Squamous cell carcinoma of the skin - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Squamous cell carcinoma (SCC) of the skin occurs in keratinocytes, which are located in the epidermis.
Second most common nonmelanoma skin cancer worldwide, secondary to basal cell carcinoma.
Cumulative ultraviolet exposure and immunosuppression are major risk factors.
Treatments include nonsurgical destruction (e.g., using cryotherapy), topical and systemic chemotherapy, traditional surgical excision, and Mohs micrographic surgery.
Neoadjuvant treatment with cemiplimab or adjuvant treatment with either cemiplimab or pembrolizumab may be considered for patients with advanced SCC.

Squamous cell carcinoma on the dorsal hand with evidence of extensive sun damage

From the private collection of Dr Nwaneshiudu and Dr Soltani

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Squamous cell carcinoma on the dorsal hand with evidence of extensive sun damage
Squamous cell in situ on nasal bridge
Biopsy showing histology of an actinic keratosis with keratinocyte atypia limited to the basal layer
Biopsy showing histology of an in-situ SCC with full-thickness keratinocyte atypia
Biopsy histology showing invasive SCC with keratinocyte atypia involving all layers of the epidermis and islands budding into the dermis
Biopsy showing histology of an invasive SCC with keratinocyte atypia involving all layers of the epidermis and islands budding into the dermis. Higher magnification (left) highlights the cellular atypia

Citations

Key Articles

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: squamous cell skin cancer [internet publication].[Full Text]
Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2018 Mar;78(3):560-78.[Abstract][Full Text]
Keohane SG, Botting J, Budny PG, et al. British Association of Dermatologists guidelines for the management of the people with cutaneous squamous cell carcinoma 2020. Br J Dermatol 2021;184:401-14.[Full Text]
Stratigos AJ, Garbe C, Dessinioti C, et al. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: part 2. Treatment - update 2023. Eur J Cancer. 2023 Nov;193:113252.[Abstract][Full Text]

Other Online Resources

NIH: skin cancer treatment PDQ - health professional version
Mayo Clinic: squamous cell carcinoma of the skin
UCSF Medical Center: basal cell and squamous cell carcinoma

Referenced Articles

1. Weimar VM, Ceilley RI, Goeken JA. Aggressive biologic behavior of basal- and squamous-cell cancers in patients with chronic lymphocytic leukemia or chronic lymphocytic lymphoma. J Dermatol Surg Oncol. 1979 Aug;5(8):609-14.[Abstract]
2. Schwartz RA. Keratoacanthoma. J Am Acad Dermatol. 1994 Jan;30(1):1-19; quiz 20-2.[Abstract]
3. Walder BK, Robertson MR, Jeremy D. Skin cancer and immunosuppression. Lancet. 1971 Dec 11;2(7737):1282-3.[Abstract]
4. Phillips TJ, Salman SM, Bhawan J, et al. Burn scar carcinoma. Diagnosis and management. Dermatol Surg. 1998 May;24(5):561-5.[Abstract]
5. Sánchez G, Nova J, Rodriguez-Hernandez AE, et al. Sun protection for preventing basal cell and squamous cell skin cancers. Cochrane Database Syst Rev. 2016 Jul 25;(7):CD011161.[Abstract]
6. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021 May;71(3):209-49.[Abstract][Full Text]
7. Rogers HW, Weinstock MA, Feldman SR, et al. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population, 2012. JAMA Dermatol. 2015 Oct;151(10):1081-6.[Abstract][Full Text]
8. Gogia R, Binstock M, Hirose R, et al. Fitzpatrick skin phototype is an independent predictor of squamous cell carcinoma risk after solid organ transplantation. J Am Acad Dermatol. 2013 Apr;68(4):585-91.[Abstract]
