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| Fig. 44.3 Variants of squamous cell carcinoma (SCC). A, Early SCC arising in an actinic keratosis. B, Large verrucous carcinoma of the genitalia. Verrucous carcinomas often reach large sizes before diagnosis because they are often treated as warts. |
Squamous cell carcinomas (SCCs) may resemble basal cell carcinomas, actinic keratoses, or warts, but often the initial appearance is that of an ill-defined, red lesion with a rough surface (Fig. 44-3A). SCCs are more likely to demonstrate overlying scale than are BCCs. At times, the scale may project above the skin surface, producing a cutaneous horn. Larger lesions may break down and ulcerate. Verrucous carcinomas are a variant of SCC that look like warts and are often misdiagnosed (Fig. 44-3B). Like warts, they often occur on hands and feet but can also appear on the anogenital epithelium and oral mucosa. These tumors are slow growing and rarely metastasize, but they can be extremely locally aggressive.
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