Squamous cell carcinoma

Squamous cell carcinoma

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Squamous cell carcinoma is the second form of skin cancer and has over 20% of cutaneous neoplasms. It appears on sun-exposed skin in people of middle or advanced age. Most squamous cell carcinomas are immediately identified and removed through small surgical. Larger and more severe lesions require aggressive surgery, radiation therapy or both. High-risk squamous cell carcinoma carries a significant risk of metastasis and thus require careful evaluation and treatment.
One cause for the increased incidence of squamous cell carcinoma is due to sun exposure. It postulates that rarefied ozone layer can increase exposure to ultraviolet light. Other contributing factors include the increasing incidence of old age. In addition the number of patients with immunosuppressive therapy used in organ transplantation and various rheumatologic and dermatologic diseases is increasing. Most squamous cell carcinomas are treated and produce few sequelae. A subset of high risk lesions determine the increased morbidity and mortality associated with this type of cancer. These injuries can cause extensive tissue destruction and their removal may leave a significant cosmetic deformity. The risk of metastasis is 2-6%, though rates have been described and 47% when perineural invasion. Lymphatic metastases are associated with significant morbidity. Once installed metastasis to lung disease is incurable.
Non-surgical options for treatment of squamous cell carcinoma is chemotherapy, immunomodulatory topical photodynamic therapy, radiotherapy and systemic chemotherapy. Radiotherapy is the choice for patients who can not apply and is adjuvant surgery for those with metastases. Most squamous cell carcinomas can be treated by surgical or destructive methods, with high rates vinecare. The use cryotherapy, and curettage electrodesicarea, conventional excision with margins, Mohs surgery. Because squamous cell carcinoma is a lesion that may reverse the cause of death and metastasis as it carries a negative prognosis, tumor removal should be attempted at first presentation to the doctor.
Low-risk tumors are healed surgical therapy, however patients who develop squamous cell carcinoma u have 40% risk of developing other squamous tumors in the next two years. The risk is increased as the patient progresses in age. Therefore patients should be assessed every 6-12 months. Patients with high risk tumors require examination of skin and lymph nodes within 3-6 months for at least 2 years after diagnosis.
Pathogenesis and causes
Squamous cell carcinoma is a malignant tumor of epidermal keratinocytes. Some cases occur de novo in the absence of precursor lesions, however, most tumors arise from precancerous lesions known as actinic keratoses. Patients with multiple actinic keratoses are at increased risk of developing tumors. Squamous cell carcinoma is able to infiltrate local, to expand the regional lymph nodes and distant metastases to determine, especially in the lungs.
The main reason is the cumulative exposure to sunlight during their lifetime. Other causes include: Exposure to ultraviolet therapy with psoralen and UV Therapy -People with skin type I and II -Ionizing radiation, chemical carcinogens-arsenic (heavy water, Chinese herbs) -Failure of DNA repair-xeroderma pigmentosum -Iatrogenic immunosuppression: sunlight, organ transplantation HPV-infection, chronic inflammation: Marjolin ulcer, dystrophic epidermolysis bullosa.
Pathological conditions that predispose to the development of squamous cell carcinoma: -Burns, venous ulcers, lymphedema, lupus erythematosus, discoid -Erosive oral lichen planus, keratodermie mutilating, Necrobiosis lipoidica -Osteomyelitis, acne Conglobata, hidraadenita suppurativa Dissecans-cellulitis of the scalp, lupus vulgaris, limfogranulomul venerian, -Inguinal granuloma, chronic deep fungal infections Oculocutanat-albinism, xeroderma pigmentosum, dyskeratosis congenital -Porokeratoza, nevus sebaceous syndrome, KID.
General risk factors associated with squamous cell carcinoma development include: Over 50 years-old, male -White skin, blond hair, blue eyes, green or gray -Skin that burns easily in the sun-type I and II -Areas near the equator, history of previous skin cancer nonmelanozic Exposure to ultraviolet: recreational, medical or artificial Exposure to chemical carcinogens, exposure to ionizing Immunosuppression, chronic, healing of chronic conditions, human papillomavirus.