9. Larese Filon F, Buric M, Fluehler C. UV exposure, preventive habits, risk perception, and occupation in NMSC patients: a case-control study in Trieste (NE Italy). Photodermatol Photoimmunol Photomed. 2019 Jan;35(1):24-30.[Abstract]
10. Laughter MR, Maymone MBC, Karimkhani C, et al. The burden of skin and subcutaneous diseases in the United States from 1990 to 2017. JAMA Dermatol. 2020 Aug 1;156(8):874-81.[Abstract][Full Text]
11. Miller DL, Weinstock MA. Nonmelanoma skin cancer in the United States: incidence. J Am Acad Dermatol. 1994 May;30(5 pt 1):774-8.[Abstract][Full Text]
12. Muzic JG, Schmitt AR, Wright AC, et al. Incidence and trends of basal cell carcinoma and cutaneous squamous cell carcinoma: a population-based study in Olmsted County, Minnesota, 2000 to 2010. Mayo Clin Proc. 2017 Jun;92(6):890-8.[Abstract]
13. Johnson TM, Rowe DE, Nelson BR, et al. Squamous cell carcinoma of the skin (excluding lip and oral mucosa). J Am Acad Dermatol. 1992 Mar;26(3 Pt 2):467-84.[Abstract]
14. Ibrahim N, Ali SR, Dobbs TD, et al. The incidence of non-melanoma skin cancer in the UK and the Republic of Ireland: a systematic review. Eur J Dermatol. 2023 Jun 1;33(3):218-29.[Abstract]
15. Massey PR, Schmults CD, Li SJ, et al. Consensus-based recommendations on the prevention of squamous cell carcinoma in solid organ transplant recipients: a Delphi consensus statement. JAMA Dermatol. 2021 Sep 1 [Epub ahead of print].[Abstract]
16. Zakhem GA, Pulavarty AN, Lester JC, et al. Skin cancer in people of color: a systematic review. Am J Clin Dermatol. 2022 Mar;23(2):137-51.[Abstract]
17. Hogue L, Harvey VM. Basal cell carcinoma, squamous cell carcinoma, and cutaneous melanoma in skin of color patients. Dermatol Clin. 2019 Oct;37(4):519-26.[Abstract][Full Text]
18. Jin F, Vajdic CM, Poynten IM, et al. Cancer risk in people living with HIV and solid organ transplant recipients: a systematic review and meta-analysis. Lancet Oncol. 2024 Jul;25(7):933-44.[Abstract]
19. Vitaliano PP, Urbach F. The relative importance of risk factors in nonmelanoma carcinoma. Arch Dermatol. 1980 Apr;116(4):454-6.[Abstract]
20. Kinlen LJ, Sheil AG, Peto J, et al. Collaborative United Kingdom-Australasian study of cancer in patients treated with immunosuppressive drugs. Br Med J. 1979 Dec 8;2(6203):1461-6.[Abstract][Full Text]
21. Weistenhöfer W, Lutz R, Hiller J, et al. Syncarcinogenesis of natural UV radiation and polycyclic aromatic hydrocarbons in the development of squamous cell carcinomas of the skin? J Dtsch Dermatol Ges. 2022 Sep;20(9):1179-86.[Abstract][Full Text]
22. Namgoong S, Kim J, Jeong KM, et al. Association of human papillomavirus and extra-genital Bowen disease (squamous cell carcinoma in situ): a systematic review. J Am Acad Dermatol. 2021 Mar;84(3):822-5.[Abstract][Full Text]
23. Paprottka FJ, Bontikous S, Lohmeyer JA, et al. Squamous-cell carcinoma arises in red parts of multicolored tattoo within months. Plast Reconstr Surg Glob Open. 2014 Apr 7;2(3):e114.[Abstract][Full Text]
24. Droll S, Bao X. Oh, the mutations you'll acquire! A systematic overview of cutaneous squamous cell carcinoma. Cell Physiol Biochem. 2021 Sep 22;55(s2):89-119.[Abstract][Full Text]
25. Kripke ML. Immunological effects of ultraviolet radiation. J Dermatol. 1991 Aug;18(8):429-33.[Abstract]
26. de Gruijl FR, van Kranen HJ, Mullenders LH. UV-induced DNA damage, repair, mutations and oncogenic pathways in skin cancer. J Photochem Photobiol B. 2001 Oct;63(1-3):19-27.[Abstract]
