A case of multiple self-healing squamous epitheliomas of Ferguson-Smith in a patient on systemic immunosuppression for rheumatoid arthritis

An 82-year-old man was referred with an 18-month history of multiple enlarging ulcerated, nontender 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. 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.