Squamous Cell Carcinoma

Ultraviolet light exposure (through the sun or tanning parlors) greatly increases the chance of developing skin cancer. Persons with light skin who burn easily are at the highest risk, although anyone can get squamous cell carcinoma. With increasing age, the risk of developing skin cancers grows. Heavy sun exposure and severe sunburns as a child may especially increase the likelihood of skin cancer. Many less common skin conditions also predispose individuals to the development of SCCs including conditions such as organ transplantation, chronic skin ulcers, prior x-ray treatment, arsenic ingestion, and toxic exposure to tars and oils.

A squamous cell carcinoma generally appears as a crusted or scaly area of the skin, with a red inflamed base. Squamous cell carcinoma can present as a growing tumor, a non-healing ulcer, or just as a crust. Any worrisome skin lesions, especially those that are not healing, are growing, bleeding, or changing in appearance, should be evaluated by a dermatologist. A skin biopsy for microscopic examination is usually necessary to confirm the diagnosis.

Squamous cell carcinomas are common in sun-exposed areas like the face, neck, and arms. The scalp, backs of hands and ears are especially common. However, SCCs can occur anywhere on the body, even on the lips, inside the mouth, and the genitalia.

Usually these skin cancers are locally destructive. If left untreated, squamous cell carcinoma can destroy much of the tissue surrounding the tumor and may result in the loss of a nose or ear. In certain aggressive types of squamous cell carcinomas, especially those on the lips and ears, or those that are left untreated, the tumor can spread to the lymph nodes and other organs, resulting in approximately 2,500 deaths each year in the United States.

Dermatologists use a variety of different surgical treatment options depending on location of the tumor, size of the tumor, microscopic characteristics of the tumor, health of the patient, and other factors. Most treatment options are relatively minor office-based procedures that require only local anesthesia. Surgical excision to remove the entire cancer is the most commonly used treatment option. Mohs micrographic surgery, a more involved method requiring specialized training by dermatologic surgeons, can be used to remove the whole tumor while sparing as much normal skin as possible. At Treasure Coast Dermatology, Dr. Ioannides is specially trained in Mohs micrographic surgery. Other dermatologic surgery treatments include laser surgery, cryosurgery with liquid nitrogen, radiation therapy, and electrodessication and curettage, which involves alternately scraping and burning the tumor with low levels of electricity.

Ultraviolet light avoidance is the primary form of prevention and is important for all ages. Outdoor activity should be avoided between late morning and early afternoon, tanning parlors should be shunned, and wide brimmed hats should be worn along with other protective clothing. Sunscreens with SPF 30 or higher and UVA block should be applied regularly even for a brief exposure to sunlight.