Diagnostic Dilemmas: Squamous Cell Carcinoma
Diagnostic Dilemmas: Squamous Cell Carcinoma
A 73-year-old white woman presented to the wound clinic with a chronic wound on the dorsum of her left second toe. The patient reported that the wound developed 3 years after cryotherapy to the toe. She had tried many different dressings and ointments on the wound, including bacitracin, Acticoat (Smith & Nephew, Largo, Fla), and wet-to-dry dressings, without improvement. She had received 2 unsuccessful allogenic grafts. An autologous skin graft resulted in significant but incomplete healing. She noted that the wound had grown in size over the several months preceding presentation.
The patient's medical history was significant for squamous cell carcinomas of the right leg, left ankle, and right forearm, diabetes mellitus, and rheumatoid arthritis. Her medications included methotrexate, leucovorin, risedronate, metformin, glyburide, and prednisone.
A 73-year-old white woman presented to the wound clinic with a chronic wound on the dorsum of her left second toe. The patient reported that the wound developed 3 years after cryotherapy to the toe. She had tried many different dressings and ointments on the wound, including bacitracin, Acticoat (Smith & Nephew, Largo, Fla), and wet-to-dry dressings, without improvement. She had received 2 unsuccessful allogenic grafts. An autologous skin graft resulted in significant but incomplete healing. She noted that the wound had grown in size over the several months preceding presentation.
The patient's medical history was significant for squamous cell carcinomas of the right leg, left ankle, and right forearm, diabetes mellitus, and rheumatoid arthritis. Her medications included methotrexate, leucovorin, risedronate, metformin, glyburide, and prednisone.
