Basal cell carcinoma - Bazalnocelični Karcinom
☆ V rezultatih raziskave Stiftung Warentest iz Nemčije leta 2022 je bilo zadovoljstvo potrošnikov z ModelDermom le nekoliko nižje kot s plačanimi telemedicinskimi svetovanji.
Ulcerativne lezije, ki prizadenejo kožo nosu pri starejših osebah, so pogosto diagnosticirane kot Bazalnocelični Karcinom (Basal cell carcinoma). Nos je pogosto mesto pojavljanja te vrste kožnega raka.
Bazalnocelični Karcinom (Basal cell carcinoma) se lahko kaže z nepravilnimi robovi in razjedami.
Bazalnocelični Karcinom (Basal cell carcinoma) lahko zamenjamo za bradavico.
References
Basal cell carcinoma (BCC) je najpogostejša vrsta kožnega raka. Izpostavljenost sončni svetlobi je glavni vzrok. Skoraj vsi primeri BCC kažejo čezmerno aktivno signaliziranje Hedgehog v molekularni analizi. Na voljo so različna zdravljenja, ki so izbrana glede na tveganje ponovitve, pomembnost ohranjanja tkiva, bolnikove želje in obseg bolezni.
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 je najpogostejša vrsta kožnega raka pri svetlopoltih odraslih, starih 50 let in več. Njihovo število po vsem svetu narašča, predvsem zaradi izpostavljenosti sončni svetlobi. Nekateri genetski pogoji lahko povzročijo, da so ljudje nagnjeni k razvoju teh rakov v mlajših letih. Basal cell carcinomas se razlikujejo po resnosti, od enostavno ozdravljivih površinskih ali nodularnih lezij do obsežnejših, ki zahtevajo razpravo s specializiranimi medicinskimi ekipami. Napoved je odvisna od verjetnosti ponovitve raka ali njegove sposobnosti, da poškoduje bližnje tkivo. Operacija je standardno zdravljenje v večini primerov, ki zagotavlja natančno odstranitev in nizke možnosti ponovitve. Manj invazivne metode lahko učinkovito zdravijo 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.
Primarno zdravljenje BCC je operacija. Pri visokorizičnem ali ponavljajočem se BCC, zlasti na kritičnih področjih, se priporoča mikrografsko nadzorovana operacija. Bolniki s površinskim BCC z nizkim tveganjem lahko razmislijo o lokalnem zdravljenju ali destruktivnih metodah. Fotodinamična terapija dobro deluje pri površinskih in nodularnih BCC z nizkim tveganjem. Za lokalno napredovali ali metastatski BCC se priporočajo zaviralci Hedgehog (vismodegib or sonidegib) . Če pride do napredovanja bolezni ali intolerance na zaviralce Hedgehog, pride v poštev imunoterapija z anti-PD1 antibody (cemiplimab) . Radioterapija je dobra možnost za bolnike, ki ne morejo na operacijo, zlasti starejše bolnike. Če operacija ali radioterapija nista možna, pride v poštev elektrokemoterapija.
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.
Dejavniki tveganja vključujejo izpostavljenost ultravijolični svetlobi, radioterapijo, dolgotrajno izpostavljenost arzenu in slabo delovanje imunskega sistema (npr. presaditev organov). Še posebej škodljiva je izpostavljenost UV svetlobi v otroštvu.
Po diagnozi z biopsijo je zdravljenje običajno kirurško odstranitev. To je mogoče s preprosto ekscizijo, če je rak majhen; Če rak ni majhen, se na splošno priporoča Mohsova operacija.
Bazalnocelični karcinom predstavlja vsaj 32 % vseh rakov na svetu. Od kožnih rakov, razen melanoma, je približno 80 % bazalnoceličnega raka. V Združenih državah približno 35 % belih moških in 25 % belih žensk prizadene bazalnocelični karcinom na neki točki v življenju.
○ Diagnoza in zdravljenje
#Dermoscopy
#Skin biopsy
#Mohs surgery