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CutaneousSquamousCell
CarcinomaDifferentialDiagnoses
DDX

DiagnosticConsiderations
Althoughthetypicalpatientwithcutaneoussquamouscellcarcinoma(cSCC)isofnorthernEuropean
descentandpresentswithafamilyhistoryofskincancer,apersonalhistoryofpreviousskincancer,
and/oranextensivehistoryofsunexposure,adetailedhistoryandphysicalexaminationiscrucial
(seePresentation).Inaddition,theclinicianshouldbeawareoftheriskfactorsforhighriskdisease
(seePrognosis).
Marjolinulcerappearsasanewareaofinduration,elevation,orulceration,atthesiteofapreexisting
scarorulcer.ThediagnosisofMarjolinulcershouldbeconsideredinanyulcerthatfailstohealwith
standardtherapy.
Pseudoepitheliomatoushyperplasia(PEH)isahistologicfindinginkeratoacanthomaandSCC,as
wellasincertainotherreactions,suchastattooreactions.Theclinicianmustdeterminewhetherthe
PEHisassociatedwithcancer.Inaddition,withlesionscontainingPEHinpatientswithahistoryof
lupus,theclinicianmustdifferentiatebetweenlesionsthataredefinitelySCCandlesionsof
hypertrophiclupusthataremimickingSCCorkeratoacanthoma.
Otherconditionstobeconsidered
ThefollowingconditionsshouldalsobeconsideredwhenevaluatingapatientwithsuspectedSCC:
Cancerouslesions:Sebaceouscellcarcinomaandrhabdomyosarcoma
Congenitaltumors:Dermoids,dermolipomas,andepiscleralosseouschoristoma
Conjunctivaldegeneration:Pingueculaandamyloidosis
Hereditarylesions:Benignhereditaryintraepithelialdyskeratosis
Lymphoidtumors:Lymphoidneoplasia,benignreactivelymphoidhyperplasia,andleukemic
infiltrates
Neuroectodermaltumors:Nevus,primaryacquiredmelanosis,andmelanoma
Papillomas:Humanpapillomavirus(HPV)inducedpapillomas
Pseudocancerouslesions:Pseudoepitheliomatoushyperplasiaandkeratoacanthoma
Vascularlesions:Angioma,lymphangioma,Kaposisarcoma,andpyogenicgranuloma
Xanthomatouslesions:Juvenilexanthogranulomaandfibrousxanthoma

DifferentialDiagnoses
ActinicKeratosis
AllergicContactDermatitis
AtopicDermatitis

AtypicalFibroxanthoma
BasalCellCarcinoma
BenignSkinLesions
BowenoidPapulosis
ChemicalBurns
LimbalDermoid
PyodermaGangrenosum
Workup
WhattoReadNextonMedscape
RelatedConditionsandDiseases

SkinCancerMelanoma
SkinCancerMerkelCellCarcinoma
TheRoleofSentinelNodeBiopsyinSkinCancer
CutaneousManifestationsofSmoking
BasalCellCarcinomaGuidelines
MalignantMelanomaGuidelines
News&Perspective

SkinCancerScreeningUrgedforNonwhiteOrganTransplantRecipients
ConfocalMicroscopyHelpsSpotSkinCancerNoninvasively

USPSTF'sFinalWordonSkinCancerExamsinPrimaryCare
Tools

DrugInteractionChecker
PillIdentifier
Calculators
Formulary
Slideshow

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