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Author: Naomi Ashman, Dermoscopist, Torbay Skin, Auckland, New Zealand; DermNet New Zealand Editor in Chief, Adjunct A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Copy edited by Gus Mitchell. Created 2019.
Introduction Clinical features Dermoscopic features Differential diagnoses Histological explanation
Cutaneous squamous cell carcinoma is a common type of keratinocytic or nonmelanoma skin cancer. It is commonly found on sun-exposed areas of skin. It can be invasive and metastasise. It is also known as cutaneous squamous cell carcinoma, and commonly abbreviated to SCC.
Cutaneous squamous cell carcinoma presents clinically as an enlarging, irregular, keratinous nodule or a firm erythematous plaque that frequently ulcerates.
They usually arise within pre-existing actinic keratosis or intraepidermal carcinoma.
Multiple squamous cell carcinomas on the scalp

Squamous cell carcinoma of the nose

Squamous cell carcinoma of the lip

High-risk cutaneous squamous cell carcinoma

Squamous cell carcinoma

Squamous cell carcinoma
The common dermoscopic features of cutaneous squamous cell carcinoma are:

White structureless areas and white circles in squamous cell carcinoma dermoscopy

White circles in squamous cell carcinoma dermoscopy

White circles and surface keratin seen in squamous cell carcinoma dermoscopy

White structures and surface keratin in squamous cell carcinoma dermoscopy

Loop vessels seen in squamous cell carcinoma dermoscopy

White structureless areas and central keratin in squamous cell carcinoma dermoscopy

White structureless areas and surface keratin in squamous cell carcinoma dermoscopy

White structureless areas, central keratin and loop vessels in squamous cell carcinoma dermoscopy

Poorly differentiated squamous cell carcinoma dermoscopy
Pigmented cutaneous squamous cell carcinoma has brown, blue or grey areas.
The dermoscopic differential diagnosis of cutaneous squamous cell carcinoma includes its variants:
Other conditions to consider include:

Intraepidermal carcinoma dermoscopy

Macro image of a cutaneous horn

Actinic keratosis dermoscopy

Keratoacanthoma dermoscopy

Keratoacanthoma dermoscopy

Verruca vulgaris dermoscopy

Verruca vulgaris dermoscopy

Macro image of chromoblastomycosis

Chondrodermatitis nodularis helicis dermoscopy

Basal cell carcinoma dermoscopy

Amelanotic melanoma, Breslow 3.2mm, CL IV dermoscopy

Amelanotic melanoma dermoscopy
Histologically, there is a proliferation of atypical keratinocytes within the dermis.

Histopathology of squamous cell carcinoma