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Early Detection and Management of Squamous Cell Carcinoma: Clinical Evaluation of Precancerous Lesions and Actinic Keratosis

A middle-aged Hispanic man in a dermatology clinic, displaying a concerned yet hopeful expression, as a Hispanic dermatologist examines a light brown skin lesion on his forearm with a dermatoscope. The lesion has irregular borders, suggesting early-stage squamous cell carcinoma. This image emphasizes the importance of clinical evaluation for precancerous lesions like actinic keratosis and the critical role of early detection in preventing metastasis.

Squamous cell carcinoma (SCC) is one of the most common forms of skin cancer, characterized by the abnormal growth of squamous cells in the epidermis. Early detection and appropriate management of precancerous lesions are crucial to prevent progression to more invasive forms of the disease. Actinic keratosis is a common precursor lesion that can evolve into SCC if not treated adequately.

Early Detection and Clinical Evaluation

The early detection of SCC relies on a thorough clinical evaluation and the use of advanced diagnostic tools. Dermatoscopy has proven to be a valuable technique for improving the diagnostic accuracy of skin neoplasms, both benign and malignant, and should be routinely used in the evaluation of pigmented and non-pigmented lesions [1]. Additionally, reflectance confocal microscopy is a non-invasive imaging technology that has shown to be extremely useful in the diagnosis and follow-up of skin diseases, including actinic keratosis and SCC [2].

The risk of metastasis in SCC significantly increases in cases of perineural invasion, highlighting the importance of early diagnosis and appropriate management [3]. The clinical evaluation should include a comprehensive review of the patient's risk factors, such as ultraviolet radiation exposure and immunological status, to guide treatment decisions.

Conclusions

The management of squamous cell carcinoma requires a multidisciplinary approach that combines early detection, detailed clinical evaluation, and the use of advanced diagnostic technologies. Educating patients about the importance of sun protection and regular follow-up is essential to prevent the progression of precancerous lesions to invasive forms of SCC. Implementing primary and secondary prevention strategies can significantly reduce the incidence of this type of skin cancer and improve long-term outcomes for patients.

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Created 13/1/2025