ABSTRACT
This chapter presents the case study of an 86-year-old. An 86-year-old man presents with a bleeding lesion on his scalp. There is a large ulcerated eroded nodule over the vertex of the scalp that is friable, erythematous and with a soft fleshy margin. Over the surrounding skin there are scattered erythematous patches with overlying scale. The likely diagnosis is an invasive squamous cell carcinoma (SCC). SCCs begin as ill-defined, erythematous papules or nodules with a hyperkeratotic top; as they enlarge they may ulcerate. The differential diagnoses would include an amelanotic malignant melanoma, and a nodular basal cell carcinoma, actinic keratoses, Bowen’s disease and a keratoacanthoma. SCCs often arise in precancerous lesions in otherwise healthy individuals over the age of 55 years. All patients with SCCs should have a full skin check to exclude any further suspicious lesions and all lymph node groups examined to exclude metastases.
