Squamous cell carcinoma of the skin in both palms, axillary node, donor skin graft site and both soles—associated hyperkeratosis and porokeratosis

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Abstract
A 74-year-old woman presented with skin squamous cell carcinomas on both palms, ankles and soles. The patient also had biopsy-proven porokeratosis. There was hyperkeratosis of the palms and soles. The left palm cancer was excised and skin grafted, but recurred. A nodule in the scar of the donor site of the skin graft in the left upper arm was biopsy-proven squamous cell carcinoma. A metastatic left axillary lymph node was excised. There were no palpable metastatic lymph nodes in either the groin or right axilla. All cancers were irradiated and disappeared, as did the incidentally irradiated hyperkeratosis. Porokeratosis may be associated with skin squamous cell carcinoma, yet in this case porokeratosis could not be identified in the heavily hyperkeratotic palms and soles. Despite poor prognostic signs, i.e. the location in the palm, and metastasis,the patient has done well so far.