A wart or SCC? A case study and literature review of clinico-dermoscopic presentation in squamous cell carcinoma (SCC)
DOI:
https://doi.org/10.66344/jpad.v31i4.1745Abstract
Squamous cell carcinoma (SCC) is the second most common skin cancer, after basal cell carcinoma, in immunocompetent white individuals, and the most common skin cancer in immunosuppressed organ transplantation recipients worldwide. The diagnosis of SCC, although easily made in typical cases, may sometimes be difficult. Dermoscopy and histopathological examination help in diagnosis of SCC. Dermoscopy improves early diagnosis of skin cancer compared to the unaided eye. We report here a case of SCC presenting with an asymptomatic, warty growth on the shin for 1 year. Dermoscopic findings include yellowish hue with silvery white scaling and surface had few, irregularly arranged haemorrhagic dots. Histopathological examination showed features of SCC: nucleomegaly, pleomorphism, hyperchromasia & keratin pearl formation. A concise review of published literature has been presented of SCC cases reported with dermoscopic findings. We have here a case of moderately differentiated Squamous cell carcinoma of the shin; with an unusual history, clinical presentation and dermoscopic findings.
References
1. AlamM, Ratner D. Cutaneous squamous-cell carcinoma. N Engl J Med.2001;344(13):975-83.
2. CuricLM, CordelliniM. Squamous cell carcinoma developed on neglected, mistreated and delayed diagnosed chronic venous leg ulcer. Arch Surg Clin Res.2019;3:16-21.
3. Kim C, Cheng J, Colegio OR. Cutaneous squamous cell carcinomas in solid organ transplant recipients: emerging strategies for surveillance, staging, and treatment. Semin Oncol.2016;43(3):390-4.
4. LallasA, PyneJ, KyrgidisA, AndreaniS, ArgenzianoG, CavallerA, et al. The clinical and dermoscopic features of invasive cutaneous squamous cell carcinoma depend on the histopathological grade of differentiation. Br J Dermatol.2015; 172:1308e15.
5. Warszawik-Hendzel O, Olszewska M, Maj M, Rakowska A, Czuwara J, Rudnicka L. Non-invasive diagnostic techniques in the diagnosis of squamous cell carcinoma. J Dermatol Case Rep.2015;9(4):89-97.
6. Que SKT, Zwald FO, Schmults CD. Cutaneous squamous cell carcinoma: Incidence, risk factors, diagnosis, and staging. J Am Acad Dermatol.2018;78(2):237-47.
7. Brewster DH, Bhatti LA, Doherty VR, et al. Recent trends in incidence of nonmelanoma skin cancers in the East of Scotland, 1992-2003. Br J Dermatol.2007;156:1295-1300.
8. Andersson EM, Paoli J, Wastensson G. Incidence of cutaneous squamous cell carcinoma in coastal and inland areas of Western Sweden. Cancer Epidemiol.2011; 35:e69-e74.
9. Katalinic A, Kunze U, Sch€afer T. Epidemiology of cutaneous melanoma and non-melanoma skin cancer in SchleswigHolstein, Germany: incidence, clinical subtypes, tumour stages and localization (epidemiology of skin cancer). Br J Dermatol.2003;149:1200-6.
10. Stang A., Khil L., Kajuter H., Pandeya N., Schmults C.D., Ruiz E.S., Karia P.S., Green A.C. Incidence and mortality for cutaneous squamous cell carcinoma: Comparison across three continents. J Eur Acad Dermatol Venereol.2019;33:6-10.
11. Zalaudek I, Citarella L, Soyer HP, Hofmann-Wellenhof R, Argenziano G. Dermoscopy features of pigmented squamous cell carcinoma: a case report. Dermatol Surg.2004;30:539-40.
12. Zalaudek I, Giacomel J, Schmid K, Bondino S, Rosendahl C, Cavicchini S, Tourlaki A, Gasparini S, Bourne P, Keir J, Kittler H, Eibenschutz L, Catricalà C, Argenziano G. Dermatoscopy of facial actinic keratosis, intraepidermal carcinoma, and invasive squamous cell carcinoma: a progression model. J Am Acad Dermatol.2012; 66(4):589-97.
13. Lallas A, Pyne J, Kyrgidis A, Andreani S, Argenziano G, Cavaller A, Giacomel J, Longo C, Malvestiti A, Moscarella E, Piana S, Specchio F, Hofmann-Wellenhof R, Zalaudek I. The clinical and dermoscopic features of invasive cutaneous squamous cell carcinoma depend on the histopathological grade of differentiation. Br J Dermatol.2015;172(5):1308-15.
14. Manfredini M, Longo C, Ferrari B, Piana S, Benati E, Casari A, Pellacani G, Moscarella E. Dermoscopic and reflectance confocal microscopy features of cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol.2017;31(11):1828-33.
15. Lozano-Masdemont B, Polimón-Olabarrieta I, Marinero-Escobedo S, Gutiérrez-Pecharromán A, Rodríguez-Lomba E. Rosettes in actinic keratosis and squamous cell carcinoma: distribution, association to other dermoscopic signs and description of the rosette pattern. J Eur Acad Dermatol Venereol.2018;32(1):48-52.
16. Corneli P, Moscarella E, Di Brizzi EV, Ronchi A, Zalaudek I, Alfano R, Argenziano G. Pigmented Squamous Cell Carcinoma: Is the Reported Prevalence Real? Dermatol Pract Concept.2019; 9(2):150-1.
17. Papageorgiou C, Spyridis I, Manoli SM, Busila I, Nasturica IE, Lallas K, Panagopoulou A, Papadimitriou I, Sideris N, Gentsidi T, Gonzalez-Cuevas R, Ilieva A, Ioannides D, Apalla Z, Lallas A. Accuracy of dermoscopic criteria for the differential diagnosis between irritated seborrheic keratosis and squamous cell carcinoma. J Am Acad Dermatol.2021;85(5):1143-50.
18. Akay BN, Maden A, Kocak O, Bostanci S, Boyvat A, Kocyigit P, Heper AO. Development of poorly differentiated invasive squamous cell carcinoma in giant Bowen's disease: a case report with dermatoscopy. Dermatol Pract Concept.2016;6(2):5-8.
19. Omori Y, Nobeyama Y, Tomita S, Ishida K, Nakagawa H. Case of spindle cell squamous cell carcinoma with dermoscopic findings of diffuse/discrete scales and predominant white color. J Dermatol.2016;43(10):1239-41.
20. Kogame T, Tanimura H, Nakamaru S, Makimura K, Okamoto H, Kiyohara T. Spindle cell squamous cell carcinoma arising in Bowen's disease: Case report and review of the published work. J Dermatol.2017;44(9):1055-8.
21. Felder S, Rabinovitz H, Oliviero M, Kopf A. Dermoscopic differentiation of a superficial basal cell carcinoma and squamous cell carcinoma in situ. Dermatol Surg.2006;32(3):423-5.
22. Lin MJ, Pan Y, Jalilian C, Kelly JW. Dermoscopic characteristics of nodular squamous cell carcinoma and keratoacanthoma. Dermatol Pract Concept.2014;4(2):9-15.
23. Chung E, Marchetti MA, Pulitzer MP, Marghoob AA. Streaks in pigmented squamous cell carcinoma in situ. J Am Acad Dermatol.2015;72:S64-5.
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Jaspriya Sandhu, Amandeep Singh, Sunil Gupta, Bhavna Garg

This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.