27. Liang SB, Ohtsuki Y, Furihata M, et al. Sun-exposure- and aging-dependent p53 protein accumulation results in growth advantage for tumour cells in carcinogenesis of nonmelanocytic skin cancer. Virchows Arch. 1999 Mar;434(3):193-9.[Abstract]
28. Ming M, Feng L, Shea CR, et al. PTEN positively regulates UVB-induced DNA damage repair. Cancer Res. 2011 Aug 1;71(15):5287-95.[Abstract]
29. Ming M, Han W, Maddox J, et al. UVB-induced ERK/AKT-dependent PTEN suppression promotes survival of epidermal keratinocytes. Oncogene. 2010 Jan 28;29(4):492-502.[Abstract][Full Text]
30. Tsai KY, Tsao H. The genetics of skin cancer. Am J Med Genet C Semin Med Genet. 2004 Nov 15;131C(1):82-92.[Abstract]
31. Han W, Ming M, He TC, et al. Immunosuppressive cyclosporin A activates AKT in keratinocytes through PTEN suppression: implications in skin carcinogenesis. J Biol Chem. 2010 Apr 9;285(15):11369-77.[Abstract][Full Text]
32. Han W, Soltani K, Ming M, et al. Deregulation of XPC and CypA by cyclosporin A: an immunosuppression-independent mechanism of skin carcinogenesis. Cancer Prev Res (Phila). 2012 Sep;5(9):1155-62.[Abstract]
33. Kanitz A, Imig J, Dziunycz PJ, et al. The expression levels of microRNA-361-5p and its target VEGFA are inversely correlated in human cutaneous squamous cell carcinoma. PLoS One. 2012;7(11):e49568.[Abstract][Full Text]
34. Hu SC, Yu HS, Yen FL, et al. CXCR7 expression correlates with tumor depth in cutaneous squamous cell carcinoma skin lesions and promotes tumor cell survival through ERK activation. Exp Dermatol. 2014 Dec;23(12):902-8.[Abstract]
35. Dong F, Wang Y, Li L, et al. CD109 expression is increased in cutaneous squamous cell carcinoma. J Dermatol. 2014 Oct;41(10):947-9.[Abstract]
36. Lee CS, Bhaduri A, Mah A, et al. Recurrent point mutations in the kinetochore gene KNSTRN in cutaneous squamous cell carcinoma. Nat Genet. 2014 Oct;46(10):1060-2.[Abstract]
37. Kuźbicki Ł, Brożyna AA. Expression of cyclooxygenase-2 in human epithelial skin lesions: a systematic review of immunohistochemical studies. Appl Immunohistochem Mol Morphol. 2021 Mar 1;29(3):163-74.[Abstract]
38. Fears TR, Scotto J. Estimating increases in skin cancer morbidity due to increases in ultraviolet radiation exposure. Cancer Invest. 1983;1(2):119-26.[Abstract]
39. Rundel RD. Promotional effects of ultraviolet radiation on human basal and squamous cell carcinoma. Photochem Photobiol. 1983 Nov;38(5):569-75.[Abstract]
40. Glover MT, Deeks JJ, Raftery MJ, et al. Immunosuppression and risk of non-melanoma skin cancer in renal transplant recipients. Lancet. 1997 Feb 8;349(9049):398.[Abstract]
41. Hofbauer GF, Anliker M, Arnold A, et al. Swiss clinical practice guidelines for skin cancer in organ transplant recipients. Swiss Med Wkly. 2009 Jul 25;139(29-30):407-15.[Abstract]
42. Bibee K, Swartz A, Sridharan S, et al. Cutaneous squamous cell carcinoma in the organ transplant recipient. Oral Oncol. 2020 Apr;103:104562.[Abstract]
43. Preciado DA, Matas A, Adams GL. Squamous cell carcinoma of the head and neck in solid organ transplant recipients. Head Neck. 2002 Apr;24(4):319-25.[Abstract]
44. Mattei PL, Alora-Palli MB, Kraft S, et al. Cutaneous effects of BRAF inhibitor therapy: a case series. Ann Oncol. 2013 Feb;24(2):530-7.[Abstract]
45. Belum VR, Rosen AC, Jaimes N, et al. Clinico-morphological features of BRAF inhibition-induced proliferative skin lesions in cancer patients. Cancer. 2015 Jan 1;121(1):60-8.[Abstract][Full Text]
