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An event is serious (based on the ICH definition) when the patient outcome is:
* congenital anomaly
* other medically important event
In a descriptive multicenter study, eight women aged 37−63 years were described, who developed cutaneous squamous cell carcinoma (SCC) during treatment with hydroquinone and clobetasol [clobetasol propionate] (n=7) or hydroquinone (n=1); two women died subsequently due to the SCC.
The women were undergoing treatment with topical hydroquinone and clobetasol for the purpose of skin bleaching since 10−35 years [dosage not stated]. They presented for consultation with symptoms of SCC. Histological exams confirmed the presence of SCC which was cauliflower-like (n=4), ulcerated (n=3) and nodular (n=1). The SCC were localised to lichenoid lesions, poikiloderma or exogenous ochronosis on the neck (n=3), face (n=1) or upper back (n=4).
The women underwent surgical resection of the SCC and the outcome was favourable in 6 out of the 8 women. One women (patient 1) developed bone metastasis and died following tumour recurrence. Another woman (patient 8) died due to haemorrhagic shock.
Author comment: "These chronic skinlesions are common but rarely prompt patients to consult a doctor; they are usually associated with long-term use of hydroquinone and clobetasol propionate." "Our aim was to report. . .SCC associated with cosmetic use of skin bleaching products in Senegal."