Cutaneous squamous cell carcinoma is the second most common form of skin cancer, also arising primarily on sun-exposed skin of middle-aged and older adults. Most SCCs arise from sun-induced precancerous lesions (actinic keratoses). As in BD, there is a higher risk of SCC in patients with radiation dermatitis (x-ray damage), leukoplakia or erythro-plakia (in oral or genital mucosa), burn scars, and chronic skin ulcers. It is important to note that organ transplant recipients have a 40 to 250 times greater risk of developing SCC, purportedly from interaction of HPV and immuno-suppression.
Lesions are typically pink to flesh-colored papules or nodules, often with crusting or ulceration (Fig. 33-84). They may also be keratotic or may develop a cutaneous horn. The most common locations include the face, scalp, lips, ears, neck, dorsal arms and hands, and genitalia (Fig. 33-85). Although many SCCs are asymptomatic, symptoms such as bleeding, pain, and tenderness, may be noted. SCC has an overall metastasis rate of 2% to 3%, but it is highly variable based on location, size, depth, invasion, and immunosuppression;
Figure 33-85 Squamous cell carcinoma on lip. © Richard P. Usatine.)
underwent MMS, recurrence after MMS was diagnosed in 15 of the 381 patients (3.9%) who completed the 5-year follow-up: 2.6% in patients with primary SCC, and 5.9% in patients with previously recurrent SCC (Leibovitch et al., 2005).
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