46. Keeler CE. Albinism, xeroderma pigmentosum, and skin cancer. Natl Cancer Inst Monogr. 1963;10:349-59.
47. Kraemer KH, Lee MM, Scotto J. Xeroderma pigmentosum: cutaneous, ocular, and neurologic abnormalities in 830 published cases. Arch Dermatol. 1987 Feb;123(2):241-50.[Abstract]
48. Yarbro JW, Page DL, Fielding LP, et al. American Joint Committee on Cancer prognostic factors consensus conference. Cancer. 1999 Dec 1;86(11):2436-46.[Abstract]
49. Wagner SL, Maliner JS, Morton WE, et al. Skin cancer and arsenical intoxication from well water. Arch Dermatol. 1979 Oct;115(10):1205-7.[Abstract]
50. Wong ST, Chan HL, Teo SK. The spectrum of cutaneous and internal malignancies in chronic arsenic toxicity. Singapore Med J. 1998 Apr;39(4):171-3.[Abstract]
51. Glogau RG. The risk of progression to invasive disease. J Am Acad Dermatol. 2000 Jan;42(1 Pt 2):23-4.[Abstract]
52. Ahmady S, Jansen MHE, Nelemans PJ, et al. Risk of invasive cutaneous squamous cell carcinoma after different treatments for actinic keratosis: a secondary analysis of a randomized clinical trial. JAMA Dermatol. 2022 Jun 1;158(6):634-40.[Abstract]
53. Sun H, Li Y, Zeng F, et al. Melanoma survivors are at increased risk for second primary keratinocyte carcinoma. Int J Dermatol. 2022 Nov;61(11):1397-404.[Abstract]
54. Lichter MD, Karagas MR, Mott LA, et al; The New Hampshire Skin Cancer Study Group. Therapeutic ionizing radiation and the incidence of basal cell carcinoma and squamous cell carcinoma. Arch Dermatol. 2000 Aug;136(8):1007-11.[Abstract][Full Text]
55. Harwood CA, Surentheran T, McGregor JM, et al. Human papillomavirus infection and non-melanoma skin cancer in immunosuppressed and immunocompetent individuals. J Med Virol. 2000 Jul;61(3):289-97.[Abstract]
56. Meyer T, Arndt R, Christophers E, et al. Importance of human papillomaviruses for the development of skin cancer. Cancer Detect Prev. 2001;25(6):533-47.[Abstract]
57. de Villiers EM, Lavergne D, McLaren K, et al. Prevailing papillomavirus types in non-melanoma carcinomas of the skin in renal allograft recipients. Int J Cancer. 1997 Nov 4;73(3):356-61.[Abstract]
58. Viac J, Chardonnet Y, Chignol MC, et al. Papilloma viruses, warts, carcinoma and Langerhans cells. In Vivo. 1993 May-Jun;7(3):207-12.[Abstract]
59. Leonardi-Bee J, Ellison T, Bath-Hextall F. Smoking and the risk of nonmelanoma skin cancer: systematic review and meta-analysis. Arch Dermatol. 2012 Aug;148(8):939-46.[Abstract]
60. Song F, Qureshi AA, Gao X, et al. Smoking and risk of skin cancer: a prospective analysis and a meta-analysis. Int J Epidemiol. 2012 Dec;41(6):1694-705.[Abstract]
61. Traianou A, Ulrich M, Apalla Z,et al; EPIDERM Group. Risk factors for actinic keratosis in eight European centres: a case-control study. Br J Dermatol. 2012 Aug;167 Suppl 2:36-42.[Abstract]
62. Shao SC, Lai CC, Chen YH, et al. Associations of thiazide use with skin cancers: a systematic review and meta-analysis. BMC Med. 2022 Jul 7;20(1):228.[Abstract][Full Text]
63. de Macedo Andrade AC, Felix FA, França GM, et al. Hydrochlorothiazide use is associated with the risk of cutaneous and lip squamous cell carcinoma: a systematic review and meta-analysis. Eur J Clin Pharmacol. 2022 Jun;78(6):919-30.[Abstract]
64. Kluger N, Koljonen V. Tattoos, inks, and cancer. Lancet Oncol. 2012 Apr;13(4):e161-8.[Abstract]
65. US Preventive Services Task Force, Grossman DC, Curry SJ, et al. Behavioral counseling to prevent skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2018 Mar 20;319(11):1134-42.[Abstract][Full Text]
66. Rönsch H, Bauer A. The preventive value of sun protection. Curr Probl Dermatol. 2021;55:316-28.[Abstract]
67. Farmer KC, Naylor MF. Sun exposure, sunscreens, and skin cancer prevention: a year-round concern. Ann Pharmacother. 1996 Jun;30(6):662-73.[Abstract]
