Skin cancer is among the most common cancers, with Squamous Cell Carcinoma (SCC) being one of the most frequently diagnosed types.Factors like too much sun exposure, a weak immune system, and genetics can cause SCC. It mostly appears on body parts exposed to the sun, like the legs, face, and forearms. Spotting it early is the key to prevention, so knowing the symptoms and risks are important.
“small non-healing lesions on skin are often overlooked as a minor skin issue, but if left untreated, it can lead to severe complications especially the most dreaded: cancer. Timely intervention improves outcomes and helps preserve limb function and appearance,” notes Dr. Leena Jain, an eminent plastic and reconstructive surgeon in Mumbai.
With years of expertise in treating complex skin conditions, she specializes in functional and aesthetic restoration following SCC treatment. Her approach combines oncologic precision with advanced reconstructive techniques, ensuring patients receive optimal care.
Ever wondered why skin cancer, especially SCC, forms on the legs or forearms? Let’s discuss the key risk factors that contribute to this condition.
Why Does SCC Develop on the Leg/ forearm? Key Causes & Risk Factors
There are several etiologic factors causing squamous cell skin cancer on leg, such as:
- Excessive Sun Exposure: Being in the sun too much can harm skin cells. Over time, this damage can lead to changes that cause SCC (Squamous Cell Carcinoma).
- Weak Immune System: People with weak immunity, such as those with HIV, organ transplants, or on immune-suppressing medicines, have a higher risk of SCC.
- Chronic scars and wounds: Burn scars, unstable tight or stretched scars following healing after injury or infection or chronic long standing non healing wounds/ulcers of a few years duration (often more than 2-3 years) can turn malignant and develop SCC.
- Non healing ulcers are often seen on legs while burns scars can occur anywhere in the body.
- Fair Skin & Aging: Light-skinned individuals and older adults are more likely to develop SCC on their legs.
- Exposure to Hazardous Substances: Being around harmful chemicals or radiation for a long time can increase the chances of getting SCC.
“Leg ulcers and old scars are potential sites for SCC development. Patients with non-healing wounds should seek early medical evaluation to rule out malignant transformation,” advises Dr. Leena Jain.
Recognizing the Symptoms
Early detection of SCC lower leg is crucial. Common signs include:
- Scaly, Red Patch: A persistent rough, red, or scaly area that doesn’t heal.
- Open Sore That Won’t Heal: A wound that bleeds, crusts over, and keeps reopening.
- Firm, Wart-Like Growth: A raised, thickened, or wart-like lesion on the leg.
- Pain or Tenderness: Discomfort, itching, or tenderness around the affected area.
- Rapidly Growing Lump: A hard bump that increases in size over weeks or months.
- Swelling Around the Lesion: Inflammation or thickening of the surrounding skin.
- Changes in an Existing Scar or Ulcer: SCC may develop in old wounds, scars, or burn sites.
“Any wound or lesion that persists beyond four weeks warrants medical attention. The sooner SCC is detected, the simpler and more effective the treatment,” highlights Dr. Leena Jain.
Diagnosis
Physical Examination: A specialist examines the lesion closely, after taking a thorough history.- Punch Biopsy: A circular tool removes a deeper skin sample for a more detailed examination.
- Ulcer Biopsy: Small multiple samples of the lesion/ulcer along with adjacent skin are taken and analyzed under a microscope to confirm the diagnosis: this is called multiple edge wedge biopsy. This is a minor surgery.
- Excisional Biopsy: If the lesion is small, the entire growth may be removed for testing.
- Lymph Node Assessment: Nearby lymph nodes may be checked to determine if the cancer has spread.
- Imaging Tests (CT, MRI, or PET scans): If SCC is suspected to have spread, imaging tests help assess deeper and widespread tissue involvement.
Physical Examination: A specialist examines the lesion closely, after taking a thorough history.Treatment Options for Squamous Cell Carcinoma on the Leg
Treatment choice depends on the SCC’s size, depth, and location. Common treatments include:
- Surgical Excision: The surgeon removes the tumor and a margin of healthy skin to ensure complete elimination.
- Mohs Surgery: A precise method where layers of cancerous tissue are removed and examined under a microscope until only healthy tissue remains. Done layer by layer and useful for very small lesions in cosmetically important areas like around eyes or nose or lips.
- Radiation Therapy: Recommended for patients who cannot undergo surgery or for cases where SCC has spread deeper.
- Topical Medications (5-Fluorouracil or Imiquimod): Used for early-stage or superficial squamous cell leg lesions to avoid invasive procedures.
- Targeted Therapy & Immunotherapy: Used in advanced cases where SCC has spread beyond the skin.
The Role of Plastic & Reconstructive Surgery in SCC Treatment
For larger SCC lesions, surgical removal may leave significant wounds. A reconstructive surgeon can help restore function and appearance through advanced techniques such as skin grafting and flap reconstruction. These methods ensure proper healing while maintaining mobility and aesthetics, especially in weight-bearing areas like the leg. In the forearm, preserving function of digits is of utmost importance hence, reconstructive surgery is essential to reform, tendons, nerves that may have been removed with the tumor and soft tissue cover to resurface the entire wound after tumor removal.
“Reconstructive surgery is not just about restoring appearance; it plays a crucial role in preserving limb function, especially when SCC affects vital areas like the lower leg,” explains Dr. Leena Jain, a distinguished plastic surgeon in Mumbai. By combining oncologic precision with reconstructive expertise, patients can achieve optimal results with minimal complications.
