Squamous cell carcinoma of the skin physical examination

Squamous cell carcinoma of the skin Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Raviteja Guddeti, M.B.B.S. [3]

Overview

The findings of physical exam helps us in diagnosis and provides information about the prognosis of the disease. Many times physcial exam done for some other reason may give us a hint for this.

Physical Exam

Skin

• Presence of ulcer makes a point to observe more in detail. It will be a shallow ulcer with heaped up edges, covered by a plaque.
• One third of the lesions are white(Leukoplakia).They may have red articulation at times making it erythroplakia. But only few of them turn up as carcinomas.
• Surface changes are very peculiar for SCC. If not seen we can think of a metastatic lesion or any other lesion instead.
  • Scaling
  • Crusting
  • Cutaneous horns

• It can be warty most of the times.
• SCC of skin of head neck may at times metastasise to lymph nodes, so they demand a look. Risk of metastasise to lymph nodes depends on the size of the tumour.
• SCC of head neck need a special mention for examination of cranial nerves as they may be involved depending upon the tumour site.

Tongue and oral cavity

• Leukoplakia/Eryhtroplakia of tongue is seen, mostly on the lateral borders.
• There are chances of spreading to the adjacent temporo mandibular joint, so checking up with the movements of joint is important.