Squamous cell carcinoma of the skin

Last reviewed: 7 Jun 2022
Last updated: 18 Mar 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • growing tumours
More key diagnostic factors

Other diagnostic factors

  • previous skin cancer
  • bleeding
  • crusting
  • evidence of sun damage to skin
  • tender or itchy non-healing wound originally caused by trauma
  • erythematous papules or plaques
  • thin, flesh-coloured or erythematous plaques
  • dome-shaped nodule
  • exophytic, fungating, verrucous nodules or plaques
  • ulcerated tumours
  • lymphadenopathy
  • bone pain
  • hepatomegaly
  • neurological signs
Other diagnostic factors

Risk factors

  • ultraviolet radiation exposure
  • solid organ transplant recipient
  • immunosuppression
  • Fitzpatrick skin phototype
  • hereditary skin conditions
  • older age
  • male sex
  • ionising radiation
  • carcinogens
  • actinic keratosis
  • previous skin cancer
  • human papillomavirus
  • tobacco smoking
  • thiazide diuretics and cardiac drugs
  • tattoos
More risk factors

Diagnostic investigations

1st investigations to order

  • biopsy
More 1st investigations to order

Investigations to consider

  • CT body scan
  • MRI scan
  • PET scan
  • FBC with differential
  • LFTs
  • chest x-ray
More investigations to consider

Emerging tests

  • non-invasive imaging technologies

Treatment algorithm

ACUTE

SCC in situ (Bowen's disease)

invasive SCC

metastatic SCC

ONGOING

immunocompromised or high risk of metastatic disease

Contributors

Authors

Keyoumars Soltani, MD
Keyoumars Soltani

Professor

Department of Medicine

Director of Immunopathology

Laboratory Section of Dermatology

The University of Chicago

Chicago

IL

Disclosures

KS declares that he has no competing interests.

Adaobi Nwaneshiudu Obasi, MD, PhD, FAAD
Adaobi Nwaneshiudu Obasi

Medical Director, Dermatologist, and Dermatopathologist

Cutis Wellness Dermatology & Dermatopathology, PLLC

Preceptor

University of the Incarnate Word

Department of Family Medicine

Laredo

TX

Disclosures

ANO has received honorarium for lectures at 2020 Cynosure and PCCA meetings.

Acknowledgements

Prof K. Soltani and Dr A. I. Nwaneshiudu would like to gratefully acknowledge Dr Carlos Paz and Dr Jessica M. Sheehan, the previous co-contributors to this topic.

Disclosures

CP and JMS declare that they have no competing interests.

Peer reviewers

Nanette Silverberg, MD

Clinical Professor of Dermatology

Columbia University College of Physicians and Surgeons

New York City

NY

Disclosures

NS declares that she has no competing interests.

Iris Aronson, MD

Associate Head

Associate Professor

Department of Dermatology

University of Illinois

Chicago

IL

Disclosures

IA declares that she has no competing interests.

Keyvan Nouri, MD

Professor of Dermatology & Otolaryngology

Director of Mohs, Dermatologic & Laser Surgery

Director of Surgical Training

Department of Dermatology & Cutaneous Surgery

University of Miami

Miami

FL

Disclosures

KN declares that he has no competing interests.

Jane McGregor, MA, MB, BChir, MRCP, MD

Senior Lecturer and Honorary Consultant Dermatologist (Barts and the London NHS Trust)

Institute of Cellular and Molecular Science

London

UK

Disclosures

JMG declares that she has no competing interests.

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