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Systemic sclerosis after silicone injections for facial cosmetic surgery

vessels with a whitish halo was a confounding aspect because never previously described in CCA. This pattern suggested a DS diagnosis of a fast growing epidermal tumours, like initially invasive SCC, but this hypothesis was excluded considering the dotted vessels arrangement. In conclusion, we believe that this case is of interest as it could indicate an aetiological role of biological therapy for CCA development in a patient with a psoriatic predisposing background. In addition, the diagnostic role of the CCA dermoscopic pattern is confirmed even in the occurrence of a newly observed DS vascular arrangement, probably due to the rate of growth of the lesion. The occurrence of CCA during infliximab can be regarded as a further psoriatic paradoxical skin reaction to the drug and could also support its probable reactive inflammatory origin, also taking into account that inflammation patterns almost invariably develop faster than those observed in true tumours.