Generality
Squamous carcinoma is a malignant tumor of the skin, which originates from the uncontrolled proliferation of a squamous cell of the epidermis.
In most cases, the formation of a squamous carcinoma is due to excessive exposure to the UV rays of the sun or tanning lamps; more rarely, to a state of immunodepression, to contact with certain toxic chemical agents or to genetic predisposition.
Squamous carcinomas manifest themselves with a cutaneous sign, whose characteristics vary mainly in relation to the site.
For the diagnosis of squamous carcinoma, the following are essential: physical examination, medical history and tissue biopsy.
Squamous carcinoma is a widely treatable tumor, provided, however, that the therapy - which consists of a work to remove the skin mark - is timely.
Short Review of the Skin
To understand what basalioma is, it is necessary to review some fundamental concepts relating to the skin and its very important cell line, the so-called basal cells:
- The skin, or skin, is the outer covering of the human body ;
- The skin consists essentially of two tissues: a more superficial tissue, called the epidermis, and a deeper tissue, called the dermis ;
- The epidermis is an example of epithelial tissue (or epithelium ); the dermis, on the other hand, is an example of dense connective tissue ; as tissues, both the epidermis and the dermis comprise different cell lines (or different types of cells).
What is Squamous Carcinoma?
Squamous carcinoma is a malignant tumor of the skin, which originates from the uncontrolled proliferation of one of the so-called squamous cells of the epidermis.
What are Epidermal Squamous Cells?
Generally flattened in shape, the squamous cells of the epidermis are the most superficial cellular elements of this skin epithelium.
The squamous cells belong to the family of keratinocytes, ie the cells responsible for the production of keratin .
The squamous cells have a very short life (a few weeks) and are the subject of continuous replacement with identical cellular elements.
Is Squamous Carcinoma Dangerous?
Squamous carcinoma is not a particularly aggressive and dangerous malignancy, but it can become so if its diagnosis is late or if treatments are inadequate.
Classification of Squamous Carcinoma
Squamous carcinoma belongs to the category of so-called skin cancers other than melanoma and, as the name suggests, is an example of carcinoma.
SKIN CANCER OTHER THAN MELANOMA: WHAT ARE THEY?
Also known as non-melanoma skin cancers, non-melanoma skin cancers are the most common skin cancers, as well as one of the most widespread forms of cancer in the general population.
The element that accumulates the various skin cancers other than melanoma is the involvement of the most superficial layers of the skin; what differentiates them, on the other hand, is the type of cell from which the neoplasia originates.
CARCINOMA: WHAT IS IT?
In oncology, the word "carcinoma" defines any malignant tumor (or cancer), which originated from the uncontrolled proliferation of a cell belonging to an epithelial tissue .
Did you know that ...
The tumors that, like carcinomas, originate from the uncontrolled proliferation of epithelial tissue are epitheliomas ; in oncology, the term " epithelioma " identifies any benign or malignant neoplasm that originates from a cell of an epithelium.
Epidemiology
Squamous carcinoma characterizes a good 20% of the total number of skin cancer cases other than melanoma, which places it in second place in the special classification of the most common non-melanoma skin tumors.
Squamous cell carcinoma most frequently affects people over the age of 50 and more common among men than women.
From what emerges from various statistical studies, the incidence rate of squamous carcinoma depends on the geographical area considered: in the areas closest to the equator and / or at high altitudes, the incidence is higher than elsewhere.
In Italy, reliable sources claim that the annual incidence is approximately 22-23 cases per 100, 000 individuals.
Did you know that ...
The most common skin cancer other than melanoma is basal cell carcinoma, also known as basalioma or basocellular epithelioma .
In numerical terms, basal cell carcinoma distinguishes 75% of the total number of cases of non-melanoma skin cancer.
Synonyms: with what other names is Squamous Carcinoma known?
In oncology, squamous carcinoma is also known by at least four other names, which are: spinocellular carcinoma, squamous cell carcinoma, squamous cell epithelioma and spinalioma .
Important
The expression "squamous carcinoma" should not be confused with the expression " squamous cell carcinoma "; the first, in fact, indicates - as reported above - the malignant tumor of the skin arising from a squamous cell of the epidermis, while the second refers to a generic carcinoma that originates from the uncontrolled proliferation of a squamous cell of a generic epithelium (all the epithelia present in the human body have a portion of squamous cells, which can give rise to a malignant tumor).
Causes
What is a Malignant Tumor and How does Squamous Carcinoma arise?
A malignant tumor is a mass of abnormal cells, whose division and growth rate is higher than the parameters considered normal.
