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Histological findings after intralesional methotrexate treatment in cutaneous squamous cell carcinoma
Author(s) -
BergónSendín Marta,
ParraBlanco Verónica,
PulidoPérez Ana,
NietoBenito Lula María,
RosellDíaz Ángel Manuel,
SuárezFernández Ricardo
Publication year - 2020
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.14377
Subject(s) - medicine , methotrexate , dermatology , basal cell , pathology
Intralesional methotrexate (il‐MTX) has been reported as a useful therapy in keratoacanthoma (KA) and cutaneous squamous cell carcinoma (cSCC). However, the data available on the histological changes induced by this therapy are very scarce. We conducted a single center, prospective study that included 65 cases of cSCC treated with il‐MTX before surgical treatment. Two histological studies were conducted in all patients: before intralesional treatment and after surgical removal. Lesions were assessed longitudinally both clinically and histologically. 60 patients (92.3%) responded to il‐MTX treatment. There were no differences regarding aggressive histological features of the cSCC between responder and non‐responder patients. All cases showed a chronic inflammatory infiltrate after il‐MTX. Intratumoral necrosis areas were frequently observed. All cases showed local fibrosis with fine thickening of collagen bundles. Il‐MTX induces a chronic lymphohistiocytic inflammatory reaction in both clinical responder and nonresponder patients. Tumor involution after il‐MTX is followed by a fine fibrosis that explains the great cosmetic results and improves the accuracy of the follow‐up.