Squamous Cell Carcinoma (SCC)of the skin

Nurul Izzah Mat Sundari

What is Squamous Cell Carcinoma (SCC)?

Dysplastic proliferation of abnormal keratinocytes may arise de novo or in pre existing skin lesions such as actinic keratoses or Bowen’s disease.

Have invasive tumor cells within the dermis.

Normal structure of the skin

Types of SCCIn-situ

Bowen’s diseaseErythroplasia of Queyrat

Invasive SCC

Keratoacanthoma

Risk factors1. Increasing age2. Fair skin 3. High intensity of UV exposure4. Radiation 5. Immunosuppression6. Previous history of SCC7. Congenital disorders such as Gorlin’s syndrome8. Chronic wound or scar ( Marjolin’s ulcer)9. HPV10.Transplant patient who are medically

immunosuppressed

CLINICAL FEATURES

Rapidly growing,painful and markedly hyperkeratotic

Expanding plaques or

usually nodular

Base ill defined, indurated, and

usually ulcerated

Surface changes include crusting,

ulceration, or formation of a

cutaneous hornSome can be

verrucous and mistaken for viral warts or indeed

arise from a chronic viral wart

A round nodule with central hyperkeratosis, firm and indolent.

Ulcerated Squamous Cell Carcinoma (SCC) of the scalp.

SCC of the cheek/jawline area. The lesion is firm and keratotic.

SCC of the mouth with keratotic at the centre.

• Squamous cell carcinoma in situ: Bowen's disease.• A large, sharply demarcated, scaly, erythematous plaque.• Appears as a persistent red-brown, scaly patch that may

resemble psoriasis or eczema.

• Squamous cell carcinoma in situ :Erythroplasia of Queyrat.

• Well demarcated, red, and shiny plaque on genital mucosa.

• Keratoacanthoma• Symmetrical, dome-shaped nodule with an

overlying thinned, telangiectatic epidermis and a central keratin plug.

• Regional lymph nodes should be palpated for local metastasis

• May have involvement of other organs

• Biopsy• CT scan maybe indicated

Management

Surgical Medical

Ideally lesions should be excised with a 4-6mm margin Skin grafting maybe required Tumour curretage and cautery

Radiotherapy In patient who develop multiple SCCs such as renal transplant patient, secondary prophylaxis maybe considered with oral retinoids

Thank you

Actinic keratosis• A red, scaly plaque on light-

exposed skin due to dysplastic epidermal

keratinocytes. It may affect the face (including lower lip), bald pate,forearms, and dorsum of the hands

• presenting as a red yellow or beige plaque, 0.5–1 cm in diameter, with surface scale or crust. It may ulcerate or develop a cutaneous horn.