Painful Skin Lesions May Signal Squamous Cell Carcinoma

December 17, 2012

When dermatology patients report painful skin lesions, their doctors may want to look for squamous cell carcinoma, according to the latest research findings from Wake Forest Baptist Medical Center.

Gil Yosipovitch, M.D., professor of dermatology at Wake Forest Baptist Medical Center, has conducted the first study of its kind to assess the prevalence of pain related to common skin cancers. Because there are nearly four million new cases of non-melanoma skin cancers (NMSC) diagnosed each year, Yosipovitch said there was a need to look at the prevalence rates of common symptoms, including pain and itch, associated with the two most common types of skin cancer - basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

"Our findings reveal that pain and itch are common symptoms of non-melanoma skin cancers," Yosipovitch said. "To our knowledge, this is the first study to assess the prevalence of pain and itch and their intensities in non-melanoma skin cancers."

Yosipovitch discussed his findings in a letter to the Archives of Dermatology, a Journal of American Medicine Association (JAMA) network, publishing online Dec. 17.

Data for the study was collected over a nine-month period from 478 patients treated at Wake Forest Baptist who had either basal cell carcinoma (BCC) or squamous cell carcinoma (SCC). A total of 576 biopsy-proven NMSCs were involved. Patients rated their pain and itch intensity on a visual analog scale from 0 (least intense) to 10 (most intense).

Itch was the most common symptom reported in both skin cancers - 43.5 percent of SCCs and 33.4 percent of BCCs, but the prevalence of pain was significantly increased in SCC (39.8 percent) as compared to BCC (17.7 percent).

Yosipovitch said that a patient's pain score was a highly significant predictor of having an SCC as opposed to a BCC. "Specifically, we have shown the intensity of pain to be a unique factor to help in differentiating SCC from BCC. The results of this study suggest that a simple assessment of pain intensity will aid in the clinical diagnosis of SCC and lead to earlier, appropriately aggressive treatment for these cancerous lesions that are more aggressive than BCC," he said.

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