jiang J, Wong HS, Zhu P, Ji X, Wang D. Global burden and prediction study of cutaneous squamous cell carcinoma from 1990 to 2030: A systematic analysis and comparison with China. J Glob Health. 2024 May 3;14:04093. doi: 10.7189/jogh.14.04093. PMID: 38695259; PMCID: PMC11063968.
Written by Grace Xiong, Medical Student Class of 2026, McMaster University
Edited by Brindley Brooks
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