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Squamous cell carcinoma

Squamous cell carcinoma on forearm

Squamous cell carcinoma on forearm (Source: National Cancer Institute)

Squamous cell carcinoma (SCC) is the second most common type of skin cancer. Like basal cell carcinoma, SCC is also a non-melanoma skin cancer. Growth usually begins in the upper layers of the epidermis (skin). It may start as actinic keratosis, a skin spot characterized by rough, dry, scaly patches. Squamous cell carcinoma is very curable if caught and treated early.

Look for the following abnormal warning signs in skin's appearance:

  • Bump or lump on the skin that crusts and may progress into a dome-shaped lump
  • Persistent, scaly red patches that crust or bleed if bumped
  • Elevated growth a with sunken center that may bleed
  • Open sores that persistently bleed, crust, heal and return
  • Wart-like sores that bleed occasionally

Are you at risk?

As with most skin cancers, a major risk factor for SCC is over-exposure to the sun throughout one's lifetime. SCC can appear on any part of the body, but is usually found on areas exposed to the sun, including face, ears, lips, neck, back of hands, arms and legs (especially in women). Men are twice as likely as women to get SCC. It is rarely seen in individuals under age 50, and most common in individuals in their 70s1. Check the following list to see if you may be at higher risk for squamous cell carcinoma:

  • Pale or fair skin
  • Light-colored hair (blond, red)
  • Light eye color: Blue, green, gray
  • Over age 50
  • Inability to tan
  • Used tanning beds or sunlamps
  • Spent a lot of time outdoors for work or leisure without proper skin protection
  • Past exposure to cancer-causing chemicals, including nicotine and insecticides
  • History of severe sunburns
  • Past diagnoses of squamous cell carcinoma, basal cell carcinoma or actinic keratosis
  • Overexposure to x-rays
  • Some types of HPV
  • Ulcers or sores that don't go away after months or years

A dermatologist will perform a skin biopsy to determine if squamous cell carcinoma is present. If the cells are cancerous, recommended treatment will depend on how far the cancer has spread, tumor location and depth, as well as patient's age and health. Options include cutting out the tumor (in office), Mohs micrographic surgery, radiation therapy, curettage, photodynamic therapy, topical chemotherapy cream and laser treatment.

Bowen's disease

Bowen disease can turn into squamous cell carcinoma

Bowen disease can turn into squamous cell carcinoma (Source: Wikipedia Commons, Klaus D. Peter)

Bowen's disease is also called squamous cell carcinoma "in situ." It has a low (3-5%) chance2 of developing into invasive squamous cell carcinoma so prognosis is often good when found and treated early. This skin cancer spreads outward on the surface of the skin rather than moving inside the body.

Bowen's disease is characterized by dry, scaly red patches that may be crusted. It may resemble other common non-cancerous skin conditions, such as rashes, eczema, fungus (ringworm), Paget's disease or psoriasis. It often develops in elderly patients.

Bowen's disease is often diagnosed when steroid treatment for another skin issue is unsuccessful. A dermatologist may biopsy the affected skin area and do a thorough examination of the skin, especially if there is a history of over-exposure to the sun. Standard treatment options for Bowen's disease include topical medication, photodynamic therapy, freezing, x-ray/radiation and surgical removal.

1: www.skincancer.org
2: emedicine.medscape.com/article/1100113-overview#a0199

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