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Skin Cancer With Hidradenitis Suppurativa: Signs To Watch Out For

Posted on July 05, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Sarah Winfrey

Hidradenitis suppurativa (HS, or acne inversa) is an autoimmune skin disease that causes boils to develop in hair follicles where the skin rubs against itself, such as in the armpits, groin, and inner thighs. Research has found that HS can be connected to certain types of skin cancer — in particular, nonmelanoma skin cancer. Melanoma is considered the most serious type of skin cancer, and “nonmelanoma” refers to all other types of the condition.

If you have been diagnosed with HS, it’s important to understand this connection and know what to look for. This can help you detect any signs of skin cancer early on and alert your health care team as soon as possible.

Is Hidradenitis Suppurativa Connected to Skin Cancer?

Hidradenitis suppurativa seems to cause an increased risk of developing several kinds of cancer. Among these is skin cancer that is not melanoma. One study links HS with a 4.6-fold rise in risk, but more studies are needed to determine how many people diagnosed with HS also go on to develop nonmelanoma skin cancer. However high they are, these rates are believed to be significant and not a result of other causes.

Some researchers have even described HS as a premalignant (precancerous) condition. These study authors advocate taking precautionary measures to remove HS lesions, abscesses, cysts, and tunnels to prevent skin cancer. They argue that the usual methods of HS care — conservative (noninvasive) observation and treatment — are not sufficient, given the potentially dire consequences of skin cancer.

Why Might HS Cause Skin Cancer?

The exact connection between hidradenitis suppurativa and skin cancer is unknown. HS is known to cause high levels of inflammation in the affected areas of the skin, and chronic inflammation is a known cancer risk. HS may also alter the structure of the affected skin cells, causing changes that eventually become cancerous.

Skin Cancer Monitoring With HS

One of the most important ways to manage skin cancer successfully is to detect it early. It can then be treated sooner, before the cancer has had a chance to spread to other areas of the body (known as metastasis).

Those living with HS can check their skin for signs of malignancies themselves. They will likely also want to schedule regular skin checks with a dermatologist — preferably one who knows HS well and understands the difference between HS lesions and skin cancer. Two or more checks every year might be recommended, depending on a person’s history of skin cancer and their individual risk, as determined by their doctor.

All skin checks — whether performed by the person with HS, a loved one, or their doctor — should include the entire body. However, special attention should be paid to areas where HS and sun exposure might overlap, which is where skin cancer is most likely to develop.

It’s important to note that skin cancer can be more difficult to detect in people who have also been diagnosed with HS. Because their skin is already irregular and may be discolored, crusted, or scabbed in places, noting potential signs of cancer can be hard. That is why many people who live with HS ask a dermatology expert to examine their skin carefully rather than trying to do it themselves.

Skin Cancer Signs To Watch For

People diagnosed with HS will need to be on the watch for signs of nonmelanoma skin cancers. The most common types of these include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Each form has unique signs and symptoms.

Signs of Basal Cell Carcinoma

Key signs of basal cell carcinoma include:

  • A new scar not preceded by an injury — BCC can look like a scar, producing a flat lesion the color of or slightly darker than the person’s skin.
  • A shiny bump that seems waxy or like a small pearl — The nodule could be pink, red, or white or tan, brown, or black, depending on skin tone, and look like a mole, according to the Skin Cancer Foundation.
  • A sore that bleeds and scabs repeatedly — It may seem to heal but then return.
  • An irritated area — The patch may be reddish or itchy or simply remain discolored.
  • A small growth that starts out pink — The raised surface may feel crusty (like a scab) in the middle or have rolled edges and later develop blood vessels.

Signs of Squamous Cell Carcinoma

Key signs of squamous cell carcinoma include:

  • A flat, irritated spot or lesion with a crusty surface — The surface may appear like a scab or dry skin that does not go away or match the skin around it. These spots usually have irregular borders and are asymmetrical.
  • A red or discolored, painful lump or nodule that seems to appear under the skin — These bumps often change color as they progress.
  • A growth that is elevated — The edges usually rise higher than the growth’s center and may bleed randomly or when irritated. In some cases, these lesions appear or grow very quickly.
  • A growth that looks like a wart — It usually becomes larger than a wart, does not respond to wart treatment, and may crust and bleed.
  • An open sore that does not heal — The sore may seem to scab over but then grow or continue to hurt and bleed rather than get better.

Treating Skin Cancer

A number of treatment options for skin cancer are available, and they are the same for people who have been diagnosed with HS and those who have not.

In most cases, dermatologists will remove the cancerous growth and enough surrounding skin to ensure that it does not spread.

Sometimes, radiation, chemotherapy, or both will also be necessary to treat skin cancer. These treatments may be applied topically, taken orally, or received via an IV injection. Cancer doctors, or oncologists, will determine whether you need these therapies and work with you to find the best option for your needs.

Some people diagnosed with hidradenitis suppurativa may choose to pursue aggressive treatment to prevent skin cancer. Dermatology specialists can identify the necessary surgeries and procedures to eliminate or minimize HS.

Find Your Team

On myHSteam, the social network for people living with hidradenitis suppurativa, more than 25,000 members from around the world come together to join ongoing conversations, ask questions, and share their stories. It won’t be long before you find a team of people who understand life with HS.

Do you live with hidradenitis suppurativa? Do you also have skin cancer or regularly monitor your skin for signs of cancer? Share your thoughts or experiences in the comments below or by posting on myHSteam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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