squamous cell carcinoma
TRANSCRIPT
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.