Squamous cell carcinoma may start out as a small, hard, red nodule with indistinct borders, which tends to become papillomatous or warty, and may have a scaly surface, with a central ulcer that tends to be granular and prone to necrosis and hemorrhage. The margins of ulcers are usually wider, can be raised in cauliflower shape, with firm texture, often with foul odor, and can be progressively enlarged. There are some squamous carcinomas that develop in the exposed areas of the elderly and grow gradually. Some squamous carcinoma may be secondary to chronic ulcers, radiodermatitis, or pre-cancerous lesions in situ, such as heliokeratosis, mucous membrane leukoplakia, etc. On top of this, due to the malignant changes occurring in the repeated inflammatory stimulation, ulcers, nodules as well as malodorous odor are formed, and this is the more typical early symptom of squamous carcinoma.