squamous cell carcinoma

Question 1

has recently started to bleed and is quite painful and looks as follows, given the prognosis what factor is associated with a worse prognosis ?

increasing age
lesion diameter of 15mm
regular use of immunosuppressants
lesion depth of 1.8mm
a well differentiated lesion

Answer 1

regular use of immunosuppressants

this man likely has squamous cell carcinoma
immunosuppressants impair the skin’s network of immune cells and cytokines > over time

Question 2

what is a squamous cell carcinoma

Answer 2

a locally invasive malignant tumour of epidermal keratinocytes

SSCs can cause pain, tenderness or bleeding
can grow over weeks or months
can metastasise

Question 3

how do they appear ?

Answer 3

irregular, ill-defined, red nodule with scale and ulceration

often occur in sun exposed areas of skin ie nose, shins etc

Question 4

what causes SSCs to develop

Answer 4

DNA mutations following exposure to ultraviolet light , certain human wart viruses or other forms of skin damage

genetic factors can predispose

Question 5

risk factors for SSCs

Answer 5

type I or II skin
history of frequent or severe previous sun burn
outdoor occupation or hobbies
personal or family history of skin cancer
immunosuppression
smoking
premalignant skin conditions (actinic keratosis or Bowens)
increasing age
male

Question 6

what is this ?

Answer 6

Bowens

aka intraepidermal SSC or SSC in situ

irregular red keratinised scaly plaques

it is pre-malignant

Question 7

management of SSC

Answer 7

surgical excision
curettage and cautery
micrographic surgery
cryotherapy
radiotherapy

Question 8

what is the prognosis like for SSC

Answer 8

usually very good if it is detected early