Squamous cell carcinoma of the skin differential diagnosis

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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

Initial presentation of Squamous cell carcinoma typically includes a history of a non-healing ulcer or a tumorous growth on the sun exposed areas of the skin of the patients.

Differential Diagnosis

The following are the few conditions that mimic Squamous cell carcinoma

  • Actinic Keratosis
  • Atopic Dermatitis
  • 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
  • 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
  • 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.