- Flap Reconstruction
Flap Reconstruction: Uses skin with underlying tissue (called flap) with its own blood supply to repair deep or complex wounds. Flaps from the vicinity of the ulcer can be used for small tumor reconstruction. Large tumor/ ulcer excisions require advanced microsurgical reconstruction using free flaps where flaps are taken from the thigh or elsewhere and transferred onto the ulcer area to be covered. Along with flap, tendons and nerve grafts can be taken to reconstruct these structures if they have been removed.- Skin grafting is usually not helpful to resurface wounds left after tumor excision as these areas may need radiation therapy after flap surgery for complete eradication of cancer. Grafts cannot sustain radiation and will breakdown causing a raw area/wound again.
Flap Reconstruction: Uses skin with underlying tissue (called flap) with its own blood supply to repair deep or complex wounds. Flaps from the vicinity of the ulcer can be used for small tumor reconstruction. Large tumor/ ulcer excisions require advanced microsurgical reconstruction using free flaps where flaps are taken from the thigh or elsewhere and transferred onto the ulcer area to be covered. Along with flap, tendons and nerve grafts can be taken to reconstruct these structures if they have been removed.- Limb Preservation & Functional Restoration
For SCC cases involving deeper tissues, reconstructive surgery helps:
- Preserve limb movement and function.
- Reduce scarring and promote better wound healing.
- Restore the skin’s natural appearance post-treatment.
Recovery & Long-Term Skin Care After SCC Treatment
Recovery depends on the treatment method used, but general care includes:
- Follow Post-Surgery Instructions: Take care of the treated area as advised by your doctor to help it heal properly and within time.
- Manage Wounds Carefully: Keep the wound clean and dry. Change the dressing as instructed to avoid infection.
- Monitor for Complications: Check for signs of infection, like redness, swelling, or unusual changes in the wound.
- Sun Protection: Apply SPF 50+ sunscreen daily, even when it’s cloudy. Wear protective clothing to keep the area safe from the sun.
- Avoid Direct Sun Exposure: Limit exposure to the sun, particularly during peak hours (10 a.m. to 4 p.m.).
- Regular Skin Checks: Conduct regular self-exams of your skin to identify new growths or changes in existing lesions.
- Healthy Diet and Hydration: Eat a balanced diet and drink plenty of water to support skin healing and recovery.
- Quit Smoking: Smoking can impair healing and increase the risk of recurrence.
- Follow-Up Appointments: Schedule regular check-ups with your doctor to ensure proper healing and detect any recurrence early.
Recovery & Long-Term Skin Care After SCC Treatment
Recovery depends on the treatment method used, but general care includes:
- Follow Post-Surgery Instructions: Take care of the treated area as advised by your doctor to help it heal properly and within time.
- Manage Wounds Carefully: Keep the wound clean and dry. Change the dressing as instructed to avoid infection.
- Monitor for Complications: Check for signs of infection, like redness, swelling, or unusual changes in the wound.
- Sun Protection: Apply SPF 50+ sunscreen daily, even when it’s cloudy. Wear protective clothing to keep the area safe from the sun.
- Avoid Direct Sun Exposure: Limit exposure to the sun, particularly during peak hours (10 a.m. to 4 p.m.).
- Regular Skin Checks: Conduct regular self-exams of your skin to identify new growths or changes in existing lesions.
- Healthy Diet and Hydration: Eat a balanced diet and drink plenty of water to support skin healing and recovery.
- Quit Smoking: Smoking can impair healing and increase the risk of recurrence.
- Follow-Up Appointments: Schedule regular check-ups with your doctor to ensure proper healing and detect any recurrence early.
Preventive Measures to Reduce Recurrence Risk
- Apply Broad-Spectrum Sunscreen Daily: Use SPF 50+ sunscreen on exposed skin.
- Wear Protective Clothing: Cover your legs with long pants and opt for UV-protective fabrics when outdoors.
- Avoid Peak Sun Hours: Limit sun exposure between 10 a.m. and 4 p.m. when UV rays are strongest.
- Stay Alert to New or Changing Lesions: Regularly check your skin for any new growths, sores, or changes in existing spots.
- Protect Healed Skin: If you’ve had SCC, ensure proper care of the treated area to prevent damage and irritation.
- Be Cautious with Chronic Wounds & Scars: Seek medical advice for non-healing wounds or persistent skin changes.
- Use Moisturizers & Skin-Nourishing Products: Keeping your skin hydrated enhances its natural barrier function.
- Follow-up with a Specialist: Routine skin examinations help detect recurrences at an early stage.
Conclusion
Preventive measures, including sun protection and regular skin screenings, play a vital role in reducing future risks. If you suspect SCC or need expert care, consult a highly skilled professional like Dr. Leena Jain for the best possible treatment and recovery options.
FAQs
Is SCC lower leg dangerous?
What are the early signs of SCC on leg?
Does SCC on leg always require surgery?
Can SCC on leg spread to other parts of the body?
What is the recovery time after SCC leg surgery?
Reference links:
https://my.clevelandclinic.org/health/diseases/17480-squamous-cell-carcinoma
https://www.webmd.com/melanoma-skin-cancer/squamous-cell-carcinoma
Disclaimer: This page is for informational purposes and not for promotional use.
