Squamous Cell Carcinoma

Question 1

Define SCC

Answer 1

Malignancy of epidermal keratinocytes of the skin.

Marjolin’s ulcer is a squamous cell carcinoma that arises in an area of chronically inflamed skin

Question 2

What are the causes/risk factors of SCC?

Answer 2

• Main risk factor = UV RADIATION
• Sun exposure can lead to actinic keratosis (sun-induced precancerous lesion)
• Radiation
• Carcinogens (e.g. tar derivatives, cigarette smoke)
• Chronic skin disease (e.g. lupus)
• HPV
• Long-term immunosuppression
• Defects in DNA repair (xeroderma pigmentosum)

Question 3

What are the symptoms of SCC?

Answer 3

• skin lesion
• ulcerated
• recurrent bleeding
• non-healing

Question 4

What are the signs of SCC?

Answer 4

• Variable appearance - may be ulcerated, hyperkeratotic, crusted or scaly, non-healing
• Often on sun-exposed areas
• Palpate for local lymphadenopathy

Question 5

What investigations are carried out for SCC?

Answer 5

• Skin Biopsy - confirm malignancy and specific type
• Fine-needle aspiration or lymph node biopsy - if metastasis is suspected
• Staging - using CT, MRI or PET