Squamous Cell Carcinoma

Squamous cell carcinoma most commonly develops on sun-exposed skin anywhere on the body. It is especially common on the face, ears, neck and scalp. These cancers are also frequent on the lower legs. Squamous cell carcinoma can present with various signs and symptoms, including:

• A flat scaly patch with crust: Squamous cell carcinoma commonly presents as a flesh colored or pink scaly patch on the skin which can resemble eczema or psoriasis. Early squamous cell carcinoma can look similar to its precursor lesion, actinic keratosis.
• A firm, red nodule: A common subtype of squamous cell carcinoma (called keratoacanthoma) may grow rapidly over weeks to months with a volcano or crater-like appearance with a central keratin core or depression. These cancers can be tender to touch.
• A wart-like growth: Squamous cell carcinoma can present as a wart-like lesion. Just like cervical cancer or throat cancer, some squamous cell carcinoma of the skin may be caused by the Human Papilloma Virus (HPV). A warty growth is a common presentation of squamous cell carcinoma of the nail or genitals.
• A sore that doesn’t heal: Squamous cell carcinoma can develop into a sore that continuously scabs, crusts, or bleeds, but never completely heals.

Squamous cell carcinoma of the skin is primarily caused by prolonged exposure to UV radiation from the sun or artificial sources such as tanning beds. UV radiation damages the DNA of skin cells, leading to mutations that can trigger the development of squamous cell carcinoma. However, there are other factors that can contribute to the development of squamous cell carcinoma:

• Fair Skin: People with fair skin, light-colored eyes, and blond or red hair are more susceptible to squamous cell carcinoma because they have less melanin, which provides natural protection against UV radiation.
• Age: Squamous cell carcinoma is more common in older adults, particularly those over the age of 50, although it can occur at any age.
• Immunosuppression: Individuals with weakened immune systems, such as organ transplant recipients, HIV/AIDS patients, or those taking immunosuppressive medications, have an elevated risk of squamous cell carcinoma. Transplant patients have a 60 to 100 times increased risk of skin cancer development.
• Previous Skin Damage: Chronic skin inflammation or injury, such as scars, burns, chronic ulcers, or radiation therapy, can increase the risk of developing squamous cell carcinoma.
• Personal or Family History: A history of previous squamous cell carcinoma or other types of skin cancer increases the risk of developing squamous cell carcinoma. Additionally, a family history of skin cancer can predispose individuals to the condition.

The diagnosis of squamous cell carcinoma is typically made through a combination of medical history, physical examination, and often a skin biopsy. Unlike other types of cancer, you can see skin cancers. This makes early detection easier. Self-examinations at home and skin cancer screening exams in the office help detect skin cancer earlier. If you notice a new or suspicious spot on your skin, or develop a nonhealing sore or tender new growth, it is best to check in with a board-certified dermatologist and skin cancer expert like Dr. Thomas Knackstedt.

Here’s how the process generally unfolds (ideally the following paragraphs are separated by arrows):

Medical History

The team at Apex Skin Center will inquire about your medical history, including any previous skin conditions, sun exposure habits, radiation exposure, changes to your immune system, family history of skin cancer, and any symptoms or changes in the skin.

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Physical Examination

Board-certified dermatologist Dr. Thomas Knackstedt will conduct a thorough examination of the skin, focusing on any suspicious lesions or growths. Dermoscopy, a tool that allows for the magnification of structures within a skin growth is used to aid in the diagnosis of squamous cell carcinoma.

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Skin Biopsy

If Dr. Knackstedt suspects squamous cell carcinoma based on the physical examination and dermoscopy findings, a skin biopsy may be performed. During a skin biopsy, a small sample of tissue is removed from the suspicious lesion under local anesthesia (numbing) and sent to a laboratory for analysis. The tissue is examined under a microscope to confirm the presence of squamous cell carcinoma and to assess the cancers characteristics.

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Once the diagnosis of squamous cell carcinoma is confirmed, further evaluation may be necessary to determine the extent of the cancer and plan appropriate treatment. As a fellowship trained, board-certified Mohs surgeon and dermatology oncologist (cancer specialist), Dr. Thomas Knackstedt and the team at Apex Skin Center have significant expertise in the management of all types of skin cancer. Dr. Knackstedt has authored over twenty papers on squamous cell carcinoma.