Abstract

Ultraviolent (UV) solar radiation is considered to be the dominant risk factor for development of squamous cell carcinoma (SCC). The development of SCC appears to be linked to the cumulative dose of UV radiation over time. Identifying patients with high-risk factors for developing SCC includes chronic immunosuppression, exposure to ionizing radiation, and certain genetic syndromes. Primary treatment goals of cutaneous SCC include cure of tumor with maximal preservation of function. Treatment options should be stratified for low- and high-risk SCC. Primary treatment options for low-risk SCC include (1) curettage and electrodesiccation, (2) excision with postoperative margin assessment (POMA) with 4 to 6 mm margins, and (3) radiation therapy (RT) for nonsurgical candidates. Options for high-risk SCC lesions include (1) Mohs surgery or resection with complete circumferential peripheral and deep margin assessment, (2) excision with POMA with wider surgical margins and primary or delayed repair, and (3) RT for nonsurgical candidates. This review contains 4 figures, 5 tables, and 32 references. Key words: cutaneous squamous cell carcinoma, Mohs micrographic surgery, pathologic risk factors, radiation therapy, surgical margins

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