A Case of Multiple Self-Healing Squamous Epitheliomas of Ferguson Smith in a Patient on Systemic Immunosuppression for Rheumatoid Arthritis

We present the case of an 82-year-old gentleman who was referred with an 18-month history of multiple enlarging ulcerated, non-tender nodules on a background of a 30-year history of multiple self-healing squamous epitheliomas of Ferguson Smith (MSSE-FS). Historically, his lesions regressed spontaneously within a few months of their appearance. At the time of presentation, he was taking sulfasalazine for rheumatoid arthritis (RA), and at higher doses, he noted a deterioration in his MSSE-FS. A variety of treatment options were trialed to no avail. After discussion with rheumatology, sulfasalazine was stopped after which his lesions rapidly regressed and have now mostly healed, however his RA has subsequently deteriorated and further treatment options are still being considered.