Squamous Cell Carcinoma (SCC)
Symptoms
SCC often appears as a red, scaly patch, rough nodule, or a sore that crusts and may bleed. It typically occurs on sun-exposed areas such as the scalp, face, lips, ears, and hands. The lesion may be tender to touch or develop into a wart-like growth. Unlike BCC, SCC may grow more rapidly. Ulceration is possible in more advanced cases. SCC in situ (Bowen’s disease) is an early form confined to the epidermis. Invasive SCC can spread to lymph nodes if untreated. Early detection improves outcomes.
Cause
Prolonged UV radiation is the primary cause of SCC. It develops from precancerous lesions called actinic keratoses. Additional risk factors include fair skin, history of sunburns, chronic wounds, HPV infection (especially in genital areas), and immunosuppression. SCC originates in the squamous cells of the epidermis. It’s the second most common type of skin cancer. Unlike BCC, SCC has a higher potential to metastasize. Occupational sun exposure (e.g., farmers, construction workers) increases risk.
Treatment
Treatment options include surgical excision, Mohs surgery, or ED&C. Mohs is preferred for high-risk or facial SCCs. Radiation therapy may be used in cases where surgery is not feasible. Topical therapies (like 5-fluorouracil) are reserved for SCC in situ. Advanced or metastatic cases may require systemic treatment, including immunotherapy. Regular skin checks are important for surveillance. Sun protection and early treatment of actinic keratoses help prevent progression.
Dr. Beth Schulz-Butulis
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