[Cutaneous squamous cell carcinoma]

Abstract

The squamous cell carcinoma (SCC) is the most frequent cutaneous carcinoma, after basal cell carcinomas. Cutaneous SCC have a good prognosis, in most cases, but the achievement of elderly people and the frequent recurrence, made a real health problem. Cutaneous SCC are able to disseminate in lymph node preferentially. It's mandatory to search this involvement clinically and radiologically in doubt, before treatment. The surgery with complete excision with 4 to 10 mm safe margins is the reference treatment. Radiotherapy is an efficient treatment when surgery can't be done or in case of incomplete unresectable excision or in adjuvant setting after complete lymph node resection. Clinical and histological factors are identified and permit to classify patients in two groups, low and high risk of recurrence. The immunosuppression is an important risk factor in the emergence of CE but also in the evolution. We observed last years at the apparition of numerous CE and keratoacanthomas, in 10 to 30 % of patients treated by BRAF inhibitors. The physiopathology of induced lesions is now well understood. Metastatic cutaneous SCC are rare but with poor prognosis. EGFR inhibitors seem to be efficient in this indication but they would be more relevant in neoadjuvant setting to obtain a tumoral reduction available to carcinologic surgery in locally advanced unresectable tumors.