Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Updated: Dec 26 2021

Squamous Cell Carcinoma

  • Snapshot
    • A 74-year-old man presents to the dermatologist’s office for his annual total body skin exam. His past medical history is significant for multiple actinic keratoses, previously treated with cryotherapy. At this visit, he points to a larger lesion on his ear, complaining that it grew back after last year’s cryotherapy. A shave biopsy was done and pathology reveals malignant cells invading the dermis. He is scheduled for an excision.
  • Introduction
    • Invasive primary skin malignancy arising from keratinocytes of skin or mucosa
    • Keratoacanthoma is a variant of low-grade squamous cell carcinoma
      • grows rapidly and regresses spontaneously
    • Bowen disease is a kind of cutaneous squamous cell carcinoma in situ that usually appears
      • well-demarcated
      • scaly patch or plaque
      • often erythematous; however,
        • can be pigmented or skin colored
  • Epidemiology
    • Common in fair-skinned individuals
    • Common in elderly patients
    • 2nd most common form of skin cancer (first is basal cell carcinoma )
    • Major risk factor = significant sun exposure (damage to keratinocytes)
      • actinic keratosis
      • actinic cheilitis
    • Other risk factors
      • immunosuppression (similar to treatment for organ transplant)
      • arsenic exposure
      • old scars or burns
      • xeroderma pigmentosum
      • ionizing radiation
    • Pathogenesis
      • typically develop from precursor actinic keratoses, but may arise de novo
      • slow-growing malignancy
      • metastases are rare
  • Presentation
    • Symptoms
      • typically asymptomatic, but may be tender especially if ulcerated
    • Physical exam
      • from actinic keratosis
        • red, poorly defined base with adherent yellow or white scale
      • de novo
        • sharply defined smooth, dull, red, dome-shaped nodule
        • crusted center
      • frequently ulcerates
      • frequently on sun-exposed areas
        • face, neck, hands, ears
        • common on lower lips
        • lesions often against a background of sun-damaged skin
          • atrophy, telangiectasias, blotchy hyperpigmentation
    • Diagnosis by skin biopsy
      • atypical keratinocytes and malignant cells
      • invasion into dermis
      • keratin “pearls” on histology
  • Differential
    • Actinic keratosis
    • Actinic cheilitis
  • Treatment
    • Prevention
      • sun avoidance
      • sunscreen use
    • Wide local surgical excision
      • with histologic confirmation of negative margins
    • Radiation if surgery is not an option
  • Complications
    • Potential recurrence if immunosuppressed
  • Prognosis
    • If treated, very excellent prognosis
    • Lesions on lip, ear, or scalp may be more aggressive
1 of 0
1 of 6
Private Note

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options