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Squamous cell
carcinoma of the
skin or cutaneous squamos cell
carcinoma
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- Squamous cell cancer (SCC) of the
skin is the cancerous (i.e., malignant) transformation of
the squamous cells (keratinocytes in skin), which normally
cover the surface of the skin and other body parts (e.g.,
lungs, mouth, nose, throat) providing protection against
outside forces (e.g., infections, injuries, sunlight). A
malignant transformation means that these cancer cells are
dividing rapidly without following the normal guidelines of
cell division and maturation. Since the depletion of the
ozone layer in the last century, harmful ultraviolet rays
(UV) of the sun are passing through unfiltered, and are
giving rise to more cases of skin cancer than ever before.
SCC constitutes 20% of all skin cancers.
- Bowen's Disease is subset of Actinic Keratosis or
SCC in situ, appearing as a reddish
skin patch. This is basically an early stage (in situ) SCC
that has not spread beyond its point of origin. SCC almost
always appears on the areas of the skin with the most
exposure to sunlight such as the nose, lower lips, back of
hands, forehead, neck, and ears. On rare occasions, there
may be an appearance in the genital areas.
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- There is often a red/pink firm bump
- Appear in areas with maximum sun
exposure (scalp, forehead, neck, ear)
- May have a scaly and rough surface,
but may appear smooth or wart like.
- The lesion may bleed easily
- May crust over
- May appear in other areas of the
skin
- On moist surfaces (mouth, head of
penis), it may appear as a whitish color (Leukoplakia).
- May be seen in areas of a previous
scar or skin damage (e.g., venous insufficiency and
ulceration).
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- Chronic sun exposure --The UV rays,
whether from sun or tanning salons, are harmful to the skin.
- Radiation exposure -- such as those
who have received radiation therapy
- Exposure to arsenic, often found in
some insecticides
- Exposure to coal, tar and Paraffin
- Immunosuppression -- weakened immune
system from disease or treatments (such as drugs used for
after organ transplantation).
- Prior Burns -- SCC may appear
on areas of a previous burn scar or other damaged skin. This
is also known as Marjolin's ulcer.
- Human papilloma virus may be
responsible for a wart like variety of
SCC.
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- Often picked up on the examination
of the skin
- Biopsy of the skin is the only
method of diagnosis where a piece of the lesion is removed
and examined under a microscope by a pathologist.
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- Fair skin people (light blue eyed,
green eyes, fair complexion) are 20 times more likely than
dark skin (African-Americans) people to get skin cancer
(nonmelanoma type).
- Males
- Those living in areas with constant
exposure to the sun, such as Arizona, may be at higher risk.
Those who are constantly outdoors (work or recreation)
without protective clothing or sunscreen are also at risk.
- Elderly
- Smoking may also be a risk factor
- The Highest rate of SCC is found in
Australia
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- Surgery is the only treatment
available at this time.
- Excision surgery is a simple
excision and removal of the lesion
- Electrodessication and Curettage is
best for lesions larger then 1.0 cm
- Cryosurgery -- the killing of cells
by freezing them.
- Micrographic and laser surgery are
some of the other treatments
- 95% of all SCC are curable
- A small number spread to the
surrounding areas as well as regional lymph nodes, and
require more aggressive
therapy.
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- The key is to reduce exposure to UV
light. Choose the shade not light if you are planning to
spend a long time outdoors.
- If out doors for extended periods of
time, wear protective clothing and sunscreen (SPF >15)
even during winter times.
- I recommend hats, long sleeve shirts
and long pants since the effects of long-term use of
sunscreen lotions and creams are still unknown
- Protect the children and elderly
since their skin is more vulnerable.
- Report any suspicious lesion to your
doctor
- Support legislation that helps to
protect the ozone layer.
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