Cutaneous squamous cell carcinoma - Anogenital in
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Synopsis

The clinical presentation is variable. SCC often presents as a hyperkeratotic papule or nodule that may ulcerate, but it may also be smooth, plaque-like, exophytic, or papillomatous. Lesions are often red to flesh colored. Secondary changes such as scale, crust, erosion, and ulceration can be present. The progression of lesions over time varies. Some enlarge slowly, while others progress rapidly to grow, infiltrate deeper tissue, and metastasize. Pain and tenderness can be present. Anal carcinomas may also feature rectal bleeding and a sensation of an object in the rectum.
The pathogenesis of SCC is multifactorial. It may evolve from intraepithelial neoplasia (including penile intraepithelial neoplasia or anal intraepithelial neoplasia) or arise de novo. TP53 gene mutations have been implicated. Penile SCC occurs almost exclusively in uncircumcised men, and neonatal circumcision is believed to be protective. Penile carcinoma is most often found on the glans (48%), followed by the foreskin (21%), corona (6%), and shaft (< 2%). It is believed that smegma, more commonly present in uncircumcised men, induces chronic inflammation and predisposes to SCC. Any repetitive trauma or insult increases risk of SCC. Additional risk factors for anogenital SCC include smoking, sexually transmitted infections, HIV infection, human papillomavirus (HPV) infection, poor genital hygiene, anogenital injury, chronic balanitis, lichen sclerosus, and erosive lichen planus.
Men who engage in receptive anal intercourse and men with immunocompromised states such as HIV should undergo regular anal Pap smear screening.
Related topics: squamous cell carcinoma in situ, erythroplasia of Queyrat, bowenoid papulosis
Codes
ICD10CM:C44.92 – Squamous cell carcinoma of skin, unspecified
SNOMEDCT:
402815007 – Squamous cell carcinoma
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Differential Diagnosis & Pitfalls
- Bowen disease
- Basal cell carcinoma
- Verruca vulgaris
- Condyloma acuminatum
- Keratoacanthoma
- Eccrine poroma
- Lobular capillary hemangioma (pyogenic granuloma)
- Amelanotic melanoma
- Sporotrichosis
- Mycobacterium marinum infection
- Nummular dermatitis
- Irritated seborrheic keratosis
- Lichen planus
- Lichen sclerosus
- Granuloma inguinale
- Lymphogranuloma venereum
- Syphilis
- Prurigo nodularis
- Bowenoid papulosis
- Adnexal carcinomas
- Dermatofibrosarcoma protuberans
- Leiomyosarcoma
- Extramammary Paget disease
- Epithelioid sarcoma
- Psoriasis
- Lichen simplex chronicus
- Basosquamous carcinoma
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:09/26/2018
Last Updated:02/03/2021
Last Updated:02/03/2021
Cutaneous squamous cell carcinoma - Anogenital in
See also in: Overview,Hair and Scalp,Nail and Distal Digit