Triggering the formation of a malignant tumor is the accumulation, by the DNA of even just one cell of the affected organ or tissue, of mutations in fundamental genes to regulate growth, development and cell division .
The malignant tumors are, therefore, masses of cells that grow and divide without any control, since the cellular element from which they derive has lost, due to a series of DNA genetic mutations, the possibility of regulating their own life cycle .
Squamous carcinoma is the malignant tumor of the skin resulting from the accumulation by the DNA of a squamous cell of the epidermis, of mutations in genes responsible for regulating growth, development and division of the same cell.
Causes of Squamous Carcinoma: what produces Genetic Mutations
In most cases, the formation of a squamous carcinoma is due to an excessive exposure to ultraviolet radiation ( UV rays ) of the sun or tanning lamps ; more rarely, it is related to a state of immunodepression (ie an inefficient immune system), to contact with some particular toxic substance or to a genetic predisposition to skin cancers other than melanoma.
Did you know that ...
The UV rays of the sun and tanning lamps are the main culprits of other skin cancers, not just of squamous carcinoma.
What Favors Squamous Carcinoma: Risk Factors
Oncological research has shown that several factors favor the appearance of squamous carcinoma, including:
- Excessive exposure to sunlight or tanning lamps . The UV rays of the sun or tanning lamps are the main cause of squamous carcinoma;
- Light skin . The light skin is poor in melanin, that is the pigment that protects the skin from the harmful consequences of the UV rays of the sun;
- Exposure to ultraviolet radiation from phototherapy . Phototherapy is a form of treatment that serves the therapeutic management of conditions such as, for example, psoriasis, acne and other skin diseases;
- Exposure to arsenic . Arsenic promotes the onset of various skin cancers, including squamous carcinoma;
- The presence of a weak immune system . Immunosuppression is usually a problem of: those who take immunosuppressive drugs (they are drugs that lower the immune system), the elderly (for physiological reasons) and people suffering from diseases that cause immunodepression (eg, AIDS patients);
- A personal or familial genetic predisposition to the development of skin cancers . The presence of genetic conditions, such as xeroderma pigmentosum, increases the likelihood of developing squamous carcinoma;
- A personal history of precancerous lesions . People with actinic keratosis and Bowen's disease - two pre-cancerous skin conditions - are more at risk of squamous cell carcinoma;
- Living in geographical areas with high sunshine and / or high altitude .
Did you know that ...
Sufferers of xeroderma pigmentosum are extremely sensitive to sunlight, so much so that they must protect themselves from the sun's rays even inside their own homes.
Symptoms and Complications
Squamous cell carcinoma manifests itself with a mark on the skin, which, depending on the location, may look like:
- A red nodule of stiff consistency;
- A scaly and crusted sore, which, due to scraping, tends to bleed;
- An ulcerative lesion that never heals;
- A wart;
- A rough and reddened sore;
- A rough and scaly sore.
Squamous carcinoma prefers, as a site of appearance, the skin areas of the human body most exposed to sunlight (ie face, back of hands, scalp, neck and ears); in reality, however, this malignant skin tumor could appear anywhere, even in the mouth, genitals and anus.
Did you know that ...
In the genitals, squamous carcinoma takes on the appearance of a wart; in the mouth, instead, of a rough and reddened sore.
When should I go to the doctor?
Species in the presence of risk factors (eg: fair skin), is a valid reason to contact a dermatologist for the sudden appearance and without obvious reasons, on an area of the skin, of a lesion with a suspicious appearance and which tends to worsen instead of to heal with the passing of days.
Did you know that ...
Bowen's disease, or squamous carcinoma in situ, is the earliest form of squamous carcinoma.
Diagnosis
For the diagnosis of squamous carcinoma, a physical examination, a history and a tissue biopsy of the skin area affected by the sign that indicates the presence of the tumor are essential.
Early diagnosis of squamous carcinoma is essential to guarantee a high probability of recovery, as it allows the implementation of the therapeutic plan before the tumor has invaded the surrounding tissues and spread into the blood.
In case of doubts concerning a sign that appeared on the skin in a completely sudden way, it is always advisable to contact your doctor immediately and without hesitation, in order to schedule a check-up visit.
Tissue Biopsy
Tissue biopsy is the only diagnostic test that can establish the true nature of the abnormal sign on the skin .
Tissue biopsy involves the taking, directly from the suspected skin area, of a small piece of tissue and the observation of this tissue under a microscope; to the instrument, any tumor cells present have an unmistakable appearance.
Tissue biopsy also makes it possible to distinguish squamous carcinoma from other skin cancers responsible for a similar cutaneous sign.
