Patient Case: Squamous cell carcinoma
A 63-year-old man presents to the dermatology clinic with a slowly enlarging, non-healing ulcerated lesion on his left forearm. He first noticed a small, scaly patch about a year ago, which gradually grew larger and developed a central ulcer. The lesion occasionally bleeds but is not painful. He has a history of extensive sun exposure due to his outdoor occupation and has fair skin.
On examination, there is a 2.5 cm erythematous, scaly plaque with an ulcerated center and raised, irregular borders. The surrounding skin appears sun-damaged, with multiple actinic keratoses visible on his arms and face. There is no regional lymphadenopathy.
A biopsy of the lesion is performed, confirming squamous cell carcinoma (SCC). The patient is counseled on treatment options, including surgical excision, and educated on sun protection to prevent further lesions.
- What is the most likely diagnosis?
a) Basal cell carcinoma
b) Squamous cell carcinoma
c) Melanoma
d) Actinic keratosis - Which of the following is the strongest risk factor for this condition?
a) Chronic fungal infection
b) Sun exposure and ultraviolet radiation
c) Frequent use of moisturizing creams
d) Excessive carbohydrate intake - What is the best treatment option for this patient?
a) Topical antifungal cream
b) Cryotherapy
c) Surgical excision
d) Oral antibiotics - Which feature differentiates squamous cell carcinoma from basal cell carcinoma?
a) Ulceration and rapid growth
b) Waxy, pearly appearance with telangiectasia
c) Exclusive occurrence on mucosal surfaces
d) Strong association with fungal infections
