How is cutaneous squamous cell carcinoma (cSCC) diagnosed?

Updated: Jul 08, 2020
  • Author: Talib Najjar, DMD, MDS, PhD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Although the typical patient with cutaneous squamous cell carcinoma (cSCC) is of northern European descent and presents with a family history of skin cancer, a personal history of previous skin cancer, and/or an extensive history of sun exposure, a detailed history and physical examination is crucial (see Presentation). In addition, the clinician should be aware of the risk factors for high-risk disease (see Prognosis).

Marjolin ulcer appears as a new area of induration, elevation, or ulceration, at the site of a preexisting scar or ulcer. The diagnosis of Marjolin ulcer should be considered in any ulcer that fails to heal with standard therapy.

Pseudoepitheliomatous hyperplasia (PEH) is a histologic finding in keratoacanthoma and SCC, as well as in certain other reactions, such as tattoo reactions. The clinician must determine whether the PEH is associated with cancer. In addition, with lesions containing PEH in patients with a history of lupus, the clinician must differentiate between lesions that are definitely SCC and lesions of hypertrophic lupus that are mimicking SCC or keratoacanthoma.

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