Basal cell carcinoma - 基底細胞癌
影響老年人鼻部皮膚的潰瘍性病變，通常被診斷為基底細胞癌 (Basal cell carcinoma)。鼻子是此類皮膚癌的常見發生部位。
基底細胞癌 (Basal cell carcinoma) 可能出現不規則的邊緣與潰瘍。
基底細胞癌 (Basal cell carcinoma) 可能會被誤認為是疣。
relevance score : -100.0%
ReferencesBasal cell carcinoma (BCC) 是最常見的皮膚癌類型，主要原因是陽光照射。幾乎所有 BCC 病例在分子分析中皆顯示 Hedgehog 訊號傳導過度活躍。根據復發風險、組織保存的重要性、患者偏好以及疾病嚴重程度，可選擇不同的治療方式。
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 carcinoma（基底細胞癌）是 50 歲及以上皮膚白皙的成年人中最常見的皮膚癌類型。其發生率在全球持續上升，主要與陽光曝露有關。某些遺傳條件會使人們在年輕時容易罹患此類癌症。Basal cell carcinoma 的嚴重程度各不相同，從易於治療的淺表或結節性病變，到需由專業醫療團隊討論的較廣泛病變。預後取決於癌症復發的可能性以及其侵襲鄰近組織的能力。手術是大多數病例的標準治療方法，可確保精確切除並降低復發機會。侵入性較低的治療方法可有效治療表淺病變。
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.
BCC 的主要治療方法是手術。對於高風險或復發性基底細胞癌，特別是在關鍵部位，建議採用顯微控制手術。低風險、表淺的基底細胞癌患者可考慮局部治療或破壞性方法。光動力療法對於淺層和低風險結節性基底細胞癌的療效良好。對於局部晚期或轉移性 BCC，建議使用 Hedgehog 抑制劑 (vismodegib or sonidegib)。若疾病進展或對 Hedgehog 抑制劑不耐受，可考慮使用 anti‑PD1 antibody (cemiplimab) 進行免疫治療。對於無法手術的患者，尤其是老年人，放射治療是一個不錯的選擇。若手術與放射治療皆不可行，亦可考慮電化學療法。
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.
危險因子包括紫外線曝露、放射治療、長期砷曝露以及免疫功能不全（例如器官移植）。兒童期的紫外線曝露尤為有害。
確診後，通常以手術切除治療。若腫瘤體積較小，可採取簡單切除；若腫瘤較大，則建議採用莫氏手術（Mohs surgery）。
基底細胞癌至少佔全球癌症總數的 32%。在除黑色素瘤外的皮膚癌中，約佔 80%。在美國，大約 35% 的白人男性與 25% 的白人女性在一生中曾罹患基底細胞癌。
○ 診斷與治療
#Dermoscopy
#Skin biopsy
#Mohs surgery