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Cutaneous squamous cell carcinoma - Anogenital in
See also in: Overview,Hair and Scalp,Nail and Distal Digit
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Cutaneous squamous cell carcinoma - Anogenital in

See also in: Overview,Hair and Scalp,Nail and Distal Digit
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Contributors: Gaurav Singh MD, MPH, Belinda Tan MD, PhD, Susan Burgin MD
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Synopsis

Squamous cell carcinoma (SCC), a keratinocyte carcinoma (previously termed nonmelanoma skin cancer), occurs most frequently on sun-exposed areas such as the face and hands. However, it also occurs on the female genitalia, where it typically presents in later decades of life. It is the most common vulvar neoplasm and accounts for 85%-95% of vulvar cancers. Vulvar cancers are diagnosed in 6000 women and kill 1200 each year in the United States. Anal cancer, of which SCC comprises a majority, newly afflicts 5600 women and kills another 700 each year in the United States.

The clinical presentation is variable. SCC often presents as a hyperkeratotic papule or nodule that may ulcerate, but it may also be smooth, plaque-like, exophytic, or papillomatous. Lesions are often red to flesh colored. Secondary changes such as scale, crust, erosion, and ulceration can be present. The progression of lesions over time varies. Some enlarge slowly, while others progress rapidly to grow, infiltrate deeper tissue, and metastasize. Pain and tenderness can be present. Anal carcinomas may also feature rectal bleeding and a sensation of an object in the rectum.

The pathogenesis of SCC is multifactorial. It may evolve from intraepithelial neoplasia (including vulvar intraepithelial neoplasia or anal intraepithelial neoplasia) or arise de novo. TP53 gene mutations have been implicated. Any repetitive trauma or insult increases the risk of SCC. Additional risk factors for anogenital SCC include smoking, sexually transmitted infections, human immunodeficiency virus (HIV) infection, human papillomavirus (HPV) infection, poor genital hygiene, anogenital injury, lichen sclerosus, and erosive lichen planus.

Women who engage in receptive anal intercourse and women with immunocompromised states such as HIV should undergo regular anal Pap smear screening.

Codes

ICD10CM:
C44.92 – Squamous cell carcinoma of skin, unspecified

SNOMEDCT:
402815007 – Squamous cell carcinoma

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 09/27/2018
Last Updated: 09/27/2018
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Cutaneous squamous cell carcinoma - Anogenital in
See also in: Overview,Hair and Scalp,Nail and Distal Digit
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Cutaneous squamous cell carcinoma : Friable papule, Verrucous scaly papule, Verrucous scaly plaque, Sun-exposed distribution
Clinical image of Cutaneous squamous cell carcinoma
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