68. Gordon LG, Scuffham PA, van der Pols JC, et al. Regular sunscreen use is a cost-effective approach to skin cancer prevention in subtropical settings. J Invest Dermatol. 2009 Dec;129(12):2766-71.[Abstract][Full Text]
69. Hirst NG, Gordon LG, Scuffham PA, et al. Lifetime cost-effectiveness of skin cancer prevention through promotion of daily sunscreen use. Value Health. 2012 Mar-Apr;15(2):261-8.[Abstract]
70. Green A, Williams G, Neale R, et al. Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinoma of the skin: a randomised controlled trial. Lancet. 1999 Aug 28;354(9180):723-9.[Abstract]
71. Thompson SC, Jolley D, Marks R. Reduction of solar keratoses by regular sunscreen use. N Engl J Med. 1993 Oct 14;329(16):1147-51.[Abstract][Full Text]
72. Darlington S, Williams G, Neale R, et al. A randomized controlled trial to assess sunscreen application and beta carotene supplementation in the prevention of solar keratoses. Arch Dermatol. 2003 Apr;139(4):451-5.[Abstract][Full Text]
73. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: squamous cell skin cancer [internet publication].[Full Text]
74. Abdi MA, Yan M, Hanna TP. Systematic review of modern case series of squamous cell cancer arising in a chronic ulcer (Marjolin's ulcer) of the skin. JCO Glob Oncol. 2020 Jun;6:809-18.[Abstract][Full Text]
75. Libson K, Sheridan C, Carr DR, et al. Use of imaging in cutaneous squamous cell carcinoma to detect high-risk tumor features, nodal metastasis, and distant metastasis: a systematic review. Dermatol Surg. 2024 Aug 1;50(8):705-9.[Abstract]
76. Barr RJ. Classification of cutaneous squamous cell carcinoma. J Cutan Pathol. 1991 Aug;18(4):225-6.[Abstract]
77. Cassarino DS, Derienzo DP, Barr RJ. Cutaneous squamous cell carcinoma: a comprehensive clinicopathologic classification. Part one. J Cutan Pathol. 2006 Mar;33(3):191-206.[Abstract]
78. Broders AC. Squamous-cell epithelioma of the skin: a study of 256 cases. Ann Surg. 1921 Feb;73(2):141-60.[Abstract][Full Text]
79. Amin MB, Edge S, Greene F, et al. (eds); American Joint Committee on Cancer. AJCC cancer staging manual. 8th ed. New York, NY: Springer; 2017.
80. Schmults CD, Karia PS, Carter JB, et al. Factors predictive of recurrence and death from cutaneous squamous cell carcinoma: a 10-year, single-institution cohort study. JAMA Dermatol. 2013 May;149(5):541-7.[Abstract][Full Text]
81. Karia PS, Jambusaria-Pahlajani A, Harrington DP, et al. Evaluation of American Joint Committee on Cancer, International Union Against Cancer, and Brigham and Women's Hospital tumor staging for cutaneous squamous cell carcinoma. J Clin Oncol. 2014 Feb 1;32(4):327-34.[Abstract]
82. US Preventive Services Task Force, Mangione CM, Barry MJ, et al. Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2023 Apr 18;329(15):1290-5.[Abstract][Full Text]
83. Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2018 Mar;78(3):560-78.[Abstract][Full Text]
84. Mittal A, Colegio OR. Skin cancers in organ transplant recipients. Am J Transplant. 2017 Oct;17(10):2509-30.[Abstract][Full Text]
85. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: vulvar cancer (squamous cell carcinoma) [internet publication].[Full Text]
86. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: vaginal cancer [internet publication].[Full Text]
87. Christensen RE, Elston DM, Worley B, et al. Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: consensus criteria and proposed reporting guidelines. J Am Acad Dermatol. 2023 Jun;88(6):1317-25.[Abstract]
88. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: penile cancer (squamous cell carcinoma) [Internet publication].[Full Text]
89. Queirolo P, Cinquini M, Argenziano G, et al. Guidelines for the diagnosis and treatment of cutaneous squamous cell carcinoma: a GRADE approach for evidence evaluation and recommendations by the Italian Association of Medical Oncology. ESMO Open. 2024 May;9(5):103005.[Abstract][Full Text]
