Squamous cell carcinoma of the skin
Resumen
Definición
Cutaneous SCC is the proliferation of atypical, transformed keratinocytes in the skin with malignant behavior. It ranges from in situ tumors (also known as Bowen disease) to invasive tumors and metastatic disease. Precursor lesions for SCCs are called actinic (or sun-damage) keratosis.[Figure caption and citation for the preceding image starts]: Squamous cell carcinoma on the dorsal hand with evidence of extensive sun damageFrom the private collection of Dr Nwaneshiudu and Dr Soltani [Citation ends].
The management of metastatic disease is beyond the scope of the topic.
Anamnesis y examen
Principales factores de diagnóstico
- growing tumors
Otros factores de diagnóstico
- previous skin cancer
- bleeding
- crusting
- evidence of sun damage to skin
- tender or itchy nonhealing wound originally caused by trauma
- erythematous papules or plaques
- thin, flesh-colored or erythematous plaques
- dome-shaped nodule
- exophytic, fungating, verrucous nodules, or plaques
- ulcerated tumors
- lymphadenopathy
- bone pain
- hepatomegaly
- neurologic signs
Factores de riesgo
- ultraviolet radiation exposure
- solid organ transplant recipient
- immunosuppression
- Fitzpatrick skin phototype
- hereditary skin conditions
- older age
- male sex
- exposure to carcinogens
- actinic keratosis
- previous skin cancer
- exposure to ionizing radiation
- human papillomavirus
- tobacco smoking
- use of thiazide diuretics or cardiac drugs
- tattoos
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- biopsy
Pruebas diagnósticas que deben considerarse
- CT scan
- MRI scan
- CBC with differential
- LFTs
Algoritmo de tratamiento
SCC in situ (Bowen disease)
invasive SCC
locally advanced SCC
immunocompromised or high risk of metastatic disease
Colaboradores
Autores
Keyoumars Soltani, MD
Professor
Department of Medicine
Director of Immunopathology
Laboratory Section of Dermatology
The University of Chicago
Chicago
IL
Divulgaciones
KS declares that he has no competing interests.
Adaobi Nwaneshiudu Obasi, MD, PhD, FAAD
Medical Director, Dermatologist, and Dermatopathologist
Cutis Wellness Dermatology & Dermatopathology, PLLC
Preceptor
University of the Incarnate Word
Department of Family Medicine
Laredo
TX
Divulgaciones
ANO has received honorarium for lectures at 2020 Cynosure and PCCA meetings.
Agradecimientos
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.
Divulgaciones
CP and JMS declare that they have no competing interests.
Revisores por pares
Catherine G. Chung, MD
Professor of Dermatology and Pathology
The Ohio State University
Wexner Medical Center
OH
Divulgaciones
CGC declares she has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: squamous cell skin cancer [internet publication].Texto completo
Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2018 Mar;78(3):560-78.Texto completo Resumen
Keohane SG, Botting J, Budny PG, et al. British Association of Dermatologists guidelines for the management of the people with cutaneous squamous cell carcinoma 2020. Br J Dermatol 2021;184:401-14.Texto completo Resumen
Stratigos AJ, Garbe C, Dessinioti C, et al. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: part 2. Treatment - update 2023. Eur J Cancer. 2023 Nov;193:113252.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Actinic keratosis
- Basal cell carcinoma
- Seborrheic keratosis
Más DiferencialesGuías de práctica clínica
- NCCN clinical practice guidelines in oncology: penile cancer (squamous cell carcinoma)
- NCCN clinical guidelines in oncology: vaginal cancer
Más Guías de práctica clínicaFolletos para el paciente
Skin cancer (squamous cell)
Staying safe in the sun
Más Folletos para el paciente
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