Basal cell carcinoma - Karcinom Bazalnih Ćelija
☆ U rezultatima Stiftung Warentest-a za 2022. iz Njemačke, zadovoljstvo potrošača ModelDerm-om bilo je samo nešto niže nego s plaćenim telemedicinskim konsultacijama.
Ulcerisane lezije koje zahvaćaju kožu nosa kod starijih osoba često se dijagnosticiraju kao Karcinom Bazalnih Ćelija (Basal cell carcinoma). Nos je uobičajeno mjesto pojave ove vrste raka kože.
Karcinom Bazalnih Ćelija (Basal cell carcinoma) može imati nepravilne ivice i čireve.
Karcinom Bazalnih Ćelija (Basal cell carcinoma) može se zamijeniti za bradavicu.
References
Basal cell carcinoma (BCC) je najčešći tip raka kože. Izlaganje sunčevoj svjetlosti je glavni uzrok. Gotovo svi BCC slučajevi pokazuju preaktivnu Hedgehog signalizaciju u molekularnoj analizi. Dostupni su različiti tretmani koji se biraju na osnovu rizika od recidiva, važnosti očuvanja tkiva, preferencija pacijenata i obima bolesti.
Basal cell carcinoma (BCC) is the most common malignancy. Exposure to sunlight is the most important risk factor. Most, if not all, cases of BCC demonstrate overactive Hedgehog signaling. A variety of treatment modalities exist and are selected based on recurrence risk, importance of tissue preservation, patient preference, and extent of disease.
Basal cell carcinoma (BCC) is the most common malignancy. Exposure to sunlight is the most important risk factor. Most, if not all, cases of BCC demonstrate overactive Hedgehog signaling. A variety of treatment modalities exist and are selected based on recurrence risk, importance of tissue preservation, patient preference, and extent of disease.
Basal cell carcinomas su najčešći tip raka kože kod ljudi svijetle puti u dobi od 50 i više godina. Njihov broj raste širom svijeta, uglavnom zbog izlaganja sunčevoj svjetlosti. Određena genetska stanja mogu učiniti ljude sklonim razvoju ovih karcinoma u mlađoj dobi. Basal cell carcinomas variraju po ozbiljnosti, u rasponu od lako izlječivih površinskih ili nodularnih lezija do onih opsežnijih koje zahtijevaju raspravu u specijaliziranim medicinskim timovima. Prognoza ovisi o vjerovatnoći povratka raka ili njegovoj sposobnosti da ošteti obližnje tkivo. Operacija je standardni tretman za većinu slučajeva, koji osigurava precizno uklanjanje i male šanse za recidiv. Manje invazivne metode mogu efikasno tretirati površinske lezije.
Basal cell carcinomas are the most frequent skin cancers in the fair-skinned adult population over 50 years of age. Their incidence is increasing throughout the world. Ultraviolet (UV) exposure is the major carcinogenic factor. Some genodermatosis can predispose to formation of basal cell carcinomas at an earlier age. Basal cell carcinomas are heterogeneous, from superficial or nodular lesions of good prognosis to very extensive difficult-to-treat lesions that must be discussed in multidisciplinary committees. The prognosis is linked to the risk of recurrence of basal cell carcinoma or its local destructive capacity. The standard treatment for most basal cell carcinomas is surgery, as it allows excision margin control and shows a low risk of recurrence. Superficial lesions can be treated by non-surgical methods with significant efficacy.
Basal cell carcinomas are the most frequent skin cancers in the fair-skinned adult population over 50 years of age. Their incidence is increasing throughout the world. Ultraviolet (UV) exposure is the major carcinogenic factor. Some genodermatosis can predispose to formation of basal cell carcinomas at an earlier age. Basal cell carcinomas are heterogeneous, from superficial or nodular lesions of good prognosis to very extensive difficult-to-treat lesions that must be discussed in multidisciplinary committees. The prognosis is linked to the risk of recurrence of basal cell carcinoma or its local destructive capacity. The standard treatment for most basal cell carcinomas is surgery, as it allows excision margin control and shows a low risk of recurrence. Superficial lesions can be treated by non-surgical methods with significant efficacy.
Primarni tretman za BCC je operacija. Za visokorizične ili ponavljajuće BCC, posebno u kritičnim područjima, preporučuje se mikrografski kontrolirana operacija. Pacijenti s niskorizičnim površinskim BCC mogu razmotriti lokalne tretmane ili destruktivne metode. Fotodinamička terapija dobro funkcionira za površinske i niskorizične nodularne BCC. Za lokalno uznapredovali ili metastatski BCC, preporučuju se Hedgehog inhibitori (vismodegib or sonidegib) . Ako postoji progresija bolesti ili intolerancija na Hedgehog inhibitore, može se razmotriti imunoterapija sa anti-PD1 antibody (cemiplimab) . Radioterapija je dobra opcija za pacijente koji ne mogu na operaciju, posebno za starije pacijente. Može se razmotriti elektrokemoterapija ako operacija ili radioterapija nisu opcija.
The primary treatment for BCC is surgery. For high-risk or recurring BCC, especially in critical areas, micrographically controlled surgery is recommended. Patients with low-risk superficial BCC might consider topical treatments or destructive methods. Photodynamic therapy works well for superficial and low-risk nodular BCCs. For locally advanced or metastatic BCC, Hedgehog inhibitors (vismodegib, sonidegib) are recommended. If there's disease progression or intolerance to Hedgehog inhibitors, immunotherapy with anti-PD1 antibody (cemiplimab) can be considered. Radiotherapy is a good option for patients who can't have surgery, especially older patients. Electrochemotherapy could be considered if surgery or radiotherapy isn't an option.
The primary treatment for BCC is surgery. For high-risk or recurring BCC, especially in critical areas, micrographically controlled surgery is recommended. Patients with low-risk superficial BCC might consider topical treatments or destructive methods. Photodynamic therapy works well for superficial and low-risk nodular BCCs. For locally advanced or metastatic BCC, Hedgehog inhibitors (vismodegib, sonidegib) are recommended. If there's disease progression or intolerance to Hedgehog inhibitors, immunotherapy with anti-PD1 antibody (cemiplimab) can be considered. Radiotherapy is a good option for patients who can't have surgery, especially older patients. Electrochemotherapy could be considered if surgery or radiotherapy isn't an option.
Faktori rizika uključuju izlaganje ultraljubičastom svjetlu, terapiju zračenjem, dugotrajno izlaganje arsenu i lošu funkciju imunološkog sistema (npr. transplantacija organa). Izlaganje UV zračenju tokom detinjstva je posebno štetno.
Nakon postavljanja dijagnoze biopsijom, liječenje je obično kirurško uklanjanje. Ovo može biti jednostavnom ekscizijom ako je rak mali; Ako rak nije mali, općenito se preporučuje Mohsova operacija.
Karcinom bazalnih ćelija čini najmanje 32% svih karcinoma u svetu. Od karcinoma kože, osim melanoma, oko 80% su karcinomi bazalnih ćelija. U Sjedinjenim Državama, oko 35% bijelih muškaraca i 25% bjelkinji su pogođeni karcinomom bazalnih stanica u nekom trenutku svog života.
○ Dijagnoza i liječenje
#Dermoscopy
#Skin biopsy
#Mohs surgery