Cutaneous squamous cell carcinoma
Risk factors for the development of SCC include chronic sun exposure, fair skin and blue eyes, family history of skin cancer, increased age, scarring processes (chronic ulcers, burns, hidradenitis), ionizing radiation, immunosuppression, certain subtypes of human papillomavirus (HPV), and chemical carcinogens. SCC may occur in tattoos.
Several genetic syndromes are associated with an increased risk of SCC as well. These include xeroderma pigmentosum, oculocutaneous albinism, epidermodysplasia verruciformis, epidermolysis bullosa, and KID syndrome (keratitis-ichthyosis-deafness).
In addition, acute-onset multiple SCCs have been described in patients taking certain medications including BRAF inhibitors, tumor necrosis factor (TNF) inhibitors, and other agents. Etanercept used for psoriasis has been reported to induce multiple SCCs. SCC has also been reported in patients on sorafenib and vemurafenib.
Patients with AIDS have an increased risk of SCC; even with antiretroviral therapy, the risk in patients with human immunodeficiency virus (HIV) infection is increased. Penile and anal SCC are seen more frequently in patients with HIV / AIDS. Anal SCC often develops within longstanding condyloma acuminata. Mucosal papillary tumors or flat lesions are seen, and symptoms may include pain, itching, burning, and/or bleeding. Over time, the lesions slowly progress into a tumorous mass or slowly infiltrate into deeper tissue. In the HIV-infected patient, one must consider the possibility of anal intraepithelial neoplasia (AIN), which is a corollary to cervical intraepithelial neoplasia. HIV-infected patients should undergo routine screening for possible AIN and anal SCC.
In individuals with darker skin phototypes, SCC has been found to occur in scars and has been known to occur in non-sun-exposed areas. SCC is about 80 times less likely to occur in individuals with dark skin phototypes than in those with light skin phototypes, and its incidence has been observed to be 3.4 per 100 000 among African Americans. Nevertheless, it is the most common skin cancer in African Americans, and black patients with SCC tend to have a higher mortality rate than white patients. This may be due to either a later diagnosis of the disease or a more highly aggressive form of the disease.
Squamous cell carcinoma in situ (SCCIS) is confined to the epidermis and includes other specific clinical entities such as Bowen disease and erythroplasia of Queyrat (on the male genitalia). As in invasive disease, SCCIS is more frequent and more aggressive in immunosuppressed individuals. These malignant tumors are prevalent in organ transplant recipients and those with HIV / AIDS.
C44.92 – Squamous cell carcinoma of skin, unspecified
402815007 – Squamous cell carcinoma
- Actinic keratosis
- Bowen disease
- Basal cell carcinoma
- Verruca vulgaris
- Eccrine poroma
- Lobular capillary hemangioma (pyogenic granuloma)
- Amelanotic melanoma
- Mycobacterium marinum
- Nummular dermatitis
- Atypical fibroxanthoma
- Merkel cell carcinoma
- Irritated seborrheic keratosis
- Chronic draining or ulcerative lesions
- Hypertrophic discoid lupus erythematosus
- Hypertrophic lichen planus
- Prurigo nodularis