Squamous cell carcinomas of the lip, tongue and floor of the mouth are each associated with unique expressions. Yet, they share one key factor: They disproportionately affect men.

Researchers suggest this may be due to high tobacco use in this group as smoking is associated with 75 percent of these three squamous cell carcinomas.

When tobacco isn’t a factor, an individual’s genetic predisposition may play a role. People who have been treated for cancer with chemotherapy or radiation may be more susceptible to oral squamous cell carcinomas (oSCC) when DNA fails to repair itself after treatment.

Also, deficiencies in vitamins A, E or C may be factors as might defects in the immune system; the body’s inability to metabolize carcinogens; or, chronic sun damage. In this article, we narrow in on a case of lip squamous cell carcinoma in a 31-year-old man.

Lip SCC

Traditionally, the classification of oral squamous cell carcinoma (oSCC) has included lip squamous cell carcinoma (lSCC), but recent studies have shown that genetics and clinical behavior associated with lSCC is unique as compared to the oral and cutaneous forms of the condition.

For instance, while the human papillomavirus plays a role in oSCC, it has not yet been implicated in lSCC, which is known to be associated with sun exposure and the effects of immunosuppression, just as in cutaneous squamous cell carcinoma (cSCC).

Treatment is associated with high success rates. The estimated five-year survival rates following surgical treatment of lSCC is over 80 percent, compared with 65-70 percent for oSCC and 92 percent for cSCC.

Lip squamous cell carcinoma can present as a verrucous or keratotic plaque, an exophytic papule or nodule, or as a non-healing ulcer. The lower lip is approximately 12 times more likely to be af ected due to greater exposure to sunlight.

“It is important for dermatologists to be aware of lSCC as a unique entity. Management options present unique  challenges,” said Nour Kibbi, M.D., a resident physician in dermatology at the Yale-New Haven Medical Center in Connecticut.