Dermatology - Squamous Cell Carcinoma (SCCIS)

Dermatology - Squamous Cell Carcinoma (SCCIS) 
HPV infection or UV radiation are the main causes of SCCIS. It frequently manifests itself in dysplastic lesions like solar keratoses. Bowen disease, erythroplasia (onglans/vulva), and anogenital, HPV-induced bowenoid papulosis are among the synonyms. Invasive squamous cell carcinoma (SCC) can develop from SSCIS. Without obvious invasion, lymph node metastasis can happen and spread.

One or more hyperkeratotic or scaling macules, papules, or plaques that may bleed in addition to being typically asymptomatic. Nodule formation, discomfort, or soreness indicate that SCC is progressing.

Sharply defined, scaling, or hyperkeratotic pink or red macules, papules, or plaques characterize the lesions. Lesions can be crusty and might be single or numerous. Scaling or crusting lesions, whether single or many, are consistently well-defined (Bowen disease). Red, distinctly outlined, gleaming lesions resembling macular or plaque formation arise on the glans or labia minora (erythroplasia).
Bowenoid papulosis, or anogenital HPV-induced SCCIS, can have a reddish-tan, brown, or black tint. Large lesions with annular or polycyclic boundaries may develop from SCCIS if it is misdiagnosed as a patch of eczema or psoriasis and remains untreated for years. Nodules become visible after invasion (Bowen cancer).

The pathologist uses histology to confirm the diagnosis. All clearly defined pink-red plaques are included in the differential: sun keratoses, psoriasis, verruca plana, verruca vulgaris, condyloma acuminatum, superficial basal cell carcinoma, amelanotic melanoma, and nummular eczema.

Treatment options include imiquimod, cryosurgery, CO2 laser evaporation, excision (including Mohs micrographic surgery), topical 5-fluorouracil (used twice daily with or without occlusion), and cryosurgery.
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Chemotherapy applied topically takes a long time. Wounds from cryosurgery are possible.
Laser treatment can be uncomfortable and time-consuming. While surgical excision offers the highest percentage of cure, it also has the highest risk of scarring; however, it should be done anytime a biopsy has not ruled out invasion.