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 Bowens disease.

Have invasive tumor cells within the dermis.

Normal structure of the skin



Types of SCC
In-situ
Bowens disease
Erythroplasia of Queyrat
Invasive SCC
Keratoacanthoma
Risk factors
1. Increasing age
2. Fair skin
3. High intensity of UV exposure
4. Radiation
5. Immunosuppression
6. Previous history of SCC
7. Congenital disorders such as Gorlins syndrome
8. Chronic wound or scar ( Marjolins ulcer)
9. HPV
10. 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 horn
Some 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, 0.51 cm
in diameter, with surface
scale or crust. It may
ulcerate or develop a
cutaneous horn.