Squamous Cell Carcinoma Arising from Trophic Ulcer in a Treated Case of Hansen’s Disease

A 65-year-old male presented with an asymptomatic growth over the left forefoot for the past 2 months. On eliciting further history, the patient had lepromatous leprosy and was released from treatment (1 year of multidrug treatment) 15 years back. He had recurrent ulceration in bilateral feet which showed little tendency to heal. On examination, a large cauliflower-like exuberant fleshy growth was present, destroying the left forefoot anatomy. Sequelae of prior Hansen’s disease in the form of the right complete claw hand, left partial claw hand, resorption of digits over right foot and trophic ulcer over right sole were appreciated. A wedge biopsy from the growth confirmed the diagnosis of poorly differentiated squamous cell carcinoma (SCC). The case highlights the rare complication of secondary SCC in patients with Hansen’s disease and trophic ulcer [Figure 1].^[1,2]

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Figure 1:

Rapidly growing painless fungating verrucous growth over left sole distorting the normal foot anatomy. Trophic ulcer over the right sole with resorption of digits. Right complete ulnar claw hand with resorption of digits.

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