SQUAMOUS CELL CARCINOMA

Yono Hadi AgusniDept of

DermatovenereologyPadjadjaran University

Squamous cell carcinoma

• SCC is a malignant proliferation of the keratinocyte of the epidermis

• Robert A. Schwartz & Howard L. Stoll Jr

Epidemiology (1)

• Incidence : • USA : 12 per 100.000 white male• 7 per 100.000 white

female• 1 per 100.000 black • Age : over 55 years

• Sex : males > females

Epidemiology (2)

• Occupation : • Persons (usually males) working

outdoor like farmers, sailors, construction worker,dock workers etc.

• Industrial workers exposed to chemical carcinogens (nitrosureas, polycyclic aromatic hydrocarbons)

Etiology

• Extrinsic factors

• Intrinsic factors

• Andrew C. Markey

Extrinsic factors :

• Ultraviolet radiation• Ionizing radiation• Human Papillomavirus• Chemical substances

Intrinsic factors :

• Genodermatoses• Immunosupression• Preexisting skin changes• Preexisting actinic keratoses

• Andrew C. Markey

Clinical manifestations

• Skin lesions :

• Distribution :• “sun-exposed areas”• (but may occur anywhere)

Clinical manifestations (2)

• Type :• indurated papule, plaque or

nodule. Ulcerated lesion may be have a crust in the centre and a firm hyperkeratotic elevated margin

Clinical manifestations (3)

• Color :• erythematous / yellowish / skin color

• Palpation : hard

• Shape : • Polygonal, oval, round or umbilicted

Clinical manifestations (3)

• Other skin changes :

• - telangiectasia• - dermatoheliosis• - dry scaly atrophic skin• - small hipopigmentation

macules

Clinical manifestations (4)

• Other physical findings :

• regional lymphadenopathy due to metastasis

Laboratorium :

• n o n e

Pathology anatomi :

• Disorganized proliferation of atypical-appearing squamous cells. Group of these tumor cells may be deeply invasive

• William A. Caro

Differential diagnosis :

• Basal cell carcinoma• Paget’s disease• In-situ SCC : numular eczema,

psoriasis

Treatment

• Surgery

• Carcinoma in-situ : • cryotherapy, 5-FU topical• Radiotherapy should be performed

only if surgery is not feasible

Prognosis :

• SCC has an overall remission rate after therapy of 90%

dermatoheliosis

• = “photoaging”

• Repeated solar injuries over many years can ultimately result in the development of a skin syndrome