小结
定义
皮肤鳞状细胞癌 (cutaneous squamous cell carcinoma, SCC) 是皮肤不典型、变形的角质形成细胞的恶性增生。其范围从原位肿瘤（也被称为 Bowen 病）到侵袭性肿瘤和转移性疾病不等。 皮肤鳞状细胞癌的前驱病变被称为光化（或阳光损伤）角化病。[Figure caption and citation for the preceding image starts]: 存在大量晒伤证据的手背部鳞状细胞癌来自Dr Nwaneshiudu和Dr Soltani的个人采集 [Citation ends].
病史和体格检查
关键诊断因素
- 存在的危险因素
- 肿瘤不断生长
其他诊断因素
- 既往皮肤癌病史
- 出血
- 结痂皮
- 皮肤日光损伤的证据
- 创伤所致迁延不愈的柔嫩或瘙痒性伤口
- 红斑样丘疹或斑块
- 肉色或红斑样薄斑块
- 圆顶状结节
- 外生性、真菌样生长、疣状结节或斑块
- 溃疡性肿瘤
- 淋巴结肿大
- 骨痛
- 肝肿大
- 神经系统体征
危险因素
- 紫外线辐照暴露
- 实体器官移植受者
- 免疫抑制
- Fitzpatrick 皮肤分型
- 遗传皮肤病
- 老年
- 男性
- 电离辐射
- 致癌因素
- 光化性角化病
- 既往皮肤癌病史
- 人乳头瘤病毒
- 吸烟
- 噻嗪利尿剂和心血管药物。
- 纹身
诊断性检查
首要检查
- 活检
需考虑的检查
- CT扫描
- MRI扫描
- PET 扫描
- 全血细胞计数 (FBC) 和分类计数
- 肝功能检查 (LFT)
- 胸部 X 线检查
新兴检查
- 无创成像技术
治疗流程
原位鳞状细胞癌（鲍恩病）
侵袭性鳞状细胞癌
转移性鳞状细胞癌
免疫抑制或高风险转移癌
撰稿人
作者
Keyoumars Soltani, MD
Professor
Department of Medicine
Director of Immunopathology
Laboratory Section of Dermatology
The University of Chicago
Chicago
IL
利益声明
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
利益声明
ANO has received honorarium for lectures at 2020 Cynosure and PCCA meetings.
鸣谢
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.
利益声明
CP and JMS declare that they have no competing interests.
同行评议者
Nanette Silverberg, MD
Clinical Professor of Dermatology
Columbia University College of Physicians and Surgeons
New York City
NY
利益声明
NS declares that she has no competing interests.
Iris Aronson, MD
Associate Head
Associate Professor
Department of Dermatology
University of Illinois
Chicago
IL
利益声明
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
利益声明
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
利益声明
JMG declares that she has no competing interests.
鉴别诊断
- 光化性角化病
- 基底细胞癌
- 脂溢性角化病
更多 鉴别诊断指南
- NCCN 肿瘤学临床实践指南：阴茎癌（皮肤鳞状细胞癌）
- NCCN 肿瘤学临床实践指南：皮肤鳞状细胞癌
更多 指南患者教育信息
皮肤肿瘤（鳞状细胞）
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