90. Stratigos AJ, Garbe C, Dessinioti C, et al. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma. Part 1: diagnostics and prevention - update 2023. Eur J Cancer. 2023 Jul;193:113251.[Abstract][Full Text]
91. Leiter U, Heppt MV, Steeb T. S3 guideline "actinic keratosis and cutaneous squamous cell carcinoma" - update 2023, part 2: epidemiology and etiology, diagnostics, surgical and systemic treatment of cutaneous squamous cell carcinoma (cSCC), surveillance and prevention. J Dtsch Dermatol Ges. 2023 Nov;21(11):1422-33.[Abstract][Full Text]
92. Keohane SG, Botting J, Budny PG, et al. British Association of Dermatologists guidelines for the management of the people with cutaneous squamous cell carcinoma 2020. Br J Dermatol 2021;184:401-14.[Full Text]
93. Behshad R, Garcia-Zuazaga J, Bordeaux JS. Systemic treatment of locally advanced nonmetastatic cutaneous squamous cell carcinoma: a review of the literature. Br J Dermatol. 2011 Dec;165(6):1169-77.[Abstract]
94. Bath-Hextall FJ, Matin RN, Wilkinson D, et al. Interventions for cutaneous Bowen's disease. Cochrane Database Syst Rev. 2013 Jun 24;(6):CD007281.[Abstract][Full Text]
95. Shimizu I, Cruz A, Chang KH, et al. Treatment of squamous cell carcinoma in situ: a review. Dermatol Surg. 2011 Oct;37(10):1394-411.[Abstract]
96. Stewart JR, Lang ME, Brewer JD. Efficacy of nonexcisional treatment modalities for superficially invasive and in situ squamous cell carcinoma: a systematic review and meta-analysis. J Am Acad Dermatol. 2022 Jul;87(1):131-7.[Abstract]
97. Goette DK. Topical chemotherapy with 5-fluorouracil. A review. J Am Acad Dermatol. 1981 Jun;4(6):633-49.[Abstract]
98. Kaur RR, Alikhan A, Maibach HI. Comparison of topical 5-fluorouracil formulations in actinic keratosis treatment. J Dermatolog Treat. 2010 Sep;21(5):267-71.[Abstract]
99. Feldman SR, Fleischer AB Jr, Williford PM, et al. Destructive procedures are the standard of care for treatment of actinic keratoses. J Am Acad Dermatol. 1999 Jan;40(1):43-7.[Abstract]
100. Kuflik EG, Gage AA. The five-year cure rate achieved by cryosurgery for skin cancer. J Am Acad Dermatol. 1991 Jun;24(6 Pt 1):1002-4.[Abstract]
101. Williamson GS, Jackson R. Treatment of squamous cell carcinoma of the skin by electrodesiccation and curettage. Can Med Assoc J. 1964 Feb 8;90:408-13.[Abstract][Full Text]
102. Rosenthal A, Juhasz MLW, Chang C, et al. Lasers for the treatment of nonmelanoma skin cancer: a systematic review of the literature. Dermatol Surg. 2024 Aug 1;50(8):714-9.[Abstract]
103. Wong TH, Morton CA, Collier N, et al. British Association of Dermatologists and British Photodermatology Group guidelines for topical photodynamic therapy 2018. Br J Dermatol. 2019 Apr;180(4):730-9.[Abstract][Full Text]
104. Xue WL, Ruan JQ, Liu HY, et al. Efficacy of photodynamic therapy for the treatment of Bowen's disease: a meta-analysis of randomized controlled trials. Dermatology. 2022;238(3):542-50.[Abstract][Full Text]
105. Antonetti P, Pellegrini C, Caponio C, et al. Photodynamic therapy for the treatment of Bowen's disease: a review on efficacy, non-invasive treatment monitoring, tolerability, and cosmetic outcome. Biomedicines. 2024 Apr 3;12(4):795.[Abstract][Full Text]
106. Zygogianni A, Kouvaris J, Tolia M, et al. The potential role of radiation therapy in Bowen's disease: a review of the current literature. Rev Recent Clin Trials. 2012 Feb;7(1):42-6.[Abstract][Full Text]
107. Brodland DG, Zitelli JA. Surgical margins for excision of primary cutaneous squamous cell carcinoma. J Am Acad Dermatol. 1992 Aug;27(2 Pt 1):241-8.[Abstract]
