# Squamous Cell Carcinoma of the Skin - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: Basal Cell Carcinoma - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK482439/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class SD25.03 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Cutaneous Squamous Cell Carcinoma - StatPearls - NCBI Bookshelf - disease-level clinical article (squamous-cell-carcinoma-skin-full.txt) - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care - Cutaneous Squamous Cell Carcinoma - StatPearls - NCBI Bookshelf - disease-level clinical article (squamous-cell-carcinoma-skin-full.txt) ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text SQUAMOUS CELL CARCINOMA OF THE SKIN Sources: Basal Cell Carcinoma - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK482439/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class SD25.03 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Cutaneous Squamous Cell Carcinoma - StatPearls - NCBI Bookshelf - disease-level clinical article (squamous-cell-carcinoma-skin- full.txt) Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (1) - Some lesions ulcerate, turn fungating, or become painful [skin lesions] SIGNS - what you find (3) - The usual appearance is a scaly papule or plaque, either red or darker than surrounding skin [papules · plaques · scaling] - Most arise on sun-damaged skin, reflecting the strong link with ultraviolet exposure - It can grow out of an existing lesion: actinic keratosis, a chronic wound known as Marjolin ulcer, HPV infection, porokeratosis, lichen sclerosus, hypertrophic or oral lichen planus, or discoid lupus [skin ulcer] TESTS (6) - Skin biopsy is required to confirm it - Sentinel node biopsy, or CT or ultrasound for nodal spread, is advised at BWH stage T2B-T3 or AJCC-8 stage T4 - AJCC-8 stage T2-3 is decided case by case - Where nodes are palpable, sample them by fine-needle aspiration or biopsy - Once nodal involvement is proven on biopsy, hunt for distant disease with CT or PET - NCCN advises baseline imaging, usually contrast MRI, for very-high-risk tumours: wider than 4 cm, invading deeper than 6 mm, or perineural invasion of nerves 0.1 mm or thicker even when unnamed IF NOT THIS - what else fits (11) - Basal cell carcinoma - Melanoma - Extramammary Paget disease - Actinic keratosis - Seborrhoeic keratosis - Porokeratosis - Warts, or verruca - Psoriasis - Nummular dermatitis - Lichen planus - Discoid cutaneous lupus erythematosus Source StatPearls "Cutaneous Squamous Cell Carcinoma" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult A skin malignancy of sun-exposed areas that can arise from actinic keratosis, presenting as a scaly, crusted, or ulcerated nodule; it has higher spread potential than basal cell carcinoma, so the GP recognises the lesion and refers promptly for biopsy and excision. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why A skin malignancy of sun-exposed areas that can arise from actinic keratosis, presenting as a scaly, crusted, or ulcerated nodule; it has higher spread potential than basal cell carcinoma, so the GP recognises the lesion and refers promptly for biopsy and excision. Caution No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. Solid organ transplant recipients on immunosuppressive therapy carry a 65- to 250-fold higher risk of squamous cell carcinoma than the general population. Immunosuppressed patients with aggressive squamous cell carcinoma need skin surveillance every 2 to 3 months for the first 2 years, then every 6 to 12 months. A lesion on the lip, ear, central face (eyelid, nose, nasolabial fold), genitalia, hands, feet or nail unit is very high risk whatever its size or appearance. Any squamous cell carcinoma of the head or neck is high risk no matter how small it is. Patients taking BRAF inhibitors, vismodegib, voriconazole or immunosuppressive agents are at increased risk of developing squamous cell carcinoma. Non-surgical treatments carry higher recurrence rates and give no histological confirmation that the tumour has been cleared. Palpable lymphadenopathy calls for fine-needle aspiration or biopsy of the node, not observation. Annual full-body skin examination is advised for adults generally, and more often for anyone with significant risk factors. RED FLAG - A rapidly growing, hardened, or ulcerating skin lesion, a lesion arising in a chronic wound or burn scar, or regional lymph node enlargement suggesting spread. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)