Use of Bilayered Wound Matrix Dressing* in the Management of a Well-Differentiated Verrucous Squamous Cell Carcinoma with Dermal Invasion

Verrucous squamous cell carcinoma (SCC), also known as Ackerman's tumor, is a rare variant of SCC, especially in the foot where only a handful of cases have been mentioned in previous publications. Wide margin surgical excision is generally curative for these lesions. Large skin deficits secondary to excising the lesion at the site may cause a postoperative complication. We discuss the case of a 50-year-old male who presented with a chronic, painful, growing soft tissue lesion along the dorsal aspect of the 2nd digit with no history of trauma, which had been present for 10 months. Initially through soft tissue biopsy of the suspicious lesion, it was diagnosed as a cutaneous horn lesion. Once MRI confirmed no bony involvement, surgical resection with clear margins of the lesion was performed. After surgical resection, it was histopathologically confirmed to be a well-differentiated verrucous squamous cell carcinoma. A large soft tissue deficit was noted to the surgical site intra-operatively. A bilayered wound matrix dressing* was immediately applied to cover the soft tissue defect and expedite surgical wound healing. The patient has followed up for six months. The area has healed with no skin deficit and is pain free with return to normal physical activity. Our case report exemplifies that application of a bilayer wound matrix dressing* should become a routine consideration following surgical excision of a SCC that cannot be primarily closed in the foot to allow for expedited healing.