108. Lambert DR, Siegle RJ. Skin cancer: a review with consideration of treatment options including Mohs micrographic surgery. Ohio Med. 1990 Oct;86(10):745-7.[Abstract]
109. Robinson JK. Mohs micrographic surgery. Clin Plast Surg. 1993 Jan;20(1):149-56.[Abstract]
110. Boettler MA, Gray AN, Brodsky MA, et al. Mohs micrographic surgery for verrucous carcinoma: a review of the literature. Arch Dermatol Res. 2023 Mar;315(2):133-7.[Abstract]
111. Connolly SM, Baker DR, Coldiron BM, et al; Ad Hoc Task Force. AAD/ACMS/ASDSA/ASMS 2012 appropriate use criteria for Mohs micrographic surgery: a report of the American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery Association, and the American Society for Mohs Surgery. Dermatol Surg. 2012 Oct;38(10):1582-603.[Abstract]
112. Emmett AJ, Broadbent GD. Shave excision of superficial solar skin lesions. Plast Reconstr Surg. 1987 Jul;80(1):47-54.[Abstract]
113. Veness MJ. Treatment recommendations in patients diagnosed with high-risk cutaneous squamous cell carcinoma. Australas Radiol. 2005 Oct;49(5):365-76.[Abstract]
114. Martinez JC, Otley CC, Okuno SH, et al. Chemotherapy in the management of advanced cutaneous squamous cell carcinoma in organ transplant recipients: theoretical and practical considerations. Dermatol Surg. 2004 Apr;30(4 Pt 2):679-86.[Abstract]
115. Gross ND, Miller DM, Khushalani NI, et al. Neoadjuvant cemiplimab for stage II to IV cutaneous squamous-cell carcinoma. N Engl J Med. 2022 Oct 27;387(17):1557-68.[Abstract][Full Text]
116. Migden MR, Khushalani NI, Chang ALS, et al. Cemiplimab in locally advanced cutaneous squamous cell carcinoma: results from an open-label, phase 2, single-arm trial. Lancet Oncol. 2020 Feb;21(2):294-305.[Abstract]
117. Gross ND, Miller DM, Khushalani NI, et al. Neoadjuvant cemiplimab and surgery for stage II-IV cutaneous squamous-cell carcinoma: follow-up and survival outcomes of a single-arm, multicentre, phase 2 study. Lancet Oncol. 2023 Nov;24(11):1196-205.[Abstract]
118. Stratigos AJ, Garbe C, Dessinioti C, et al. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: part 2. Treatment - update 2023. Eur J Cancer. 2023 Nov;193:113252.[Abstract][Full Text]
119. National Institute of Health and Care Excellence. Cemiplimab for treating advanced cutaneous squamous cell carcinoma. Jun 2022 [internet publication].[Full Text]
120. Cañueto J, Muñoz-Couselo E, Cardona-Machado C, et al. Efficacy and safety of cemiplimab in the treatment of advanced cutaneous squamous cell carcinoma: a multicentre real-world retrospective study from Spain and systematic review of the published data. J Eur Acad Dermatol Venereol. 2024 Aug;38(8):e666-70.[Abstract]
121. Young NR, Liu J, Pierce C, et al. Molecular phenotype predicts sensitivity of squamous cell carcinoma of the head and neck to epidermal growth factor receptor inhibition. Mol Oncol. 2013 Jun;7(3):359-68.[Abstract]
122. Markovic A, Chung CH. Current role of EGF receptor monoclonal antibodies and tyrosine kinase inhibitors in the management of head and neck squamous cell carcinoma. Expert Rev Anticancer Ther. 2012 Sep;12(9):1149-59.[Abstract]
123. Pham JP, Rodrigues A, Goldinger SM, et al. Epidermal growth factor receptor inhibitors in advanced cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Exp Dermatol. 2024 Jan;33(1):e14978.[Abstract][Full Text]
124. Zhang J, Wang Y, Wijaya WA, et al. Efficacy and prognostic factors of adjuvant radiotherapy for cutaneous squamous cell carcinoma: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2021 Sep;35(9):1777-87.[Abstract][Full Text]
125. Daniels CP, Liu HY, Porceddu SV. Indications and limits of postoperative radiotherapy for skin malignancies. Curr Opin Otolaryngol Head Neck Surg. 2021 Apr 1;29(2):100-6.[Abstract]
126. Niles RM. Recent advances in the use of vitamin A (retinoids) in the prevention and treatment of cancer. Nutrition. 2000 Nov-Dec;16(11-12):1084-9.[Abstract]
