Introduction: Squamous cell carcinoma (SCC) is a rare complication of long-standing discoid lupus erythematosus (DLE). The reported risk factors associated with the malignant transformation include chronic inflammation, scarring, immunosuppression, and the dysfunctional healing already evident in discoid lesions. If underdiagnosed and left untreated, this may lead to higher rates of recurrences, metastases and death. Objective: The main objective of this article is to report the diagnosis and management of a DLE-associated SCC on the upper lip of an elderly Filipino female. A short discussion on the pathogenesis and treatment of this disease entity is also presented.ugs/topical medications, family history and accompanying systemic symptoms were reviewed and analyzed. Case: A 78-year-old female, pawid maker, developed a rapidly growing verrucous tumor measuring 4.0 x 2.0 x 2.0 cm from a depigmented atrophic plaque located on the upper lip. Initial histopathologic findings were consistent with SCC and DLE. Considering the tumor size and the challenging anatomical location, the surgical oncology and plastic surgery team carried out a wide excision with 5 mm margin of the entire upper lip mass and surrounding plaque, followed by lip reconstruction. Biopsy findings of the excised mass were consistent with the initial findings. Three months post-operation, there was significant wound healing with no recurrences. Conclusion: Although the incidence is rare, SCC occurring in DLE is considered to be high-risk and should warrant early recognition and prompt treatment. In this paper, the authors also highlight the use of a standard wide excision in lieu of Mohs Microscopic Surgery as an alternative option where resources are limited.
surgical flaps ; Lupus Erythematosus, Discoid ; Carcinoma, Squamous Cell

Nevoid hyperkeratosis of the nipple and areola (NHNA) is a rare, asymptomatic skin condition characterized by verrucous, hyperpigmented papules, and plaques. It predominantly affects the nipple and areola, often bilaterally. Less than 50 cases have been reported worldwide, with only 39% showing unilateral breast involvement. In the Philippines, a single medical literature from 2014 describes two cases of adolescent‑onset NHNA. We report a rare case of a 40‑year‑old, Filipino woman with a 1‑year history of a mildly pruritic, solitary, well‑demarcated, irregularly shaped, black papule that progressed into a plaque on her right areola. There was suspicion of cutaneous malignancy due to some of the clinical features of the lesion and lack of response to initial treatment. With a correlation between clinical presentation and histopathologic findings, the features were consistent with NHNA. This is a benign skin condition that can mimic and must be differentiated from malignant tumors. Various treatment modalities were described in different medical literatures, some resulting in recurrence or treatment failure, but there is no standard management for this condition. Skin biopsy is crucial to rule out malignancy in cases presenting with persistent and progressively solitary pigmented lesions that do not respond to topical medications. The usual treatment options based on literature include various topicals, lasers, and surgical procedures. In our case, clobetasol propionate ointment was used. While most published cases show varied responses to topical corticosteroids, the result in our case was significant.
Nipples ; Clobetasol ; Nipples