Therapy
The treatment of a squamous carcinoma involves a therapy aimed at the complete removal of the abnormal sign appeared on the skin (as this is, in fact, the mass of tumor cells).
Currently, to eliminate squamous carcinomas, dermatologists can draw on a wide availability of therapeutic techniques .
The choice of a therapeutic approach in spite of the others is not accidental, but depends on 3 important factors, which are: the site, the size and the aspect of the cutaneous sign that represents the squamous carcinoma.
Techniques to Eliminate Squamous Carcinoma: What Are They?
Going into more detail, among the therapeutic techniques that can be used to remove a squamous carcinoma, there are:
- Cutaneous curettage combined with electrocautery . Skin curettage is a work of scraping the skin, carried out with a special tool, in order to eliminate an area of unwanted skin; electrocautery, on the other hand, is a medical technique that serves to block possible bleeding, after operations such as the aforementioned curettage .
Cutaneous curettage combined with electrocautery is ideal when the cutaneous sign due to squamous carcinoma is small;
- Photodynamic therapy . It involves the combined use of a photosensitizing drug for topical use, to make the tumor area sensitive to light, and a source of luminous radiation, to kill hyper-photosensitive neoplastic cells (made such by the aforementioned drug).
- Mohs surgery . It is the elimination of the neoplastic sore layer by layer, combined with the microscopic observation of each layer removed.
Thanks to the microscopic examination of each layer of tumor cells removed, the surgeon is able to understand when the elimination of squamous carcinoma is complete.
Since it ends with the observation of the first layer of cells without tumor characteristics, Mohs surgery guarantees the exclusive removal of the tumor, without unduly compromising healthy tissues;
- Cryotherapy (or cold therapy ). It consists in applying liquid nitrogen on the area of extension of the skin sign; liquid nitrogen has the power to freeze cancer cells and cause death;
- Classical surgical excision (or excision ). It is the removal by surgical incision of the tumor lesion present on the skin. The major drawback of this therapeutic option consists in the possibility of forming a noticeable skin scar, especially in the most delicate areas of the human body (eg: face);
- Topical chemotherapy drugs (or chemotherapeutic cream ). Chemotherapy drugs are special drugs, capable of killing rapidly growing cells, such as tumor cells.
Topical chemotherapy drugs are drugs designed to be applied to an area of skin affected by a tumor, in order to destroy the cells making up the latter.
Among the topical chemotherapy drugs most commonly used for the treatment of squamous carcinoma are those based on 5-fluorouracil;
- Immunotherapies for topical use (or immunotherapies in cream ). Intended for application to the tumor area, the immunotherapies in cream destroy the cells of a tumor, through greater activation of the immune system.
The immunotherapeutic drug of choice for the treatment of squamous carcinomas is the amiquimod in cream;
- Radiotherapy . It involves the use of a source of high-energy X-rays, which, projected onto the tumor area, kill the neoplastic cells. It is not always effective, as relapses can occur.
Radiation therapy is especially useful against very deep scaly carcinomas;
- Laser therapy . It consists in exposing the skin sign to an intense beam of luminous light, which has the power to vaporize the tumor, without excessively damaging the adjacent healthy areas and without causing excessive loss of blood.
Laser therapy is indicated against the most superficial squamous carcinomas.
Based on the location, size and appearance of the squamous carcinoma, dermatologists choose the most effective therapy that leaves a minimal scar.
What happens after a Squamous Carcinoma Therapy?
After the treatment of a squamous carcinoma, regardless of the therapeutic technique adopted, the patient must undergo a series of periodic checks, in order to monitor how the recovery proceeds.
These periodic checks are very important, because the treating dermatologist can notice in time if the therapy has been successful or if, instead, the squamous carcinoma needs further therapeutic intervention.
Prognosis
The curability and the possibilities to completely recover from a squamous carcinoma are high, if: the tumor does not arise in delicate sites, the diagnosis is early and the treatment is adequate, and the patient is not affected by immunosuppression.
Prevention
Squamous carcinoma is a preventable tumor, provided however that certain recommendations are followed; these recommendations include:
- Avoid prolonged exposure to the sun in the central hours of the hottest days ;
- Use sunscreen, especially in the presence of fair skin or a predisposition to skin cancer;
- Cover the parts of the body that are usually most exposed to sunlight and wear sunglasses, especially in the presence of a predisposition to skin cancer;
- Avoid the use of tanning lamps ;
- Periodically check the skin, even in the most unthinkable points;
- Don't overlook any skin abnormality that appears suddenly, because it could be a squamous cell carcinoma or another skin cancer.
