Periocular Squamous Cell Carcinoma (SCC)

1 Signs and Symptoms

Primarily effects elderly faired-skin individuals with a history of chronic sun exposure or younger individuals with a predisposing condition (immune suppression [organ transplant], carcinogenic factor [radiation], or genetic factor [albinism]). May arise in sun-damaged skin areas (actinic keratosis) or de novo. Clinical signs develop slowly (mean 1 y) but faster than BCC and include a painless lesion of nodular, ulcerative, placoid, and infiltrative cystic or papillomatous type. Ulceration, cicatricial ectropion, and madarosis commonly occur in SCC (as well as in other malignancies). Red skin with scale of keratin is more typical of SCC. Deep invasion (T4 AJCC Cancer Staging Manual, 8th edition) is associated with long-term neglect or recurrent failed treatment attempt. Sings of deep invasion include a nonmobile lesion, impaired ocular motility or blink, and exophthalmos or a sensory defect secondary to perineural spread. Larger lesions (T2c AJCC 8th edition) may...