Squamous cell skin cancer
Cancer - skin - squamous cell; Skin cancer - squamous cell; Nonmelanoma skin cancer - squamous cell; NMSC - squamous cell; Squamous cell skin cancer; Squamous cell carcinoma of the skinSquamous cell skin cancer is the second most common type of cancer in the United States.
Other common types of skin cancer are:
- Basal cell cancer
Basal cell cancer
Basal cell cancer is the most common form of cancer in the United States. Most skin cancers are basal cell cancer. Other common types of skin cancer...
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Melanoma
Melanoma is the most dangerous type of skin cancer. It is also the rarest. It is the leading cause of death from skin disease. Other common types o...
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Causes
Squamous cell skin cancer affects the epidermis, the top layer of skin.
Squamous cell cancer may occur in undamaged skin. It can also occur in skin that has been injured or inflamed. Most squamous cell cancers occur on skin that is regularly exposed to sunlight or other ultraviolet radiation.
The earliest form of squamous cell cancer is called Bowen disease (or squamous cell carcinoma in situ). This type does not spread to nearby tissues, because it is still in the outermost layer of the skin.
Actinic keratosis is a precancerous skin lesion that may become a squamous cell cancer. (A lesion is a problem area of the skin.)
Actinic keratosis
Actinic keratosis is a small, rough, raised area on your skin. Often this area has been exposed to the sun over a long period of time. Some actinic ...
Read Article Now Book Mark ArticleA keratoacanthoma is a mild type of squamous cell cancer that grows rapidly.
Risks of squamous cell cancer include:
- Having light-colored skin, blue or green eyes, or blond or red hair.
- Long-term, daily sun exposure (such as in people who work outside).
- Many severe sunburns early in life.
- Older age.
- Having had many x-rays.
- Chemical exposure, such as arsenic.
- A weakened immune system, especially in people who have had an organ transplant.
Symptoms
Squamous cell cancer usually occurs on the face, ears, neck, hands, or arms. It may occur in other areas.
The main symptom is a growing bump that may have a rough, scaly surface and flat reddish patches.
The earliest form (squamous cell carcinoma in situ) can appear as a scaly, crusted, and large reddish patch that can be larger than 1 inch (2.5 centimeters).
A sore that does not heal can be a sign of squamous cell cancer. Any change in an existing wart, mole, or other skin lesion could be a sign of skin cancer.
Wart
Warts are small, usually painless growths on the skin. Most of the time, they are harmless. They are caused by a virus called human papillomavirus ...
Read Article Now Book Mark ArticleMole
A birthmark is a skin marking that is present at birth. Birthmarks include cafe-au-lait spots, moles, and Mongolian spots. Birthmarks can be red or...
Read Article Now Book Mark ArticleExams and Tests
Your health care provider will check your skin and look at the size, shape, color, and texture of any suspicious areas.
If your provider thinks you might have skin cancer, a piece of skin will be removed. This is called a skin biopsy. The sample is sent to a lab for examination under a microscope.
Skin biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined under a microscope. The skin is tested to look for skin conditi...
Read Article Now Book Mark ArticleA skin biopsy must be done to confirm squamous cell skin cancer or other skin cancers.
Treatment
Treatment depends on the size and location of the skin cancer, how far it has spread, and your overall health. Some squamous cell skin cancers may be more difficult to treat.
Treatment may involve:
- Excision: Cutting out the skin cancer and stitching the skin together.
- Curettage and electrodessication: Scraping away cancer cells and using electricity to kill any that remain. It is used to treat cancers that are not very large or deep.
- Cryosurgery: Freezing the cancer cells, which kills them. This is used for small and superficial (not very deep) cancers.
Cryosurgery
Cryotherapy is a method of superfreezing tissue in order to destroy it. This article discusses cryotherapy of the skin.
Read Article Now Book Mark Article - Medicines: Skin creams containing imiquimod or 5-fluorouracil for superficial squamous cell cancer.
- Mohs surgery: Removing a layer of skin and looking at it immediately under a microscope, then removing layers of skin until there are no signs of the cancer, usually used for skin cancers on the nose, ears, and other areas of the face.
Mohs surgery
Mohs micrographic surgery is a way to treat and cure certain skin cancers. Surgeons trained in the Mohs procedure can do this surgery. It allows sk...
Read Article Now Book Mark Article - Photodynamic therapy: Treatment using light may be used to treat superficial cancers.
Photodynamic therapy
Photodynamic therapy (PDT) uses a medicine together with a special type of light to kill cancer cells.
Read Article Now Book Mark Article - Radiation therapy: may be used if squamous cell cancer has spread to organs or lymph nodes or if the cancer cannot be treated with surgery.
Radiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
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Support Groups
You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society. Support and online communities. www. cancer. org/...
Read Article Now Book Mark ArticleOutlook (Prognosis)
How well a person does depends on many things, including how soon the cancer was diagnosed, the location, and whether or not you have a weakened immune system. Most of these cancers are cured when treated early.
