EPIDEMIOLOGI PATRIKS

Cutaneous malignancies are not generally documented by the national cancer institute or most state
cancer registries. It is generally accepted, however, that well over 1 milion cases are diagnosed in the
united states each year, with approximately 200.000 representing SCC. All though less common than
BCC, SCC carries a risk of metastasis and thus accounts for the majority of the several thousand deaths
attributable to non-melanoma skin cancer each year. By comparison, cutaneous melanoma accounts for
only 60,000 cases, but approximately 9000 deaths, annually. Similar trends for SCC have been noted in
Australia and the Caribbean.

SCC is strongly associated with advanced age, and a sharp increase In incidence is seen after age
40 years. To day, the lifetime risk of SCC among whites is approximately 15 percent , almost double that
of two decades ago. Increased exposures to ultraviolet radiation (through greater use of tanning salons,
increased time spent out-doors, changes in clothing styles, and ozone depletion) and greater longevity
have been suggested as possible causes for the incease in disease. It is likely that this trend will continue
as a result of further depletion of the ozone layer and the aging of the U.S. population. The rising
incidence of SCC over the past several decades has been paralleled by at 20 percent decrease on
mortality, attributed largely to increased public awareness and aggressive treatment of high risk lesions.
After a diagnosis of SCC, patients have a 44 percent to 50 percent cumulative risk of developing another
non melanoma skin cancer (18 percent to 30 percent risk of SCC) in the subsequent 3 to 5 years. In
addition, these patients are at increased risk for extra cutaneus cancers

kejadian tepat BCC dan SCC tidak diketahui, karena ini keganasan kulit umumnya tidak
didokumentasikan oleh lembaga kanker nasional atau paling pendaftar kanker negara. Hal ini berlaku
umum, bagaimanapun, bahwa lebih dari 1 juta kasus didiagnosis di Amerika Serikat setiap tahun,
dengan sekitar 200.000 mewakili SCC. Semua meskipun kurang umum daripada BCC, SCC membawa
risiko metastasis dan dengan demikian menyumbang mayoritas beberapa ribu kematian yang
disebabkan oleh kanker kulit non-melanoma setiap tahun. Sebagai perbandingan, melanoma kulit
menyumbang hanya 60.000 kasus, tetapi kira-kira 9000 kematian setiap tahunnya. Tren serupa untuk
SCC teHlah dicatat di Australia dan Karibia.

HISTOPATOLOGI

This epidermis displays full-thickness atypia, including in the intraepidermal portions of the adnexal
structures. Involvement reaches from the stratum corneum down through the basal cell layer, although
the basement membrane remains intact. Characteristically, parakeratosis and hyperkeratosis are
precent, is a acanthosis, with complete disorganization of the epidermal architecture. At times the
hyperkeratosis and parakeratosis are so pronounced that a cutaneus horn is precent. Throughout the
epidermis are numerous atypical, pleomorphic, hyperchromatic keratinocytes. These cells are
sometimes vacuolated and have a prominent pale-staining cytoplasm, reminiscent of thecells in paget
disease. These cells show loss of maturation and polarity, in addition to numerous mitotic figures.
Individually keratinized cells with large, rounded, eosinophilic cytoplasm and hyperchromatic nuclei can
be found in the epidermis, as can be found in the epidermis, as can multinucleated cells. These atypical
cells also are seen throughout the pilosebaceous units, whitin the acrotrichia , follicular infundibula, and
sebaceous glands. The upper dermis is typically infiltrated by numerous cells associated with chronic,
inflammation, including lymphocytes, plasma cells, and histiocytes

PENGOBATAN

a number of different modalities are available for the treatment of bd. Such treatments can be divided
into three main categories : surgical and destructive therapies, topical therapies, and non surgical
ablative therapies. Surgical and destructive therapies include excision, mohs micrographic surgery,
curettage with or without electrocautery, chemoablation with TCA, and cryosurgery. Topical therapies
include 5-FU and 5 percent imiquimod cream. Non-surgical ablative therapies are lacer ablation,
radiotherapy, and PDT. Although some of these modalities have reported cure retes that are better than
others, no one treatment is right for all forms of BD. Therapy must be quided by the size and location of
the BD, in addition to individual patient characteristics, sucgh as age and healing capability.