Basal cell carcinoma - Karsinoma Sel Basal
☆ Dalam keputusan Stiftung Warentest 2022 dari Jerman, kepuasan pengguna terhadap ModelDerm hanya lebih rendah sedikit berbanding dengan perundingan teleperubatan berbayar.
Lesi ulser yang menjejaskan kulit hidung pada individu warga emas selalunya didiagnosis sebagai Karsinoma Sel Basal (Basal cell carcinoma). Hidung adalah tapak biasa kejadian untuk jenis kanser kulit ini.
Karsinoma Sel Basal (Basal cell carcinoma) mungkin hadir dengan sempadan yang tidak teratur dan ulser.
Karsinoma Sel Basal (Basal cell carcinoma) boleh disalah anggap sebagai ketuat.
References
Basal cell carcinoma (BCC) ialah jenis kanser kulit yang paling biasa. Pendedahan cahaya matahari adalah punca utama. Hampir semua kes BCC menunjukkan isyarat Hedgehog yang terlalu aktif dalam analisis molekul. Rawatan yang berbeza tersedia dan dipilih berdasarkan risiko berulang, kepentingan pemeliharaan tisu, keutamaan pesakit, dan tahap penyakit.
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 adalah jenis kanser kulit yang paling biasa di kalangan orang dewasa berkulit cerah berumur 50 tahun ke atas. Bilangan mereka meningkat di seluruh dunia, terutamanya disebabkan oleh pendedahan kepada cahaya matahari. Keadaan genetik tertentu boleh menyebabkan orang terdedah kepada kanser ini pada usia yang lebih muda. Basal cell carcinomas berbeza dari segi keterukan, daripada lesi cetek atau nodular yang mudah dirawat kepada yang lebih meluas yang memerlukan perbincangan dalam pasukan perubatan khusus. Prognosis bergantung pada kemungkinan kanser kembali atau keupayaannya untuk merosakkan tisu berdekatan. Pembedahan adalah rawatan standard untuk kebanyakan kes, memastikan penyingkiran tepat dan peluang yang rendah untuk berulang. Kaedah yang kurang invasif boleh merawat luka cetek dengan berkesan.
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.
Rawatan utama untuk BCC adalah pembedahan. Untuk BCC yang berisiko tinggi atau berulang, terutamanya di kawasan kritikal, pembedahan dikawal secara mikrografik disyorkan. Pesakit dengan BCC cetek berisiko rendah mungkin mempertimbangkan rawatan topikal atau kaedah yang merosakkan. Terapi fotodinamik berfungsi dengan baik untuk BCC nodular dangkal dan berisiko rendah. Untuk BCC lanjutan atau metastatik tempatan, perencat Hedgehog (vismodegib or sonidegib) disyorkan. Jika terdapat perkembangan penyakit atau tidak bertoleransi terhadap perencat Hedgehog, imunoterapi dengan anti-PD1 antibody (cemiplimab) boleh dipertimbangkan. Radioterapi adalah pilihan yang baik untuk pesakit yang tidak boleh menjalani pembedahan, terutamanya pesakit yang lebih tua. Elektrokimoterapi boleh dipertimbangkan jika pembedahan atau radioterapi bukan pilihan.
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.
Faktor risiko termasuk pendedahan kepada cahaya ultraungu, terapi sinaran, pendedahan jangka panjang kepada arsenik dan fungsi sistem imun yang lemah (contohnya pemindahan organ). Pendedahan kepada cahaya UV semasa zaman kanak-kanak amat berbahaya.
Selepas mendiagnosis melalui biopsi, rawatan biasanya melalui pembuangan pembedahan. Ini boleh dilakukan dengan pengasingan mudah jika kansernya kecil; Jika kanser tidak kecil, pembedahan Mohs biasanya disyorkan.
Karsinoma sel basal menyumbang sekurang-kurangnya 32% daripada semua kanser di seluruh dunia. Daripada kanser kulit selain melanoma, kira-kira 80% adalah kanser sel basal. Di Amerika Syarikat, kira-kira 35% lelaki kulit putih dan 25% wanita kulit putih dipengaruhi oleh karsinoma sel basal pada satu ketika dalam hidup mereka.
○ Diagnosis dan Rawatan
#Dermoscopy
#Skin biopsy
#Mohs surgery