Summary
Definition
O CCE cutâneo é a proliferação de ceratinócitos transformados, atípicos, na pele com comportamento maligno. Ele varia de tumores in situ (também conhecidos como doença de Bowen) a tumores invasivos e doença metastática. As lesões precursoras dos CCEs são denominadas de ceratose actínica (ou dano solar).[Figure caption and citation for the preceding image starts]: Carcinoma de células escamosas no dorso da mão com evidência de danos solares extensivosDo acervo particular de Dr. Nwaneshiudu e Dr. Soltani [Citation ends].
History and exam
Key diagnostic factors
- presença de fatores de risco
- tumores crescentes
Other diagnostic factors
- câncer de pele prévio
- sangramento
- crostas
- evidência de dano solar à pele
- ferida sensível ou que coça, que não cicatriza, causada originalmente por trauma
- pápulas ou placas eritematosas
- placas finas, da cor da pele ou eritematosas
- nódulo em forma de domo
- nódulos ou placas verrucosos, exofíticos e vegetantes
- tumores ulcerados
- linfadenopatia
- dor óssea
- hepatomegalia
- sinais neurológicos
Risk factors
- exposição à radiação ultravioleta
- receptor de transplante de órgão sólido
- imunossupressão
- Fototipagem de Fitzpatrick
- condições cutâneas hereditárias
- idade avançada
- sexo masculino
- exposição a carcinógenos
- ceratose actínica
- câncer de pele prévio
- exposição a radiação ionizante
- papilomavírus humano
- tabagismo
- diuréticos tiazídicos e medicamentos cardíacos
- tatuagens
Diagnostic tests
1st tests to order
- biópsia
Tests to consider
- Tomografia computadorizada (TC)
- ressonância nuclear magnética (RNM)
- tomografia por emissão de pósitrons (PET)
- Hemograma completo com diferencial
- TFHs
Treatment algorithm
carcinoma de células escamosas (CCE) in situ (doença de Bowen)
carcinoma de células escamosas (CCE) invasivo
carcinoma de células escamosas (CCE) metastático
imunocomprometidos ou com alto risco de doença metastática
Contributors
Authors
Keyoumars Soltani, MD
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
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.
References
Key articles
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: squamous cell skin cancer [internet publication].Full text
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.Full text Abstract
Keohane SG, Botting J, Budny PG, et al. British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020. Br J Dermatol. 2021 Mar;184(3):401-14.Full text Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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