Some squamous cell cancers may return. There is also a risk that squamous cell skin cancer may spread to other parts of the body.
When to Contact a Medical Professional
Contact your provider for an appointment if you have a sore or spot on your skin that changes in:
- Appearance
- Color
- Size
- Texture
Also contact your provider if a spot becomes painful or swollen or if it starts to bleed or itch.
Prevention
Experts disagree about the value of routine skin examinations by your provider. But all agree it's important to know your own skin and to contact your provider if you notice anything unusual.
The best way to prevent skin cancer is to reduce your exposure to sunlight. Always use sunscreen:
Reduce your exposure to sunlight
Many skin changes, such as skin cancer, wrinkles, and age spots are caused by exposure to the sun. This is because the damage caused by the sun is p...
Read Article Now Book Mark Article- Apply sunscreen with sun protection factor (SPF) of at least 30, even when you are going outdoors for a short time.
- Apply a large amount of sunscreen on all exposed areas, including ears and feet.
- Look for sunscreen that blocks both UVA and UVB light.
- Use a water-resistant sunscreen.
- Apply sunscreen at least 30 minutes before going out. Follow package instructions about how often to reapply. Be sure to reapply after swimming or sweating.
- Use sunscreen in winter and on cloudy days too.
Other measures to help you avoid too much sun exposure:
- Ultraviolet light is most intense between 10 a.m. and 4 p.m. So try to avoid the sun during these hours.
- Protect your skin by wearing wide-brim hats, long-sleeve shirts, long skirts, or pants. You can also buy sun-protective clothing.
- Avoid surfaces that reflect light more, such as water, sand, concrete, and areas that are painted white.
- The higher the altitude, the faster your skin burns.
- Do not use sun lamps and tanning beds (salons). Spending 15 to 20 minutes at a tanning salon is as dangerous as a day spent in the sun.
References
American Cancer Society website. Skin cancer prevention and early detection. www.cancer.org/content/dam/CRC/PDF/Public/6930.00.pdf. Reviewed April 20, 2017. Accessed October 3, 2023.
Dinulos JGH. Premalignant and malignant nonmelanoma skin tumors. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 21.
National Cancer Institute website. Skin cancer treatment (PDQ) - Health Professional Version. www.cancer.gov/types/skin/hp/skin-treatment-pdq#section/_222. Updated March 2, 2023. Accessed July 17, 2023.
National Comprehensive Cancer Network website. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Squamous cell skin cancer. Version 1.2024 – November 9, 2023. www.nccn.org/professionals/physician_gls/pdf/squamous.pdf. Updated November 9, 2023. Accessed November 27, 2023.
US Preventive Services Task Force, Mangione CM, Barry MJ, et al. Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2023;329(15):1290-1295. PMID: 37071089 pubmed.ncbi.nlm.nih.gov/37071089/.
Sun's effect on skin
Animation
Squamous cell cancer - illustration
Squamous cell cancer involves cancerous changes to the cells of the middle portion of the epidermal skin layer. It is a malignant tumor, and is more aggressive than basal cell cancer, but still may be relatively slow-growing. It is more likely than basal cell cancer to spread (metastasize) to other locations, including internal organs. Treatment usually involves surgical removal of the tumor along with some surrounding tissue.
Squamous cell cancer
illustration
Sun protection - illustration
Clothing which blocks or screens the harmful rays of the sun (UVA and UVB), in combination with wide-brimmed hats, sunglasses, and sunscreen, are all helpful in preventing damage to the eyes and skin. Any one of these by itself, even the sunscreen, may not be enough to prevent sun damage.
Sun protection
illustration
Bowen's disease on the hand - illustration
Bowen's disease is a malignant condition (technically, it is an intraepidermal squamous cell carcinoma). Early lesions may resemble fungal infections, dermatitis, or psoriasis. The diagnosis is made by biopsy (examining a tissue sample).
Bowen's disease on the hand
illustration
Keratoacanthoma - illustration
Keratoacanthomas are rapidly growing, red (erythematous), dome shaped bumps (papules/nodules) with central craters. Occasionally, these will disappear spontaneously (involute). Often, they are treated to avoid further involvement or destruction of underlying tissue. They are of concern because of the similarity to squamous cell cancer.
Keratoacanthoma
illustration
Keratoacanthoma - illustration
Keratoacanthomas are rapidly growing, red (erythematous), dome shaped bumps (papules/nodules) with central craters. Occasionally, these will disappear spontaneously (involute). Often, they are treated to avoid further involvement or destruction of underlying tissue. They are of concern because of the similarity to squamous cell cancer.
Keratoacanthoma
illustration
Skin cancer, squamous cell - close-up - illustration
Squamous cell carcinoma is one of the three most common types of skin cancer. Basal cell, squamous cell, and melanoma. Squamous cell cancers can metastasize (spread) and should be removed surgically as soon as they are diagnosed.
