PMC5301118_01
a A dome-shaped, easy-to-bleed nodule on the parietal scalp. b Dermal infiltration of atypical keratinocytes with dyskeratotic cytoplasm. c Another red nodule that developed in the left temporal region. d Dermal infiltration of atypical keratinocytes with dyskeratotic cytoplasm. e Keratotic lesions were apparent around the grafted area. f Dermal infiltration of atypical keratinocytes with dyskeratotic cytoplasm.
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F1
On her initial visit, physical examination revealed a dome-shaped, easy-to-bleed nodule on her parietal scalp (Fig. 1a). Skin biopsy from the nodule revealed a dermal infiltration composed of atypical keratinocytes with dyskeratotic cytoplasm (Fig. 1b). Four years after the initial excision, another red nodule developed in the left temporal region (Fig. 1c). Since the histological findings of the second tumor were similar to those of the first cutaneous SCC (Fig. 1d), we excised the tumor with a 10-mm margin. Eleven months after the second surgical treatment, a keratotic lesion was apparent around the grafted area (Fig. 1e), and again we excised it with a 10-mm margin. The histological findings of the third tumor were similar to those of the first cutaneous SCC, which was a widely spread SCC in situ (Fig. 1f).
Paraffin-embedded tissue samples from the tumor sites (a, b, d) or surgical margin (c) were deparaffinized and stained with anti-IL-17R antibody (a-c) and anti-IL-17 antibody (d). The sections were developed with Liquid Permanent Red. Original magnification, x50 (a, c), x100 (d), x200 (b).
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F2
IL-17 as well as IL-17R in the lesional skin of each of the cutaneous SCC in our case. Immunohistochemical staining revealed that these atypical keratinocytes strongly expressed IL-17R (Fig. 2a, b), whereas normal keratinocytes in the marginal area of the tumor did not (Fig. 2c). In contrast, IL-17-producing cells were detected in the dermis of both the tumor area and the marginal area (Fig. 2d).