Clinical features and diagnosis of cutaneous squamous cell carcinoma (SCC)
- Jean Lee Lim, MD
Jean Lee Lim, MD
- Department of Dermatology
- Kaiser Permanente Medical Group, Santa Rosa, CA
- Maryam Asgari, MD, MPH
Maryam Asgari, MD, MPH
- Associate Professor
- Massachusetts General Hospital at Harvard Medical School
- Section Editors
- Robert S Stern, MD
Robert S Stern, MD
- Section Editor — Nonmelanoma Skin Cancer
- Professor of Dermatology
- Harvard Medical School
- June K Robinson, MD
June K Robinson, MD
- Section Editor — Nonmelanoma Skin Cancer
- Professor of Clinical Dermatology
- Northwestern University Feinberg School of Medicine
Cutaneous squamous cell carcinoma (SCC) presents with a wide variety of clinical manifestations, including papules, plaques, or nodules, and smooth, hyperkeratotic, or ulcerative lesions. Skin biopsies are required to confirm the diagnosis. Biopsies also provide information that is useful for staging.
The clinical presentation and diagnosis of SCC will be reviewed here. The epidemiology and risk factors for the development of SCC and the treatment of cutaneous SCC are reviewed separately. (See "Epidemiology and risk factors for cutaneous squamous cell carcinoma" and "Evaluation for locoregional and distant metastases in cutaneous squamous cell and basal cell carcinoma" and "Treatment and prognosis of cutaneous squamous cell carcinoma".)
Location — SCC can develop on any cutaneous surface, including the head, neck, trunk, extremities, oral mucosa, periungual skin, and anogenital areas (picture 1A-D). In fair-skinned individuals, SCCs most commonly arise in sites frequently exposed to the sun. In a cohort of 145 patients with SCC in Australia, the following distribution of SCC was observed .
●Head and neck (55 percent)
●Dorsum of the hands and forearms (18 percent)
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- CLINICAL FEATURES
- Clinical findings
- - SCC in situ (Bowen's disease)
- Erythroplasia of Queyrat
- - Invasive SCC
- - Other variants
- Oral SCC
- Verrucous carcinoma
- SCC of the lip
- Marjolin's ulcer
- - Cutaneous metastases
- - SCC in situ
- - Invasive SCC
- DIFFERENTIAL DIAGNOSIS
- Actinic keratoses
- Bowenoid papulosis
- Other disorders