squamous cell carcinoma.ppt
TRANSCRIPT
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SQUAMOUS CELL CARCINOMA
Yono Hadi AgusniDept of
DermatovenereologyPadjadjaran University
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Squamous cell carcinoma
• SCC is a malignant proliferation of the keratinocyte of the epidermis
• Robert A. Schwartz & Howard L. Stoll Jr
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Epidemiology (1)
• Incidence : • USA : 12 per 100.000 white male• 7 per 100.000 white
female• 1 per 100.000 black • Age : over 55 years
• Sex : males > females
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Epidemiology (2)
• Occupation : • Persons (usually males) working
outdoor like farmers, sailors, construction worker,dock workers etc.
• Industrial workers exposed to chemical carcinogens (nitrosureas, polycyclic aromatic hydrocarbons)
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Etiology
• Extrinsic factors
• Intrinsic factors
• Andrew C. Markey
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Extrinsic factors :
• Ultraviolet radiation• Ionizing radiation• Human Papillomavirus• Chemical substances
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Intrinsic factors :
• Genodermatoses• Immunosupression• Preexisting skin changes• Preexisting actinic keratoses
• Andrew C. Markey
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Clinical manifestations
• Skin lesions :
• Distribution :• “sun-exposed areas”• (but may occur anywhere)
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Clinical manifestations (2)
• Type :• indurated papule, plaque or
nodule. Ulcerated lesion may be have a crust in the centre and a firm hyperkeratotic elevated margin
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Clinical manifestations (3)
• Color :• erythematous / yellowish / skin color
• Palpation : hard
• Shape : • Polygonal, oval, round or umbilicted
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Clinical manifestations (3)
• Other skin changes :
• - telangiectasia• - dermatoheliosis• - dry scaly atrophic skin• - small hipopigmentation
macules
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Clinical manifestations (4)
• Other physical findings :
• regional lymphadenopathy due to metastasis
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Laboratorium :
• n o n e
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Pathology anatomi :
• Disorganized proliferation of atypical-appearing squamous cells. Group of these tumor cells may be deeply invasive
• William A. Caro
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Differential diagnosis :
• Basal cell carcinoma• Paget’s disease• In-situ SCC : numular eczema,
psoriasis
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Treatment
• Surgery
• Carcinoma in-situ : • cryotherapy, 5-FU topical• Radiotherapy should be performed
only if surgery is not feasible
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Prognosis :
• SCC has an overall remission rate after therapy of 90%
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dermatoheliosis
• = “photoaging”
• Repeated solar injuries over many years can ultimately result in the development of a skin syndrome