Squamous cell carcinoma is the second most common group of skin cancer accounting for 150,000 new cases per year. Squamous cell carcinoma typically arises on the face due to the high amount of sun exposure. Its gross appearance is usually a localized hyperkeratosis, which is usually produces increasing amounts of keratin. Microscopic examination reveals atypical keratinocytic hyperplasia involving all the epidermal layers. Invasion is seen when there is extension of the atypical keratinocytes into the underlying connective tissue.
Lip lesion have the highest rate of metastasis in squamous cell carcinoma.
The healing is by secondary intention where the fixed tissue remaining was allowed to slough. The fixed tissue technique is preferred in certain circumstances such as with vascular tumors, tumors arising in vascular areas and also tumors involving bone. It has also been used in the treatment of osteomyelitis and tumors that have penetrated bone. Frozen or permanent sections are not necessary if previous biopsy established the diagnosis. The planned excision is delineated on the skin with 2mm to 5mm margins of normal appearing skin is marked from the margin of the curetted tumor.