Squamous Cell Carcinoma (SCC)

Figure 5.7
A: Bowen’s disease*
B: SCC arising within DLE*
C: SCC, lip
* Courtesy of Dr. Paul Getz

(Figure 5.7B, C)

Second most common type of skin cancer; often presents as erythematous keratotic papule, plaque or nodule typically in sun-exposed sites
High risk for metastasis: SCC on l ip or ear (10–20%), recurrent SCCs (up to 30%), SCCs arising within scars/chronic ulcers, perineural invasion or poor differentiation on histology, immunosuppression
Organ transplant patients have 6 5-fold increased risk for developing cutaneous SCC
Histology: irregular sheets or islands of atypical, brightly eosinophilic squamous cells with nuclear pleomorphism originating from the overlying epidermis and invading the dermis, keratin pearls, ± vascular or perineural invasion, necrotic keratinocytes, mitoses
Variants: acantholytic, adenoid, bowenoid, mucinous, sclerotic, spindle cell, and verrucous
Treatment: standard excision with margins, Mohs micrographic surgery, electrodessication and curettage, radiotherapy