Guidelines for the management of people with cutaneous squamous cell carcinoma

Primary cutaneous squamous cell carcinoma (cSCC) is a type of skin cancer. It is the sixth most common cancer in the UK and its incidence continues to rise. It has a 5% chance of spreading to other parts of the body. Its occurrence is usually related to too much ultraviolet light exposure and therefore it is especially common in people with sun‐damaged skin or with skin diseases that put people at higher risk of skin cancers. Individuals with weakened immune systems, for example those receiving immunosuppressive drugs and those with lymphoma or leukaemia, are at increased risk of developing cSCC. The British Association of Dermatologists commissioned a multidisciplinary group of dermatologists, clinical oncologists, a plastic surgeon, a maxillo‐facial surgeon, a dermato‐pathologist, a dermatology nurse specialist, a general practitioner, patient representatives and methodologists to update its cSCC guidelines. The UK‐based group produced 46 recommendations, based on systematic reviews of the evidence, for the management of cSCC in general practitioner clinics and hospitals, using the GRADE system (Grading of Recommendations Assessment, Development and Evaluation) for guideline development. Standard surgical excision is the first‐line treatment option for people with cSCC in most cases. In some cases, surgery is not possible or not chosen by the patient therefore other treatments should be considered, such as curettage and cautery (which involves scraping the cSCC away using local anaesthetic), a type of surgery called Mohs or radiotherapy. The recommended patient treatment and management pathways are presented as flow diagrams in the article. Future research recommendations and audit criteria are included. Linked Article:   Keohane et al. Br J Dermatol 2021; 184 :401–414.