癌症非黑色素瘤皮肤的诊断与治疗

Q4 Medicine
L. Pérez, Do, Faafp, Facofp
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引用次数: 1

摘要

非黑色素瘤皮肤癌(NMSC)是世界上最常见的癌症。基底细胞癌(BCC)和鳞癌(SCC)是最常见的类型。与BCC相比,SCC病变更容易转移,但由于转移风险低,NMSC预后良好。紫外线照射是NMSC发病的主要危险因素。默克尔细胞癌和隆突性皮肤纤维肉瘤是罕见的NMSC。最常见的BCC病变类型是结节性、浅表性和硬化性。结节性基底细胞癌通常由具有珍珠边界的丘疹性病变组成。浅表BCC病变呈扁平或微凸起,常呈红色至棕色。硬化性基底细胞癌通常有不连续的边缘。鳞状细胞癌的大体外观为带有鳞屑和/或溃疡的红斑斑块。NMSC的诊断从大体检查开始,然后进行活检。推荐的活检技术包括打孔、刮刀和切除活检。皮肤镜检查也应用于帮助评估疑似NMSC和其他皮肤癌,因为它大大提高了皮肤恶性肿瘤的即时诊断。对于低风险病变,手术切除是治疗的基石,尽管根据临床情况,可以使用刮除和电干燥或非手术方式。冷冻疗法、局部治疗、光动力疗法或放射治疗可用于治疗BCC和SCC,但治愈率低于手术切除。高危病变需要专科转诊。所有接受NMSC治疗的患者都应定期接受全面的皮肤检查,并就使用防晒和避免晒太阳进行咨询。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnosis and Management of Nonmelanoma Skin Cancer
Nonmelanoma skin cancer (NMSC) is the most common cancer in the world. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common types. SCC lesions are more likely to metastasize when compared to BCC, but due to low risk for metastasis, prognosis for NMSC is excellent. Ultraviolet radiation exposure is the main risk factor for developing NMSC. Merkel cell carcinoma and dermatofibrosarcoma protuberans are rare forms of NMSC. The most common BCC lesions types are nodular, superficial, and sclerosing. Nodular BCC typically consists of papular lesions with a pearly border. Superficial BCC lesions are flat or slightly raised, often red to brown. Sclerosing BCC lesions usually have nondiscrete margins. The gross appearance of SCC is that of an erythematous plaque with scale and/or ulceration. The diagnosis of NMSC starts with gross examination, followed by biopsy. Recommended biopsy techniques include punch, shave, and excisional biopsy. Dermatoscopy should also be used to aid in the evaluation of suspected NMSC and other skin cancers, as it greatly enhances the point-of-care diagnosis of skin malignancies. For low-risk lesions, surgical excision is the cornerstone of treatment, although depending on the clinical situation, curettage and electrodessication or non-surgical modalities may be used. Cryotherapy, topical treatments, photodynamic therapy, or radiation treatment can be used to treat BCC and SCC, but cure rates are lower than with surgical excision. High-risk lesions require specialist referral. All patients treated for NMSC should undergo regular complete skin exams, and counseling on the use of sun protection and avoidance.
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来源期刊
Osteopathic Family Physician
Osteopathic Family Physician Medicine-Family Practice
CiteScore
0.10
自引率
0.00%
发文量
17
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