Squamous cell carcinoma

Question 1

Define

Answer 1

DEFINITION: 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

Causes

Answer 2

Main risk factor = UV RADIATION

Sun exposure can lead to actinic keratosis (sun-induced precancerous lesion)

Other risk factors:

• 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

Epidemiology

Answer 3

SECOND most common cutaneous malignancy (20% of all skin cancers)

Occurs mainly in MIDDLE-AGED and ELDERLY people

LIGHT-SKINNED individuals are at higher risk

2-3 x more common in MALES

Question 4

Symptoms

Answer 4

Skin lesion

Ulcerated

Recurrent bleeding

Non-healing

Question 5

Signs

Answer 5

Variable appearance - may be ulcerated, hyperkeratotic, crusted or scaly, non-healing

Often on sun-exposed areas

Palpate for local lymphadenopathy

Question 6

Investigations

Answer 6

Skin Biopsy - confirm malignancy and specific type

Fine-needle aspiration or lymph node biopsy - if metastasis is suspected

Staging - using CT, MRI or PET