Squamous cell intraepidermal carcinoma

What is it intraepidermal scaly cell carcinoma?

Squamous cell intraepidermal carcinoma (SCC) is a common superficial form of keratinocytes Cancer. It is also known as Bowen's disease, intraepidermal carcinoma (IEC), and carcinoma. in the place (SCC in situ).

Intraepidermal SCC is derived from squamous cells, apartment epidermal cells that make curb, the corneal protein that forms the skin, hair and nail. "Intraepidermal" and "in situ" mean evil one cells are confined to the tissue of origin, in this case, the epidermis.

Who gets intraepidermal squamous cell carcinoma?

Risk factors for intraepidermal SCC include:

• Sun Exposure - Intraepidermal SCC is most often found in sun-damaged people.

• Arsenic ingestion: intraepidermal SCC is common in populations exposed to arsenic.

• Ionizing radiation: Intraepidermal SCC was common in the unprotected hands of radiologists in the early 20th century.
• Human Papillomavirus (HPV) infection: This is implicated in intraepidermal SCC in fingers and nails.
• Immunosuppression due to illness (eg. chronic lymphocytic leukemia) or medications (eg azathioprine, cyclosporine).

Up to 50% of patients with intraepidermal SCC have other keratinocytic skin cancers, mainly basal cell carcinoma

What causes intraepidermal SCC?

Ultraviolet radiation (UV) is the main cause of intraepidermal SCC. It damages the nucleic acids of skin cells (DNA), resulting in a mutant clone of the gene p53, triggering the uncontrolled growth of skin cells. UV radiation also suppresses the immune response, preventing recovery from damage.

Human papillomavirus (HPV) is another important cause of intraepidermal SCC. Oncogenic HPV strains are the main cause of squamous intraepithelial lesions (SIL), that is, squamous cell carcinoma in situ in mucous membrane tissue.

What are the clinical features of intraepidermal SCC?

Intraepidermal SCC presents as one or more irregular scaly plates up to several centimeters in diameter. They are often orange-red in color but can also be brown.

Although intraepidermal SCC can develop in any area of the skin, it is most often diagnosed at sun-exposed sites on the ears, face, hands, and legs. When there are many plates, distribution It is not symmetrical (unlike psoriasis).

See more images of intraepidermal SCC ...

Intraepidermal SCC can begin to grow under a nail when it produces a red streak (erythronychia) which can then destroy the nail plate.

Complications of intraepidermal squamous cell carcinoma

Invader SCC arises at approximately 5% of intraepidermal SCC lesions.

How is intraepidermal squamous cell carcinoma diagnosed?

Intraepidermal SCC is often recognized clinically. Dermoscopy of an irregular scaly red license plate is supportive if it reveals rounded and rolled crops blood vessels.

The diagnosis can be confirmed by biopsy; histology reveals full thickness dysplasia of the epidermis.

What is the treatment for intraepidermal SCC?

Since intraepidermal SCC is limited to the surface of the skin, there are several ways to remove it. Reappearance rates are high regardless of the method used, particularly in immunosuppressed patients.

Observation

Since the risk of invasive SCC is low, it may not be necessary to remove all lesions, particularly in elderly patients. Keratolytic emollients Containing urea or salicylic acid may be enough to improve symptoms.

Excision

Solitary lesions can be cut and the defect repaired by stitching. Excision is often recommended if invasive SCC is suspected.

Superficial skin surgery.

Superficial skin surgery refers to shaving, curettage, and electrosurgery, and is an excellent option for the lonely or few. hyperkeratotic Injuries injury it is cut or scraped; then the base is cauterized. Dressings are applied to the open wound to encourage moist wound healing for the next several weeks.

Cryotherapy

Cryotherapy means removing a lesion by freezing it, usually with liquid nitrogen. Moderately aggressive cryotherapy is suitable for multiple, small, flat patches of intraepidermal SCC. Leaves a permanent white mark on the treatment site.

Fluorouracil cream

5-fluorouracil cream contains a cytotoxic agent and can be applied to multiple injuries. The cream can be used for intraepidermal SCC for four weeks and repeated if necessary. Causes a vigorous skin reaction that can ulcerate.

Imiquimod cream

Imiquimod cream is an immune response modifier used without a license to treat intraepidermal SCC. It is applied 3 to 5 times a week for 4 to 16 weeks and produces a inflammatory reaction.

Photodynamic therapy

Photodynamic therapy (PDT) refers to treatment with a photosensitizer (a porphyrin chemical) that is applied to the affected area before exposing it to a strong source of visible light. The treated area develops an inflammatory reaction and then heals for a couple of weeks or so. The best-studied methyl levulinate cream PDT, used without a license, provides high cure rates for intraepidermal SCC on the face or legs, with excellent cosmetic results. The main disadvantage is the pain experienced by many patients during treatment.

Other treatments

Other treatments occasionally used in the treatment of intraepidermal SCC include:

• Combined treatments
• Diclofenac gel
• Current retinoid (tazarotene, tretinoin)
• Chemical peel
• Radiotherapy
• Electron beam therapy
• Carbon dioxide To be ablation

• Erbium: YAG laser ablation

• Oral retinoid (acitretin, isotretinoin)

How can intraepidermal SCC be prevented?

Meticulous sun protection at any time in life can reduce the number of intraepidermal SCCs and is particularly important for the aging of sun-damaged white skin; and in patients immunosuppressed by disease, for example with the human immunodeficiency virus (HIV) infection, or medications.

• Stay indoors or in the shade in the middle of the day.
• Wear hedging clothing.
• Generously apply high protection broad spectrum SPF50 + sunscreens to exposed skin yes outdoors
• Avoid tanning indoors (hammocks and sun beds).

What is the outlook for intraepidermal SCC?

Intraepidermal SCC can recur months or years after treatment. You can repeat the same procedure or use another method.

Patients who have been treated for intraepidermal SCC are at risk of developing new intraepidermal SCC lesions. They are also at increased risk for other skin cancers, especially squamous cell carcinoma, basal cell carcinoma, and melanoma.