⚕️ FREE MSRA PODCAST – Squamous Cell Carcinoma (SCC)
🎧 A high-yield breakdown of this common but potentially serious skin cancer – essential for MSRA prep and clinical practice.

🧠 Key Learning Points

📌 Definition
• SCC is a malignant tumour of squamous cells in the epidermis.
• It is the second most common non-melanoma skin cancer and has metastatic potential.

📌 Causes & Risk Factors
• Chronic UV radiation exposure ☀️
• Fair skin, older age, male gender
• Immunosuppression (e.g. transplant patients, HIV)
• Chronic inflammation (old burns, scars, ulcers)
• Exposure to arsenic or past radiotherapy
• Premalignant lesions (actinic keratosis, Bowen’s disease)
• Genetic conditions (xeroderma pigmentosum, albinism)
💡 Mnemonic: "SUN BURN" – Sun, Ulcers, Neoplasia in situ (Bowen's), Burns, UV, Radiotherapy, Nevus (genetic)

📌 Pathophysiology
• UV-induced DNA mutations → dysregulated squamous cell growth
• Tumour invades dermis, then lymphatics or blood → local/distant spread
• Risk factors amplify mutation accumulation

📌 Symptoms
• Firm, red nodule or scaly ulcer that won’t heal
• Can bleed easily, ulcerate or crust over
• Typically found on sun-exposed areas: face, ears, lips, scalp, hands
• May arise from actinic keratosis or Bowen’s disease

📌 Differential Diagnosis
• Keratoacanthoma
• Basal cell carcinoma (pearly appearance)
• Amelanotic melanoma
• Actinic keratosis
• Pyogenic granuloma
• Warts or chronic verrucae (esp. periungual)

📌 Diagnosis
• Clinical suspicion + histological confirmation via biopsy
• Excisional or punch biopsy preferred
• Imaging (CT/MRI) if deep invasion suspected
• Always refer suspected cases via 2-week wait pathway

📌 Management
• Surgical excision with clear margins (4–6mm depending on size)
• Mohs surgery for high-risk or cosmetically sensitive areas
• Cryotherapy or curettage for superficial lesions
• Radiotherapy if surgery contraindicated
• Topical 5-FU or Imiquimod for SCC in situ (Bowen’s disease)
• MDT involvement for advanced or recurrent disease

📌 Complications
• Local invasion (e.g. lip, eye, cartilage, bone)
• Perineural spread (causing pain or numbness)
• Lymphatic or haematogenous metastasis (lungs, liver, brain)
• Cosmetic disfigurement, post-surgical scarring

📌 Prognosis
• Excellent with early diagnosis and complete excision
• Poorer outcomes if: lesion >20mm, depth >2–4mm, poor differentiation, perineural invasion, immunosuppressed, lip/ear site
• Most recurrences within first 2 years – regular follow-up vital

📎 More MSRA Resources for Squamous Cell Carcinoma
📝 Revision Notes: https://www.passthemsra.com/topic/squamous-cell-carcinoma-revision-notes/
🧠 Flashcards: https://www.passthemsra.com/topic/squamous-cell-carcinoma-flashcards/
💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/squamous-cell-carcinoma-accordion-qa-notes/
🚀 Rapid Quiz: https://www.passthemsra.com/topic/squamous-cell-carcinoma-rapid-quiz/
🎓 Full Course: https://www.passthemsra.com/courses/dermatology-for-the-msra/

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