Basal cell carcinoma - Basalcellekarcinom
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Ulcererede læsioner, der påvirker næsehuden hos en ældre person, diagnosticeres ofte som Basalcellekarcinom (Basal cell carcinoma). Næsen er et almindeligt sted for forekomst for denne type hudkræft.
Basalcellekarcinom (Basal cell carcinoma) kan vise sig med uregelmæssige kanter og sår.
Basalcellekarcinom (Basal cell carcinoma) kan forveksles med vorte.
References
Basal cell carcinoma (BCC) er den mest almindelige type hudkræft. Udsættelse for sollys er hovedårsagen. Næsten alle BCC-tilfælde viser overaktiv Hedgehog-signalering i den molekylære analyse. Forskellige behandlinger er tilgængelige og valgt baseret på gentagelsesrisiko, vigtigheden af vævskonservering, patientens præference og omfanget af sygdommen.
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 er den mest almindelige type hudkræft hos lyshudede voksne på 50 år og derover. Deres antal stiger på verdensplan, primært på grund af eksponering for sollys. Visse genetiske forhold kan gøre folk tilbøjelige til at udvikle disse kræftformer i en yngre alder. Basal cell carcinomas varierer i sværhedsgrad, lige fra let behandlelige overfladiske eller nodulære læsioner til mere omfattende læsioner, der kræver diskussion i specialiserede medicinske teams. Prognosen afhænger af sandsynligheden for, at kræft vender tilbage eller dens evne til at beskadige nærliggende væv. Kirurgi er standardbehandlingen i de fleste tilfælde, hvilket sikrer præcis fjernelse og lave chancer for tilbagefald. Mindre invasive metoder kan effektivt behandle overfladiske læsioner.
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.
Den primære behandling for BCC er kirurgi. Ved højrisiko eller tilbagevendende BCC, især i kritiske områder, anbefales mikrografisk kontrolleret kirurgi. Patienter med lavrisiko overfladisk BCC kan overveje topiske behandlinger eller destruktive metoder. Fotodynamisk terapi fungerer godt til overfladiske og lavrisiko nodulære BCC'er. Ved lokalt fremskreden eller metastatisk BCC anbefales Hedgehog-hæmmere (vismodegib or sonidegib) . Hvis der er sygdomsprogression eller intolerance over for Hedgehog-hæmmere, kan immunterapi med anti-PD1 antibody (cemiplimab) overvejes. Strålebehandling er en god mulighed for patienter, der ikke kan opereres, især ældre patienter. Elektrokemoterapi kan overvejes, hvis operation eller strålebehandling ikke er en mulighed.
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.
Risikofaktorer omfatter eksponering for ultraviolet lys, strålebehandling, langvarig eksponering for arsen og dårlig immunsystemfunktion (f.eks. organtransplantation). Eksponering for UV-lys i barndommen er særligt skadelig.
Efter diagnosticering ved biopsi er behandlingen typisk ved kirurgisk fjernelse. Dette kan være ved simpel excision, hvis kræften er lille; Hvis kræften ikke er lille, anbefales Mohs operation generelt.
Basalcellekarcinom tegner sig for mindst 32% af alle kræfttilfælde globalt. Af andre hudkræftformer end melanom er omkring 80 % basalcellekræft. I USA er omkring 35 % af de hvide mænd og 25 % af de hvide kvinder ramt af basalcellekarcinom på et tidspunkt i deres liv.
○ Diagnose og behandling
#Dermoscopy
#Skin biopsy
#Mohs surgery