SquamousCellCarcinoma in afya

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malignant tumour of keratinocytes, 
indurated erythematous with adherent keratotic scale may be ulcerated, 
found on sun exposed areas, esp in fair skinned, (cumulative sun exposure being most common risk factor), grow rapidly, more common and aggressive in immunocompromised
grow laterally and vertically, becoming fixed and nodular, everted irregular border
can metastasize via lymphatics (2% overall, 0.5% in sun damaged skin) - list of lesions more likely to met ....
Rx - 2ndary care - C&C if small well diff, 2-5mm margin with 2-3 cycles, larger, lesions need bigger margin - ?MOHS - 97% 5 year cure rate

May have telangiectasia scattered around - different to BCC where they are usually found on rolled edge

risk factors
sun exposure
Actinic Keratosis and Bowens
immunosuppression (eg renal transplant)
smoking
long term leg ulcers - Marjolins ulcer

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