Squamous Cell Carcinoma
This is the second most common skin cancer. It is usually seen in fair skinned individuals, blond or red heads, freckled skin and people exposed to excessive ultraviolet radiation. The tumor occurs on sun exposed areas of the body such as the face, scalp, ears, dorsal hands and neck. Squamous cell carcinoma can occur in places of the body that have not been exposed to the sun. This tumor sometimes spread to lymph nodes and other organs. When this happens they can become deadly. Other risk factors include scarring processes such as lupus, lichen planus, chronic ulcerations, human papilloma viral infection, X-radiation exposure, systemic PUVA therapy, and immunosuppression from disease or medication. Squamous cell carcinoma is estimated to metastasize in 20-30% when it develops in areas of scarring.
Squamous cell carcinoma can appear as a wart like growth, an open sore that bleeds, a scaly patch that does not resolve or an elevated growth, which bleeds when there is an attempt to remove the crust. It is usually on sun damaged skin with evidence of hyperpigmentation, extreme wrinkling and loss of elasticity.
The diagnosis of Squamous cell carcinoma is made after your dermatologist takes a sample of your skin and sends it for pathological examination.
Treatment of skin cancer can be done using many modalities. Factors that influence the method of removal include the location of the tumor, the size of the tumor, the depth of penetration of the tumor, and the general health of the patient. Surgery is the usual mode of removal. This can be done with a simple elliptical excision. Cure rates are generally above 95%. A repeat excision may be necessary if the tissue removed is returned with tumor present at the margin of resection. Mohs micrographic surgery offers the highest cure rate of 99%. This method is indicated if the tumor is located on the central face, have indistinct borders, is a recurrent tumor, is a large tumor in a cosmetically important area or are in critical areas around the eyes, ears, nose and lips. Curettage and electrodessication has the same cure rate as elliptical excisional surgery and is usually reserved for smaller lesions. Other treatment methods include oral and topical chemotherapy, or radiation therapy.
