Squamous cell carcinoma: The Daily PANCE Blueprint

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Squamous cell carcinoma: The Daily PANCE Blueprint

A 62-year-old male with a history of diabetes and tobacco abuse (1 pack per day for the past 20 years) presents to the clinic due to a painless lesion near his lower lip. It has been there for five months. He has worked as a mower/lawn maintenance worker for 20 years. On physical exam, you note a single ulcer near the left vermillion border. What is the most likely diagnosis?

A. Basal cell carcinoma
B. Squamous cell carcinoma
C. Actinic keratosis
D. Herpes simplex virus
E. Varicella zoster virus

Answer and topic summary

The answer is B. Squamous cell carcinoma

Cutaneous squamous cell carcinoma (cSCC) happens from malignancy transformation of keratinocytes of the epidermis. It is the 2nd MC type of skin cancer. Risk factors include UV exposure (most significant), ionizing radiation, chemical carcinogens, non-healing wounds, and precancerous lesions (like actinic keratosis). The classic presentation is a plaque-like lesion that eventually ulcerates (ulcers are usually red with everted edges) with adjacent inflamed/indurated skin. It occurs mostly on the face/neck. All skin lesions that are suspicious of cSCC should be biopsied. Treatment is surgical excision with a wide safety margin.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Dermatology ⇒ Dermatologic Neoplasms ⇒ Squamous cell carcinoma

Also covered as part of the General Surgery EOR topic list

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