{"id":27084,"date":"2026-02-27T12:10:46","date_gmt":"2026-02-27T12:10:46","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=27084"},"modified":"2026-03-16T11:37:47","modified_gmt":"2026-03-16T11:37:47","slug":"squamous-cell-carcinoma","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/squamous-cell-carcinoma\/","title":{"rendered":"Squamous Cell Carcinoma"},"content":{"rendered":"\n<p>Cutaneous squamous cell carcinoma (SCC) begins in cells called keratinocytes which are found in the epidermis. SCC is faster growing than basal cell carcinomas. Up to 5% of SCC metastasise. Around 23% of skin cancers are SCCs.<\/p>\n\n\n\n<p>Patients who have had a SCC are prone to developing further skin cancer.<\/p>\n\n\n\n<p><strong>Risk factors for all skin cancers<\/strong> include:<\/p>\n\n\n\n<p>Excessive sunlight exposure and sun bed use (UV radiation) and is highest in people with fair skin colour and a susceptibility to burn.<\/p>\n\n\n\n<p><strong>Other risk factors for SCC<\/strong> include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Multiple small actinic keratoses<\/li>\n\n\n\n<li>Being immunocompromised<\/li>\n\n\n\n<li>High levels of previous UV-A photochemotherapy<\/li>\n<\/ul>\n\n\n\n<p><strong>Suspect<\/strong> <strong>Squamous Cell Carcinoma<\/strong> if there is:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hyperkeratotic (scaly) nodule or indurated (thickened) lesion<\/li>\n\n\n\n<li>Ulcerated nodule that may bleed easily<\/li>\n\n\n\n<li>Painful or tender lesion on palpation<\/li>\n\n\n\n<li>Generally faster growing lesion<\/li>\n\n\n\n<li>Background of actinic keratosis<\/li>\n<\/ul>\n\n\n\n<p><strong>Suspect<\/strong> <strong>Squamous Cell Carcinoma (SCC) of the nail apparatus<\/strong> if there is:<\/p>\n\n\n\n<p>A lesion growing underneath the nail that may be associated with local tissue destruction <\/p>\n\n\n\n<p>A change such as a nodule growing in an established periungual wart<\/p>\n\n\n<style>.wp-block-kadence-advancedgallery .kb-gallery-type-masonry.kb-gallery-id-27084_30cf81-07{margin:-5px;}.kb-gallery-type-masonry.kb-gallery-id-27084_30cf81-07 .kadence-blocks-gallery-item{padding:5px;}.kb-gallery-id-27084_30cf81-07 .kadence-blocks-gallery-item .kb-gal-image-radius, .kb-gallery-id-27084_30cf81-07 .kb-slide-item .kb-gal-image-radius img{border-radius:0px 0px 0px 0px;;}.kb-gallery-caption-style-bottom.kb-gallery-id-27084_30cf81-07 .kadence-blocks-gallery-item .kadence-blocks-gallery-item-inner .kadence-blocks-gallery-item__caption, .kb-gallery-caption-style-bottom-hover.kb-gallery-id-27084_30cf81-07 .kadence-blocks-gallery-item .kadence-blocks-gallery-item-inner .kadence-blocks-gallery-item__caption{background:linear-gradient(0deg, rgba(0, 0, 0, 0.8) 0, rgba(0, 0, 0, 0) 100%);}<\/style><div class=\"kb-gallery-wrap-id-27084_30cf81-07 alignnone wp-block-kadence-advancedgallery\"><ul class=\"kb-gallery-ul kb-gallery-non-static kb-gallery-type-masonry kb-masonry-init kb-gallery-id-27084_30cf81-07 kb-gallery-caption-style-bottom kb-gallery-filter-none\" data-image-filter=\"none\" data-item-selector=\".kadence-blocks-gallery-item\" data-lightbox-caption=\"true\" data-columns-xxl=\"3\" data-columns-xl=\"3\" data-columns-md=\"3\" data-columns-sm=\"2\" data-columns-xs=\"1\" data-columns-ss=\"1\"><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\" style=\"max-width:480px;\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic\" style=\"padding-bottom:133%;\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Ear-1.png\" width=\"480\" height=\"640\" alt=\"SCC Ear\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Ear-1.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Ear-1.png\" data-id=\"27089\" class=\"wp-image-27089\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Ear-1.png 480w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Ear-1-225x300.png 225w\" sizes=\"auto, (max-width: 480px) 100vw, 480px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">SCC Ear &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\" style=\"max-width:602px;\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic\" style=\"padding-bottom:75%;\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Face-1.png\" width=\"602\" height=\"452\" alt=\"SCC Face\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Face-1.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Face-1.png\" data-id=\"27090\" class=\"wp-image-27090\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Face-1.png 602w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-Face-1-300x225.png 300w\" sizes=\"auto, (max-width: 602px) 100vw, 602px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">SCC Face &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\" style=\"max-width:1024px;\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic\" style=\"padding-bottom:75%;\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-1024x768.jpg\" width=\"1024\" height=\"768\" alt=\"SCC\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC.jpg\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC.jpg\" data-id=\"27091\" class=\"wp-image-27091\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-1024x768.jpg 1024w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-300x225.jpg 300w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-768x576.jpg 768w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-1536x1152.jpg 1536w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-2048x1536.jpg 2048w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/SCC-1520x1140.jpg 1520w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">SCC &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><\/ul><\/div>\n\n\n<p>All images on this page are sourced from&nbsp;<a href=\"https:\/\/dermnetnz.