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Squamous Cell Carcinoma

Squamous Cell Carcinoma (SCC), also known as Epidermoid Carcinoma or Prickle Cell Carcinoma occurs less frequently than Basal Cell Carcinoma, but it’s cutaneous, i.e. non-mucous membrane type, is the second most frequently diagnosed form of skin cancer. Beginning in squamous cells of the upper skin layer, SCC is treatable in almost ninety-five percent of cases when identified early. When a patient or family member is diagnosed with SCC, it’s important to seek professional treatment from a triple board-certified dermatologist such as Dermatology Specialists of Atlanta.

About two hundred fifty thousand people in the United States are diagnosed with SCC every year. About one percent or more of these patients die as a result of this cancer’s ability to spread throughout the body. About ninety-six percent of all cases of SCC don’t metastasize but, in the remaining four percent of cases, SCC’s ability to spread can become deadly in a short period of time.

Incidence

Primarily fair-complexioned patients in middle age or older get SCC. In most instances, the patients have a history of exposure to ultraviolet light from the sun. The lesions may appear at the site of previously damaged skin, including chemical or other burns, chronic sores, or scars. Inflammation or autoimmune diseases can promote the development of SCC, according to studies reported by the National Institutes of Health (NIH). Finally, individuals who’ve previously suffered, or concurrently suffer, another type of skin cancer may also be at risk for SCC. Dermatology Specialists of Atlanta has the skill and experience to identify patients at risk for SCC.

Evaluation

SCC presents as a crusty, scaled area skin patch. The base of appears red or inflamed, such as a sore or ulcer that isn’t healing well. Most patients experience SCC on parts of the body that have been exposed to sunlight, but SCC can grow anywhere. Patients occasionally develop SCC lesions in the mouth or genital area. SCC tumors may be yellowish to black, reddish to brown, or skin-toned. Some forms are virtually indistinguishable from BCC in appearance. In all cases, biopsy is necessary to confirm the patient’s skin cancer type. Shave, punch, excisional, or incisional biopsy methods are often used.

Dr. Kathleen J. Smith will take the patient’s family history. Individuals of Scottish or Irish heritage have the highest incidence of SCC. Individuals of Asian or African descent rarely present with SCC but, when they have skin cancer, SCC is the most frequent type.

Types

The SCC cancer site can “take over” a scar site or start as a new skin ulcer anywhere on the patient’s body. Variations of SCC include:

  • Post-Actinic Keratosis: If the patient has actinic keratosis, also known as solar keratosis, considered a pre-cancerous condition by most researchers, SCC lesions may present there. Researchers say that lesions appearing in this way are often less-aggressive and aren’t invasive. These lesions are likely to grow more slowly.
  • SCC lesions may appear as a result of a human papilloma virus (HPV) infection, known as verrucous carcinoma.
  • SCC in situ, or the appearance of a single lesion, is known as Bowen’s Disease. Cutaneous horn may also cover the lesion: the lesion becomes covered with a hard keratin. Queryat Disease refers to SCC of the glans penis.
  • Invasive SCC: Metastatic tumors are statistically likely to appear on ears, lips, or lesions greater than two centimeters in diameter. SCC tumors in the mucous membranes are more likely to spread.
  • Subungual SCC: This variation mimics the appearance of warts.
  • Basaloid SCC: Occurs in men between the ages of forty and seventy years. This is a rare form of SCC.

Considerations

Individuals who’ve received an organ transplant seem to have a higher risk of squamous cell carcinoma on the skin at the wound site. Skin lesions from autoimmune disease, such as discoid lupus, are also more likely to suffer invasive SCC. In both situations, the patient is suffering from a mediated immune system (e.g., the transplant patient is given immunosuppressants) or an immune system disorder.

Treatment

After squamous cell carcinoma confirmation by biopsy, Dermatology Specialists of Atlanta will use a variety of treatment options to manage the patient’s health. The first line of therapy includes:

  • Complete excision
  • Electrocautery or electrodesiccation and curettage (ED&C)
  • Cryosurgery (LN2)
  • Mohs surgery
  • Radiation therapy

As a secondary line of treatment, Dr. Kathleen J. Smith may prescribe immunomodulators, chemotherapy, or photodynamic therapy (PDT), or systemic medicines.

Conclusion

Squamous cell carcinoma is a serious and potentially fatal disease. It’s essential for patients with suspected SCC in the Greater Atlanta area (including North Decatur, GA, Druid Hills, GA, Sandy Springs, GA, and Decatur, GA) to call Dr. Kathleen J. Smith right away at 678-904-4932.

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