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Squamous Cell Carcinoma

The Squamous Cell Carcinoma (SCC) can be found on any skin surface or mucous membrane. It is the second most common skin cancer. The aggressiveness of this skin cancer is highly variable. In general, the larger the SCC, the more likely the SCC will invade deeper structure, nerves, lymphatics, blood vessel, and spread to other parts of the body. Early diagnosis and treatment is important in reducing morbidity and mortality.

Most commonly, the SCC is found on sun-damaged skin, either as a new red scaly bump or evolving from a flat scaly patch known as an actinic keratosis. Typically, these lesions grow over the course of many months to years. However, in a special variant of SCC called the keratoacanthoma, the lesion may grow to a tremendous size in a short amount of time.

The SCC is usually biopsied by the dermatologist to obtain a diagnosis. If a diagnosis of squamous cell carcinona is confirmed, the treatment options are discussed. Depending on the location, size, and needs of the patient, the appropriate treatment is determined.

The following are the treatment options for SCC:

  • Topical treatments- Imiquimod (Aldara, Zyclara), ingenol mebutate (Picato), 5-fluorouracil (Efudex, Carac) (Time: 4-16 weeks, Cure rate: 50-90%)
  • Electrodessication and Currettage- Scraping and burning of the lesion. No pathology confirmation of removal. (Time: 15 minutes, Cure rate: 85-90%)
  • Excision- Cutting out the skin cancer with a scalpel. Surgical margins examined for clearance of tumor. Re-excision may be necessary if margins are not clear. (Time: 60-90 minutes, Cure rate: 85-90%)
  • Mohs Surgery- Cutting out the skin cancer under microscopic control. After removal of the skin cancer with small margins, the tissue is mapped out and cut in a way to be able to examine the deep and side margins. If the margins are clear, the wound can be closed. If the margins are not clear, a small amount of additional tissue is removed in only the involved area. This tissue is then inspected microscopically and if the margins are now clear, the wound can be closed. If not clear, the process is repeated until the margins are finally clear and the wound is finally closed. (Time: 2 hours- 8 hours, Cure rate: 90-99%)
  • Radiation and Electronic Brachytherapy- Lesion is exposed to radiation in multiple doses. Eight to twenty sessions may be needed. (Time: 15 minute appointment per session over 1 month period, Cure rate:85-90%)

ADSCI - Advanced Dermatology Skin Cancer Institute Linage Dermatology Linage Skin Care