127. Jambusaria-Pahlajani A, Miller CJ, Quon H, et al. Surgical monotherapy versus surgery plus adjuvant radiotherapy in high-risk cutaneous squamous cell carcinoma: a systematic review of outcomes. Dermatol Surg. 2009 Apr;35(4):574-85.[Abstract]
128. Han A, Ratner D. What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion? Cancer. 2007 Mar 15;109(6):1053-9.[Abstract]
129. Chen AC, Martin AJ, Choy B, et al. A phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention. N Engl J Med. 2015 Oct 22;373(17):1618-26.[Abstract][Full Text]
130. Mainville L, Smilga AS, Fortin PR. Effect of nicotinamide in skin cancer and actinic keratoses chemoprophylaxis, and adverse effects related to nicotinamide: a systematic review and meta-analysis. J Cutan Med Surg. 2022 May-Jun;26(3):297-308.[Abstract][Full Text]
131. Tosti G, Pepe F, Gnagnarella P, et al. The role of nicotinamide as chemo-preventive agent in NMSCs: a systematic review and meta-analysis. Nutrients. 2023 Dec 27;16(1):100.[Abstract][Full Text]
132. Schmalbach CE, Ow TJ, Choi KY, et al. American Head and Neck Society position statement on the use of PD-1 inhibitors for treatment of advanced cutaneous squamous cell carcinoma. Head Neck. 2023 Jan;45(1):32-41.[Abstract][Full Text]
133. Likhacheva A, Awan M, Barker CA, et al. Definitive and postoperative radiation therapy for basal and squamous cell cancers of the skin: executive summary of an American Society for Radiation Oncology Clinical Practice Guideline. Pract Radiat Oncol. 2020 Jan-Feb;10(1):8-20.[Abstract][Full Text]
134. American College of Obstetricians and Gynecologists. Committee Opinion No. 509: management of vulvar intraepithelial neoplasia. Obstet Gynecol. 2011 Nov;118(5):1192-4.[Abstract]
135. Silk AW, Barker CA, Bhatia S, et al. Society for Immunotherapy of Cancer (SITC) clinical practice guideline on immunotherapy for the treatment of nonmelanoma skin cancer. J Immunother Cancer. 2022 Jul;10(7):e004434.[Abstract][Full Text]
136. Heppt MV, Leiter U, Steeb T, et al. S3 guideline "actinic keratosis and cutaneous squamous cell carcinoma"- update 2023, part 1: treatment of actinic keratosis, actinic cheilitis, cutaneous squamous cell carcinoma in situ (Bowen's disease), occupational disease and structures of care. J Dtsch Dermatol Ges. 2023 Oct;21(10):1249-62.[Abstract][Full Text]
137. Nakanishi S, Hiramoto T, Ahmed MN, et al. [The role of leukotrienes in hypoxic pulmonary vasoconstriction in dogs]. [in jpn]. Nihon Kyobu Shikkan Gakkai Zasshi. 1986 Aug;24(8):865-70.[Abstract]
138. Marcil I, Stern RS. Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer: a critical review of the literature and meta-analysis. Arch Dermatol. 2000 Dec;136(12):1524-30.[Abstract]
139. Zakhem GA, Pulavarty AN, Carucci J, et al. Association of patient risk factors, tumor characteristics, and treatment modality with poor outcomes in primary cutaneous squamous cell carcinoma: a systematic review and meta-analysis. JAMA Dermatol. 2023 Feb 1;159(2):160-71.[Abstract][Full Text]
140. Russell E, Udkoff J, Knackstedt T. Squamous cell carcinoma with bone invasion: a systematic review and pooled survival analysis. Dermatol Surg. 2022 Oct 1;48(10):1025-8.[Abstract]
141. Mulvaney PM, Massey PR, Yu KK, et al. Differential molecular expression patterns associated with metastasis in cutaneous squamous cell carcinoma: a systematic review and meta-analysis. J Invest Dermatol. 2021 Sep;141(9):2161-9.[Abstract][Full Text]
142. Epstein E, Epstein NN, Bragg K, et al. Metastases from squamous cell carcinoma of the skin. Arch Dermatol. 1968 Mar;97(3):245-51.[Abstract]
143. Jones TP, Boiko PE, Piepkorn MW. Skin biopsy indications in primary care practice: a population-based study. J Am Board Fam Pract. 1996 Nov-Dec;9(6):397-404.[Abstract]