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">DermNet | Dermatology Resource (dermnetnz.org)<\/a><\/p>\n\n\n\n<p><strong>Other skin lesions that are concerning for malignancy<\/strong><\/p>\n\n\n\n<p>The following skin changes should raise concern for a malignant lesion (including Merkel&#8217;s tumour, sarcoma, or amelanotic melanoma):<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Nodule grows quickly (over weeks)<\/li>\n\n\n\n<li>A new change (growth, pigmentation, or pain) in a long-standing ulcer, scar, traumatic or inflamed area of skin<\/li>\n\n\n\n<li>Non-healing and\/or destructive atypical ulcer<\/li>\n\n\n\n<li>Progressive unexplained scar-like area<\/li>\n\n\n\n<li>An unexplained skin lesion with loco-regional lymphadenopathy<\/li>\n<\/ul>\n\n\n\n<p>Please refer these as USOC via the Melanoma pathway.<\/p>\n\n\n\n<p><strong>B.C, C.L &amp; P.O -16-03-2026<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>Refer as USOC via Sci Gateway: Lauriston\/SJH&gt;Dermatology&gt;LI Suspected SCC.<\/p>\n\n\n\n<p>Please use the&nbsp;<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/using-the-consultant-connect-app\/\" target=\"_blank\" rel=\"noreferrer noopener\">Using the Consultant Connect App \u2013 RefHelp<\/a> to take photos of the lesion(s) and then attach these to your Sci Gateway referral.<\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dermatology\/attaching-photos-to-referrals\/\" target=\"_blank\" rel=\"noreferrer noopener\">Attaching photos to referrals \u2013 RefHelp<\/a><\/p>\n\n\n\n<p>Any patient who has a squamous cell carcinoma removed in primary care must be referred USOC via the above pathway.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resouces and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>For Patients<\/strong><\/p>\n\n\n\n<p>The BAD (British Association&nbsp;of Dermatologists) have PILs on SCC. These can be found at: <a href=\"https:\/\/www.bad.org.uk\/patient-information-leaflets\" target=\"_blank\" rel=\"noreferrer noopener\">Patient Information Leaflets &#8211; British Association of Dermatologists &#8211; Patient Information Leaflets &#8211; British Association of Dermatologists<\/a><\/p>\n\n\n\n<p><strong>For Healthcare Professionals<\/strong><\/p>\n\n\n\n<p>PCDS &#8211; &nbsp;<a href=\"https:\/\/www.pcds.org.uk\/clinical-guidance\/squamous-cell-carcinoma\" target=\"_blank\" rel=\"noreferrer noopener\">Squamous cell carcinoma<\/a><\/p>\n\n\n\n<p>Scottish Referral Guidelines for suspected Cancer &#8211; &nbsp;<a href=\"https:\/\/www.gov.scot\/binaries\/content\/documents\/govscot\/publications\/advice-and-guidance\/2025\/08\/scottish-referral-guidelines-suspected-cancer-2025\/documents\/scottish-referral-guidelines-suspected-cancer-2025\/scottish-referral-guidelines-suspected-cancer-2025\/govscot%3Adocument\/scottish-referral-guidelines-suspected-cancer-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Referral Guidelines for Suspected Cancer 2025<\/a> DermNet &#8211; &nbsp;<a href=\"https:\/\/dermnetnz.org\/topics\/cutaneous-squamous-cell-carcinoma\" target=\"_blank\" rel=\"noreferrer noopener\">Cutaneous squamous cell carcinoma: Symptoms, Causes, and Treatment \u2014 DermNet<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Cutaneous squamous cell carcinoma (SCC) begins in cells called keratinocytes which are found in the epidermis. SCC is faster growing than basal cell carcinomas. Up to 5% of SCC metastasise. Around 23% of skin cancers are SCCs. Patients who have had a SCC are prone to developing further skin cancer. Risk factors for all skin<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"class_list":["post-27084","page","type-page","status-publish","hentry"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"mariamazoysaavedra","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/mariamazoysaavedra\/"},"rttpg_comment":0,"rttpg_category":false,"rttpg_excerpt":"Cutaneous squamous cell carcinoma (SCC) begins in cells called keratinocytes which are found in the epidermis. SCC is faster growing than basal cell carcinomas. Up to 5% of SCC metastasise. Around 23% of skin cancers are SCCs. Patients who have had a SCC are prone to developing further skin cancer. Risk factors for all skin","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27084","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=27084"}],"version-history":[{"count":6,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27084\/revisions"}],"predecessor-version":[{"id":27276,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27084\/revisions\/27276"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=27084"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=27084"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}