Squamous Cell Carcinoma of Skin, Unspecified (C44.92)

Name of the Condition

• Squamous Cell Carcinoma of the Skin
• SCC

Summary

Squamous Cell Carcinoma (SCC) is a type of skin cancer that arises from squamous cells, which are flat cells located in the outer layer of the skin. It can develop on various parts of the body, but is most commonly found in areas with significant sun exposure, like the face, neck, and hands. While it can be aggressive, SCC is often treatable, especially when caught early.

Causes

• Excessive exposure to ultraviolet (UV) radiation from the sun or tanning beds.
• History of radiation therapy.
• Presence of precancerous skin lesions (actinic keratosis).
• Chronic exposure to harmful chemicals such as arsenic.

Risk Factors

• Prolonged sun exposure or history of sunburns.
• Fair skin, light hair, and eye color.
• Older age, particularly those over 50.
• Weakened immune system.
• Human papillomavirus (HPV) infection.

Symptoms

• Rough, scaly patches on the skin that are red or brown.
• Raised growths with a central depression.
• Open sores that do not heal.
• Wart-like growths.

Diagnosis

• Physical examination and review of medical history.
• Skin biopsy to analyze suspected cancerous tissue.
• Dermoscopy to examine skin lesions more closely.

Treatment Options

• Surgical Removal: Excision or Mohs surgery to remove the cancerous tissue.
• Cryotherapy: Freezing abnormal cells with liquid nitrogen.
• Topical Medications: For superficial SCCs, like 5-fluorouracil or imiquimod.
• Radiation Therapy: Used for those who can't undergo surgery.
• Photodynamic Therapy: Combines light exposure with a photosensitizing drug.

Prognosis and Follow-Up

• Most cases are curable, especially when detected early.
• Regular skin checks are essential to monitor for recurrence or new cancers.
• Prognosis varies with stage, location, and patient health.

Complications

• Metastasis: If untreated, SCC can spread to other parts of the body.
• Local tissue destruction leading to functional or cosmetic issues.

Lifestyle & Prevention

• Use broad-spectrum sunscreen with an SPF of at least 30.
• Wear protective clothing and hats.
• Avoid tanning beds.
• Perform regular skin self-examinations.
• Seek shade during peak sun hours.

When to Seek Professional Help

• New or changing skin lesions.
• Non-healing sores.
• Growths that bleed or feel tender.

Additional Resources

• American Academy of Dermatology: AAD Website
• Skin Cancer Foundation: Skin Cancer Website

Tips for Medical Coders

• Verify that the diagnosis is confirmed through biopsy or histopathological exam.
• Double-check the site of the carcinoma for accurate localization coding (not specified in C44.92).
• Ensure documentation supports the unspecified nature of the cancer type when coding as "unspecified."