Squamous Cell Carcinoma

By Kira Mayo

You can’t get rid of that red, scaly patch on the back of your left hand. It’s been there for about six months. You’ve flaked off the scale several times, but it always seems to come back. It’s starting to itch and it’s getting bigger. What could it be?

One of the more serious diagnoses in this case would be squamous cell carcinoma (SCC). 250,000 new cases of SCC are diagnosed annually, making it the second most common type of skin cancer, after basal cell carcinoma. There are two main layers in the skin: the epidermis (top) and the dermis (bottom).  SCC affects the cells of the epidermis. The infected outer cells then invade the dermis.

Sun exposure causes the overwhelming majority of SCC. This has been proven many times in multiple ways. Consider the following:

  • the incidence of SCC is lower the farther you get from the equator; the incidence of SCC is 5x greater in New Orleans than Chicago
  • these lesions are more common in lighter-skinned individuals
  • they can be brought on in animal models by solar irradiation
  • they can be prevented by the use of sunscreens

And that’s not even all the evidence suggesting that sun exposure increases your chance of getting SCC!

Other risk factors for SCC include age; fair skin, light hair, or light eyes; chemical exposure, such as exposure to arsenic or tar; radiation exposure; a history of sunburns; a personal or family history of skin cancers; a chronically suppressed immune system (SCC is common in organ transplant recipients); and areas of chronic injury, such as burn scars.

SCC usually appears on sun-exposed areas, such as the face, neck and back of the hand. The appearance of SCC varies greatly. It may begin as a red bump or patch with a scaly or crusted surface and may develop a bumpy surface. If you notice a non-healing lesion on any sun-exposed surface, you should have a dermatologist look at it.

Here is a link with pictures of what SCC may look like: http://www.skincancer.org/scc-what-to-look-for-images.html

Once you visit your doctor, you will probably need a biopsy to definitively diagnose SCC. During the biopsy, your doctor will remove and carefully inspect a piece of the affected skin.

The type of destruction caused by SCC depends on how soon you catch it, how far it has invaded, its location, your general health and other similar factors. SCC is locally invasive, which means that it will continue to grow larger over time. Lesions caught early and removed surgically generally have good outcomes. However, the larger a lesion becomes, the more it will destroy surrounding tissues. Lesions that have had more time to destroy surrounding tissue may be removed, but they may be harder to remove completely and they may leave more of a noticeable scar. One of the worst case scenarios is a SCC that has spread to other organs in your body, such as the esophagus, lung and cervix.  It is important, however, to note that only 2% of SCC’s metastasize.

Finally, new tumors may develop, so if you have been diagnosed with SCC in the past, you should have your dermatologist examine your skin on a regular basis and be extra diligent about regularly examining your own skin.

The bottom line? Call your physician if you notice any change in color, size, texture or appearance of a skin lesion. Especially if the lesion is on a sun-exposed area.

Here are some ways to reduce your chances of getting SCC:

  • Protect your skin from the sun by wearing sunblock, long-sleeves, and wide-brimmed hats.
  • Try to avoid the midday sun (between 10am-4pm) as much as possible.
  • Avoid sunburning.
  • Conduct self skin checks at regular intervals.
  • Visit your dermatologist annually for a professional skin exam.

Originally written for DermHub, http://www.dermhub.com

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