What are the characteristics of cutaneous squamous cell carcinoma (cSCC) tumors?

Updated: Jul 08, 2020
  • Author: Talib Najjar, DMD, MDS, PhD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Surface changes on a typical SCC may include scaling, ulceration, crusting, or the presence of a cutaneous horn. Less commonly, the lesion may manifest as a pink cutaneous nodule without overlying surface changes.

The absence of surface changes should raise suspicion of a metastatic focus from another skin or nonskin primary site or of a different and potentially more lethal tumor, such as a Merkel cell carcinoma. A background of severely sun-damaged skin, including solar elastosis, mottled dyspigmentation, telangiectasia, and multiple actinic keratoses, is often noted.

Clinically, lesions of SCC in situ (SCCIS) range from a scaly, pink patch to a thin keratotic papule or plaque similar to an actinic keratosis. Bowen disease is a subtype of SCCIS characterized by a sharply demarcated, pink plaque arising on non–sun-exposed skin (see the image below).

Squamous cell carcinoma in situ (Bowen disease). C Squamous cell carcinoma in situ (Bowen disease). Courtesy of Hon Pak, MD.

SCC of the lip usually arises on the vermillion border of the lower lip. It is sometimes predated by a precursor lesion, actinic cheilitis, which manifests as xerosis, fissuring, atrophy, and dyspigmentation. Actinic cheilitis is analogous to actinic keratosis of the skin.

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