Skin cancer: Squamous cell carcinoma

Squamous cell carcinoma (SCC). This cancer is very common ( ~30% of all skin cancer) but, not as common as Basal cell carcinoma. It is however, more dangerous but not as bad as some melanomas. For an SCC to spread, it tends to be very large >1cm and usually on the scalp/lip/ears and .... of the "moderate to poorly differentiated variety"

Scc can be tricky to pick up but, we do not go mole mining or sunspot mining for them. Why ? when they come they will come and they will be easily picked up and removed. There is no point in biopsying every single scaly spots on some one's skin, creating more business for the pathology lab. Skin cancer practitioners shouldn't need to biopsy 3,6, or even 14 lesions for diagnosis of something so simple as skin cancer.

Some even argue for sunspots to be pushed into the SCC variety... creating  more work through further more unnecessary surgeries, particularly when those pathology reports are read by inexperienced practitioners.

And as every one knows sunspots ( technically is an SCC ) but will take millennium (~ maybe <1-5% over the patients life time)  to become something so "deadly" as an INSITU SCC or INVASIVE SCC.

As a patient you should ask if biopsy is REALLY necessary and  is invasive surgery really necessary for lower risk skin lesions.

Solar keratosis / Actinic Keratosis/  Sunspots
Solar Keratosis or better known as Sunpots. These arise from chronically sun damaged skin. They are an indicator of your skin having accumulated excessive amount of UV light, They do become cancerous but, the risk of that is very low. In Australia most will get one or two or more by the age of 30. In the UK, Their doctors will get very excited when they see one, something very exotic ! But, in Australia they are as common as weeds.

Squamous cell carcinoma or SCC
When a solar keratosis becomes cancerous. It tends to become swollen, red, tender or sore to touch. This Squamous cell carcinoma has a prickly horn . The more horny-hyperkeratotic an SCC the better - indicating a low risk carcinoma.  
This non tender horny lesion looks sinister but is the least dangerous of the SCC family. It's called a hypertrophic actinic keratosis ( or simply as a thickened sunspot) . Easily treated in less than 2 minutes ! 

Squamous cell carcinoma to the leg
This one is bad. It grows rapidly over a few week, bleeds easily and most doctors will be at a lost of what to do about them. These troublesome SCCs tend to occur on the lower legs and they are difficult to treat. Another one will pop up as soon one is treated. 
Squamous cell carcinoma to the ear
Despite it's aggressive appearance, this solid Squamous cell carcinoma to the ear is pretty ordinary and easily treated. This Scc has been around for more than a year. It's just gotten too big for the blood supply to keep up hence the necrosis ( dead black charred skin , non smelly one at that - dry necrosis)
Squamous cell carcinoma to the lip
Squamous cell carcinoma to the lip. Every body jumps up and down when seeing scc on the lip. The first thing that comes to mind is - METASTASIS - but, from our experience ( backed up by academia) these nice firm crusty, prickly and mildly tender small <1cm SCCs are easily treated and have low risk of blood born spread. SO RELAX ! just quickly remove them to minimise the risk of microstomia ( smaller mouth opening )
This lesion looks alarming and grows all most overnight. It's a KERATOACANTHOMA. The natural history of these type of lesions is of rapid growth and destruction then involution over a few weeks.  Get rid of them fast or permanent nasal deformity will ensure.