Cutaneous squamous-cell carcinoma (cSCC) is a common form of skin cancer that originates in the squamous cells of the skin. It typically appears as a firm, scaly bump or an ulcerated lesion and most often develops on areas exposed to the sun, such as the face, ears, neck, and hands. cSCC is more likely to spread to other parts of the body compared to basal-cell carcinoma. The primary risk factor for cSCC is prolonged ultraviolet (UV) radiation exposure, including from sunlight and tanning beds, with other contributing factors being fair skin, chronic wounds, smoking, and a weakened immune system.
The clinical presentation of cSCC is highly variable, with tumors often starting as a small, slow-growing nodule that may ulcerate or bleed intermittently. Lesions may appear as red, scaly plaques or hard papules with small blood vessels. cSCC is frequently associated with actinic keratosis, a precancerous skin condition caused by sun damage. In some cases, it may develop from existing scars or actinic keratoses. Although it typically grows slowly, there is a risk of metastasis, particularly for larger, deeper, or poorly differentiated tumors, or those located in high-risk areas like the lips or ears.
Treatment for cSCC usually involves surgical removal of the tumor, with Mohs surgery used for more complex cases. In advanced stages or when metastasis occurs, radiation therapy, chemotherapy, or biologic treatments may be necessary. Prevention is primarily focused on reducing sun exposure, using sunscreen, and avoiding tanning beds. Regular skin checks are essential for early detection. When caught early and treated appropriately, the prognosis for cSCC is generally favorable, but if the cancer spreads, survival rates can be significantly lower.