These guidelines for management of primary cutaneous squamous cell carcinoma presentevidence-based guidance for treatment, with identification of the strength of evidence available at thetime of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis andinvestigation. These guidelines aim to ensure people with cutaneous squamous cell carcinomareceive the best possible treatment and care.
SCC is the second most common skin cancer and, in many countries, its incidence is rising.1-7Itsoccurrence is usually related to chronic ultra violet light exposure and is therefore especiallycommon in people with sun-damaged skin, fair skin, albinism and xeroderma pigmentosum. It maydevelop de-novo, as a result of previous exposure to ultraviolet or ionising radiation, or arsenic,within chronic wounds, scars, burns, ulcers or sinus tracts and from pre-existing lesions such asBowen s disease （intraepidermal SCC）。8-17Individuals with impaired immune function, for examplethose receiving immunosuppressive drugs following allogeneic organ transplantation or forinflammatory disease, and those with lymphoma or leukaemia, are at increased risk of this tumour.The risk of SCC with the new wave of biologic therapies （for inflammatory and haematologicaldisease） has yet to be quantified, although reports identify cases of rapid-onset or reactivation ofSCC in patients with risk factors or a past history of the disease.18-27Some SCCs are associated withhuman papilloma virus infection.28-36There is good evidence linking SCCs with chronic actinicdamage, （including that from the use of tanning devices）8and to support sun avoidance, use ofprotective clothing and effective sunblocks37in the prevention of actinic keratoses and SCCs. Thesemeasures are particularly important for people receiving long term immunosuppressive medication.