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Squamous cell carcinoma of the skin is the second most common form of non-melanoma skin cancer. While a fair complexion, excessive sun exposure and tanning, living at higher altitudes or close to the equator, and personal and/or family history of skin cancer are well recognized risk factors for developing these skin tumors, there are a few other less recognized risks as well.
“We do know that immunosuppression greatly increases the chances of developing squamous cell carcinoma,” says Dr. Adam Mamelak, board-certified dermatologist and fellowship training Mohs micrographic surgeon in Austin, Texas. In fact, patients with kidney, liver and heart transplants that take medication to suppress their immune systems and prevent the rejection of transplanted organs have an over 200 fold increased risk of developing squamous cell carcinoma of the skin.
There are some less recognized health conditions that also increase the risk of tumor development. “Some infections have been linked to the development of squamous cell carcinoma,” notes Dr. Mamelak. These infections tend to be associated with significant swelling, excessive inflammation and scarring in the skin.
“it’s not often that we think a pimple can lead to cancer develop,” explains Dr. Mamelak, “but squamous cell carcinoma has been noted in patients with Acne conglobata.” This severely inflammatory form of acne is characterized nodules, abscesses, subcutaneous tract formation and scarring. Similar inflammatory conditions that effect the arm pits and groin (Hidradenitis suppurativa) and scalp (Dissecting cellulitis of the scalp) can also contribute to the formation of these skin cancers.
The other types of infections are more uncommon and include tuberculosis of the skin (Lupus vulgaris) and deep fungal infections that cause significant inflammation and scarring in the skin. “We do not understand exactly how these conditions induce squamous cell carcinoma,” says Dr. Mamelak. Many theorize that it is the chronic inflammation and scarring that body induces to fight these infections that causes the tumors to develop as opposed to the infectious agents themselves.
Further evidence of this ‘chronic inflammation’ risk might be seen in a number of other inflammatory medical conditions that have been associated with the development of squamous cell carcinoma. “Squamous cell carcinoma has been associated with burns and chronic leg ulcers,” explains Dr. Mamelak. It has also been noted to appear in areas onthe body affected by discoid lupus, lichen sclerosis et atrophicus, certain types of lichen planus and even lymphedema.
Because of the underlying medical condition that may have led to the development of skin cancer, these tumors can be more difficult or challenging to treat. In these situations, your dermatologist may recommend Mohs surgery or ensure complete removal and to decrease the chances of recurrence.
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If you have been diagnosed with squamous cell carcinoma, or are concerned your medical condition may be predisposing you to the development of skin cancer, please contact us at Sanova Dermatology. Our board-certified dermatologists and the skin and expertise to help you with all of your skin care needs.