Squamous cell carinoma in situ (SCCIS) is most often caused by ultraviolet radiation (UVR) or human papillomavirus (HPV) infection, presenting as solitary or multiple macules, papules, or plaques, which may be scaling or hyperkeratotic. SCCIS commonly arises in epithelial dysplastic lesions such as solar keratoses or HPV-induced squamous intraepithelial lesions (SIL).
In situ SCC may be caused by:
* Immunosuppression from drugs such as ciclosporin or azathioprine. The longer the course, the more likely that skin cancer will arise, especially in sun-damaged skin.
* In situ squamous cell carcinoma is most often found on sun exposed sites of fair skinned individuals. This is because ultraviolet radiation damages the skin cell nucleic acids (DNA) resulting in a mutant clone of the gene p53.
* Ionising radiation: in situ SCC was common on the hands of radiologists early in the 20th century.
Lesions appear as pink, rough, scaly patches or nodules that have a tendency to bleed. The growth is typically firm and sometimes extends inward as well as outward in the skin. As the tumor grows, it ulcerates and scabs over.
It is frequently develops on the face, lips, ears, and hands. Metastasis to other parts of the body can occur. The incidence of metastatic SCC varies; however, larger and deeper lesions especially on the lips, hands, temples, and ears are more likely to spread.
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