Squamous cell carcinoma of the skin differential diagnosis

Squamous cell carcinoma of the skin Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Raviteja Guddeti, M.B.B.S. [3]

Overview

Squamous cell carcinoma is a non-melanomatous form of skin cancer. It accounts for 20% of all non-melanomatous tumors, and is fairly invasive contrary to its counterpart, Basal cell carcinoma. Squamous cell carcinoma typically presents as a non-healing ulcer or growth on a sun exposed are of the skin.

Differential Diagnosis

The following are the few conditions that mimic Squamous cell carcinoma

• Actinic Keratosis (also called solar keratosis, or AK) is a premalignant condition of thick, scaly, or crusty patches of skin. It is most common in fair-skinned people who are frequently exposed to the sun, because their pigment isn't very protective. It usually is accompanied by solar damage. Since some of these pre-cancers progress to squamous cell carcinoma, they should be treated.
• Atopic Dermatitis ( Atopic Eczema ) is a hereditary, and non-contagious skin disease characterized by chronic inflammation of the skin.
• Atypical Fibroxanthoma is a tumor that occurs primarily in older individuals when the skin of their head and neck area is exposed to sun and/or therapeutic radiation. Clinically, lesions usually are suggestive of malignancy because they arise rapidly in skin in which other skin cancers have been found and treated. Clinical presentation is a red, beefy, sessile nodule.Solar telangiectasias can be found around the lesions.
• Bowenoid Papulosis presents as papules on the genitalia of both the sexes and is induced virally by the HPV. Many of these lesions are benign but there are case reports of malignant transformation (2.6%).
• Contact Dermatitis
• Erythroplasia of Queyrat is squamous cell carcinoma in situ of the penis.
• Keratoacanthoma is a low-grade malignancy of the skin. It originates in the pilo-sebaceous glands, and is similar in clinical presentation and microscopic analysis to squamous cell carcinoma, except that it contains a central keratin plug. Statistically, it is less likely to become invasive than squamous cell carcinoma.
• Bowen's disease is a sunlight-induced skin disease, and is considered to be an early form of squamous cell carcinoma.
• Marjolin's ulcer is a type of squamous cell carcinoma that arises from a non-healing ulcer or burn wound.
• Melanoma
• Basal Cell Carcinoma is the most common skin tumor accounting for 80% of all non-melanoma tumors of skin. It is a malignant epithelial cell tumor that begins as a papule (a small, circumscribed, solid elevation of the skin) and enlarges peripherally, developing into a crater that erodes, crusts and bleeds
• Pyoderma Gangrenosum is an uncommon ulcerative condition associated with systemic disease in at least 50% of the cases. This condition is a diagnosis of exclusion.