Allergic contact dermatitis (ACD) is a well-recognized adverse event associated with implantable medical devices that contain allergenic materials like nickel. However, other cutaneous consequences of such chronic exposures are not well understood. Herein, we report a clinical case of Marjolin's ulcer, an invasive squamous cell carcinoma (SCC) developing at the site of chronic inflammation from a previously unreported cause: chronic ACD caused by an orthopedic implant. To determine whether chronic ACD promotes skin carcinogenesis, we utilized a standard murine model of contact hypersensitivity. The chronic application of 1-Fluoro-2,4-dinitrobenzene (DNFB) to carcinogen-treated skin led to the development of papillomas and aggressive SCC. The DNFB-driven chronic ACD was marked by type 2 inflammation that mediated the skin carcinogenesis. Importantly, we found similar tumor-promoting inflammation surrounding the SCC in our patient. Our findings demonstrate that chronic ACD caused by constant exposure to an allergen can promote tumorigenesis at skin sites with pre-existing cancer-initiated cells. This has great implication for the monitoring of implantable devices that are placed in the proximity of the skin and highlights the importance of patch testing prior to the placement of such devices.
Citation Format: Shadmehr Demehri, Trevor J. Cunningham, Eva A. Hurst, Andras Schaffer, David M. Sheinbein, Wayne M. Yokoyama. Chronic allergic contact dermatitis, A potent tumor promoter of Marjolin's ulcer. [abstract]. In: Proceedings of the AACR Special Conference: Tumor Immunology and Immunotherapy: A New Chapter; December 1-4, 2014; Orlando, FL. Philadelphia (PA): AACR; Cancer Immunol Res 2015;3(10 Suppl):Abstract nr A64.
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