# Human Papillomavirus (HPV)-Positive Perianal Squamous Cell Carcinoma in a Patient With Hidradenitis Suppurativa and Psoriasis

## TL;DR

A man with hidradenitis suppurativa and psoriasis developed perianal squamous cell carcinoma linked to HPV infection, highlighting the need for early detection and monitoring.

## Contribution

This case report highlights the rare but serious risk of SCC in HS patients with HPV infection and chronic inflammation.

## Key findings

- A 43-year-old man with HS and psoriasis developed perianal SCC associated with HPV types 6 and 16.
- The tumor infiltrated the sacral bone and showed lymph node metastasis, requiring radical surgery and radiotherapy.
- Monoclonal IgG gammopathy and secondary thrombocytosis were observed due to chronic inflammation.

## Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that can lead to rare but aggressive complications, including squamous cell carcinoma (SCC), particularly in the anogenital region. Risk factors such as human papillomavirus (HPV) infection, chronic inflammation, and coexisting conditions such as psoriasis can increase the likelihood of malignant transformation in HS lesions.

We report a 43-year-old man with a history of HS (Hurley stage II) and psoriasis who developed a rapidly progressing perianal SCC. The patient, a chronic smoker, tested positive for low-risk HPV type 6 and high-risk HPV type 16. Imaging revealed an extensive tumor mass infiltrating the sacral bone and surrounding tissues. Histopathology confirmed well-differentiated SCC with inguinal lymph node metastasis. The patient underwent radical surgery and radiotherapy. Laboratory findings showed monoclonal immunoglobulin G (IgG) gammopathy and secondary thrombocytosis related to chronic inflammation.

SCC is a rare but serious complication of HS, particularly in the presence of chronic inflammation and HPV infection. Early detection through regular biopsies and vigilant monitoring of high-risk patients is essential. The consideration of HPV vaccination in severe HS cases, especially those undergoing immunosuppressive therapy, may reduce the risk of malignant transformation.