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October 2013

Press for an Underestimated Nemesis

Author Affiliations
  • 1Mohs Micrographic and Dermatologic Surgery, Ronald O. Perelman Department of Dermatology, New York University–Langone Medical Center, New York
JAMA Dermatol. 2013;149(10):1147-1148. doi:10.1001/jamadermatol.2013.5273

“Thank goodness it’s not a melanoma!” Many of us may have said or thought that when explaining the diagnosis of a nonmelanoma skin cancer to a patient. We would do well to avoid the temptation to underestimate cutaneous squamous cell carcinoma (SCC). Dermatologists, head and neck surgeons, medical and surgical oncologists, and transplant physicians are aware that cutaneous SCC can and does behave aggressively and has the potential to metastasize.1-3 Recent studies have shown that the death rate for SCC approaches that for melanoma in parts of the United States.4 Other studies have defined risk factors for especially aggressive behavior by SCC that include large size; deep invasion; and involvement of nerves, lymphatics, and blood vessels.5,6 Some groups, including our own, have set out to define SCC at the molecular level, with the aim of identifying mechanisms of cancer development, progression, and immunity.7-14 The natural progression of this work would be to define and test novel therapies for advanced SCC. Currently, there is a relative paucity of studies concerning metastatic cutaneous SCC.

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