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Squamous cell carcinoma

Published: September 18, 2026Updated: September 18, 2026

Important: Informational content intended for healthcare professionals. It does not replace clinical evaluation or establish a doctor-patient relationship.

Overview

  • Definition and names
    • Malignant epithelial neoplasm originating from epidermal keratinocytes, with distinct squamous differentiation, potential for deep local invasion and lymphatic/hematogenous metastasis. Cassarino 2006 , Motaparthi 2017
    • Common synonyms: Cutaneous squamous cell carcinoma , cutaneous spinocellular carcinoma , cutaneous epidermoid carcinoma .
  • History
    • Tumor described progressively in the dermatology and pathology of the 19th century (spinal cell epithelioma), but today there is no single author or «official» date of first description in modern indexed literature; the concept was consolidated in the early-mid 20th century.
  • Epidemiology
    • The second most common skin cancer after basal cell carcinoma and responsible for the majority of deaths from non-melanoma skin cancer. Motaparthi 2017 , Chang 2022
    • Incidence in Europe/USA: on the order of tens per 100,000 inhabitants/year , steadily increasing; in those over 70 years of age it can easily exceed 100/100,000. Keim 2023 , Cozma 2023
    • More frequent in men (approx. 2:1), phototypes I–III, and outdoor occupations. Thompson 2016
    • Immunosuppressed patients (transplant recipients, hematologic malignancies, HIV, biological/intensive therapies) : risk tens of times higher, with more multiple and aggressive tumors. Chang 2022 , Cozma 2023
    • Overall risk of lymph node metastasis in general series ~2–5%; it can reach ≥15–20% in high-risk tumors (thickness, desmoplastic, PNI, lip/ear location). Brantsch 2008 , Thompson 2016 , Karia 2013
  • Codes
    • ICD-10 : C44.x (skin malignancy at specific sites; histological subtype CEC is coded with ICD-O-3 morphology M-8070/3–8078/3).
    • ICD-11 : 2C31.* (squamous cell carcinoma of the skin, with subcategories by location).
  • Diagnostic checklist (quick)
    • Clinic
      • Exact location, maximum size (cm) and appearance (ulceration, hyperkeratosis, induration).
      • Duration and growth rate.
      • Relevant history: sun exposure, immunosuppression, previous scars/ulcers, previous radiotherapy.
      • Exploration of regional lymph node chains.
      • Neurological symptoms (pain, paresthesia, cranial nerves).
    • Histological report (diagnostic biopsy)
      • Confirmation of invasive CEC (not only in situ).
      • Degree of differentiation (good/moderate/poor).
      • Tumor thickness and level of invasion (how far it reaches).
      • Presence/absence of PNI and lymphovascular invasion.
      • Histological subtype (conventional, desmoplastic, spindle cell, verrucous, etc.).
      • Margin status (if it is a split piece).
    • Laboratory/imaging
      • Regional lymph node ultrasound ± CT/MRI in high-risk tumors or with suspicious lymph nodes.
      • Consider PET-CT or additional studies in advanced disease.

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