Squamous vs Actinic Keratosis

I had a patch of discolored, scaling skin on my lower lip.  That area seemed slightly inflamed and sensitive.  The doctor thought it was actinic keratosis and prescribed 2-4 weeks using Carac cream.  After reading about Squamous Cell Cancer, I am worried that I may have that, and it was missed because my doctor did not do a biopsy.  I am finishing my third week of Carac and it turned out about 85% of my bottom lip was affected and I have had crusting, bleeding in response to the cream.  The original problem area is the worst, with bleeding still.  

Question:  If I did in fact have squamous cell cancer on that patch, what will happen since I did the Carac cream?  Attached is photo showing affect of cream on lower lip  

[Bhupinder Kaur, MD]

Hello,
From the symptoms it looks like actinic cheilitis. It is a form of cheilitis which is the counterpart of actinic keratosis of the skin and can develop into squamous cell carcinoma. Without biopsy, it is very difficult to confirm a diagnosis and hence I suggest you to get a biopsy skin done.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.