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Dermatology > Squamous Cell Carcinoma > Flashcards

Squamous Cell Carcinoma Flashcards

1
Q

What is SCC?

A
  • A locally invasive malignant tumour of the keratinocytes arising from the epidermal layer
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2
Q

What are the causes of SCC?

A
  • Excessive UV exposure - Primarily UVB
  • Pre- Malignant skin conditions ( Actinic Keratoses + Bowen’s Disease )
  • Chronic Inflammation
  • Immunosuppression - Following renal transplant, HIV
  • Genetic Predisposition
  • Smoking
  • Herpes Simplex or HPV
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3
Q

What are the Clinical Features of SCC?

A
  • Located on Sun exposed areas
  • Grow over weeks to months
  • Can be nodular, indurated or keratinised
  • Associated with bleeding and ulceration
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4
Q

What are the Differential Diagnoses for SCC?

A
  • Bowen’s Disease
  • Actinic Keratosis
  • Keratoacanthoma
  • Verrucous Carcinoma
  • Cutaneous Horns
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5
Q

What Investigations would you do?

A
  • History and Examination
  • Palpation of Regional Lymph Nodes
  • Dermoscopy - White circles/ Structureless areas, looped blood vessels and a central keratin plug
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6
Q

What is the mainstay Surgical treatment for SCC?

A
  • Surgical Excision ( Treatment of Choice) - excision biopsy with peripheral margins
  • Moh’s Micrographic Surgery - necessary for ill-defined, large, recurrent tumours
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7
Q

What are the margins for low risk SCC?

A
  • 4mm
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8
Q

What are the margins for high risk SCC?

A
  • 6mm
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9
Q

What are the margins for very high risk SCC?

A
  • 10mm
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10
Q

When would dermatologists perform curettage and cautery?

A
  • For immunocompetent patients who have small <1cm and clinically low risk SCC
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11
Q

What are the non- Surgical managment options?

A

-1. Primary Radiotherapy (surgery is not feasible)
- Adjuvant radiotherapy ( close or involved margins if further surgery is not possible)
- 2. Immune Checkpoint Inhibitors - locally advanced SCC
-3. Chemotherapy - 3rd line for people not suitable for Immune Checkpoint inhibitors, generally more poorly tolerated

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12
Q

What is the Classification system for SCC?

A
  • Broder’s Grading System (1-4)
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13
Q

What are the types of Biopsy?

A
  • Excisional Biopsy
  • Incisional Biopsy
  • Punch Biopsy
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14
Q

What is an Excisional Biopsy?

A
  • The whole lesion is excised with the margin of normal tissue
  • Removes all abnormal tissue
  • Requires more time and results in a larger scar
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15
Q

What is an Incisional Biopsy?

A
  • A portion of the lesion is removed via a relatively smaller skin incision
  • Quicker Procedure and less invasive
  • Lesion will require further treatment
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16
Q

What is a Punch Biopsy?

A
  • A small Deep hole is punched out of the lesion
  • Quicker procedure, Full thickness sample, good cosmetic outcome
  • Lesion will require further treatment

Dermatology (32 decks)

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