Skin cancer, squamous cell - close-up
illustration
Skin cancer - squamous cell on the hands - illustration
This is a picture of squamous cell skin cancer on the hands. Squamous cell carcinoma is one of the three most common types of skin cancer. Basal cell, squamous cell, and melanoma. Squamous cell cancers can metastasize (spread) and should be removed surgically as soon as they are diagnosed.
Skin cancer - squamous cell on the hands
illustration
Squamous cell carcinoma - invasive - illustration
This irregular red nodule is an invasive squamous cell carcinoma (a form of skin cancer). Initial appearance, shown here, may be very similar to a noncancerous growth called a keratoacanthoma. Squamous cell cancers can metastasize (spread) and should be removed surgically as soon as they are diagnosed.
Squamous cell carcinoma - invasive
illustration
Cheilitis - actinic - illustration
Actinic chelitis is caused by chronic and excessive exposure to the ultraviolet radiation in sunlight. There is thickening whitish discoloration of the lip at the border of the lip and skin. There is also loss of the usually sharp demarcation between the red of the lip and the normal skin (vermilion border). This condition is considered premalignant and may lead to squamous cell skin cancer.
Cheilitis - actinic
illustration
Squamous cell cancer - illustration
Squamous cell cancer involves cancerous changes to the cells of the middle portion of the epidermal skin layer. It is a malignant tumor, and is more aggressive than basal cell cancer, but still may be relatively slow-growing. It is more likely than basal cell cancer to spread (metastasize) to other locations, including internal organs. Treatment usually involves surgical removal of the tumor along with some surrounding tissue.
Squamous cell cancer
illustration
Sun protection - illustration
Clothing which blocks or screens the harmful rays of the sun (UVA and UVB), in combination with wide-brimmed hats, sunglasses, and sunscreen, are all helpful in preventing damage to the eyes and skin. Any one of these by itself, even the sunscreen, may not be enough to prevent sun damage.
Sun protection
illustration
Bowen's disease on the hand - illustration
Bowen's disease is a malignant condition (technically, it is an intraepidermal squamous cell carcinoma). Early lesions may resemble fungal infections, dermatitis, or psoriasis. The diagnosis is made by biopsy (examining a tissue sample).
Bowen's disease on the hand
illustration
Keratoacanthoma - illustration
Keratoacanthomas are rapidly growing, red (erythematous), dome shaped bumps (papules/nodules) with central craters. Occasionally, these will disappear spontaneously (involute). Often, they are treated to avoid further involvement or destruction of underlying tissue. They are of concern because of the similarity to squamous cell cancer.
Keratoacanthoma
illustration
Keratoacanthoma - illustration
Keratoacanthomas are rapidly growing, red (erythematous), dome shaped bumps (papules/nodules) with central craters. Occasionally, these will disappear spontaneously (involute). Often, they are treated to avoid further involvement or destruction of underlying tissue. They are of concern because of the similarity to squamous cell cancer.
Keratoacanthoma
illustration
Skin cancer, squamous cell - close-up - illustration
Squamous cell carcinoma is one of the three most common types of skin cancer. Basal cell, squamous cell, and melanoma. Squamous cell cancers can metastasize (spread) and should be removed surgically as soon as they are diagnosed.
Skin cancer, squamous cell - close-up
illustration
Skin cancer - squamous cell on the hands - illustration
This is a picture of squamous cell skin cancer on the hands. Squamous cell carcinoma is one of the three most common types of skin cancer. Basal cell, squamous cell, and melanoma. Squamous cell cancers can metastasize (spread) and should be removed surgically as soon as they are diagnosed.
Skin cancer - squamous cell on the hands
illustration
Squamous cell carcinoma - invasive - illustration
This irregular red nodule is an invasive squamous cell carcinoma (a form of skin cancer). Initial appearance, shown here, may be very similar to a noncancerous growth called a keratoacanthoma. Squamous cell cancers can metastasize (spread) and should be removed surgically as soon as they are diagnosed.
Squamous cell carcinoma - invasive
illustration
Cheilitis - actinic - illustration
Actinic chelitis is caused by chronic and excessive exposure to the ultraviolet radiation in sunlight. There is thickening whitish discoloration of the lip at the border of the lip and skin. There is also loss of the usually sharp demarcation between the red of the lip and the normal skin (vermilion border). This condition is considered premalignant and may lead to squamous cell skin cancer.
Cheilitis - actinic
illustration
- Melanoma and other skin cancers - InDepth(In-Depth)
- Skin cancer(Alt. Medicine)
- Skin wrinkles and blemishes - InDepth(In-Depth)
- Cervical cancer - InDepth(In-Depth)
- Psoriasis-In-Depth(In-Depth)
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- Vitamin A (Retinol) (Alt. Medicine)
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Review Date: 7/1/2023
Reviewed By: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 11/27/2023.