Squamous cell carcinoma

Question 1

Squamous cell carcinoma risk factors

Answer 1

• chronic UV exposure
• skin type
• PUVA therapy for psoriasis
• radiation
• immunosuppression
• progression from Bowen’s disease, actinic keratosis

Question 2

Squamous cell carcinoma presentation

Answer 2

• slow-growing nodule
• may be crusted, scaly, or warty
• may have a keratin horn
• can present as an ulcer
• metastasises to local lymph nodes

Question 3

Squamous cell carcinoma diagnosis

Answer 3

• biopsy for histological confirmation
• may be punch, incision or excision
• degree of differentiation, depth of tumour, margins of excised specimen

Question 4

Squamous cell carcinoma management

Answer 4

• if under 20mm diameter - excise with 4mm margins
• if over 20mm diameter - excise with 6mm margins
• sentinel lymph node biopsy
• alternatives - curettage and cautery, radiotherapy