Basal cell carcinoma - 基底細胞癌
影響老年人鼻子皮膚的潰瘍性病變通常被診斷為基底細胞癌 (Basal cell carcinoma)。鼻子是這類皮膚癌的常見發生部位。
基底細胞癌 (Basal cell carcinoma) 可能會出現不規則的邊界和潰瘍。
基底細胞癌 (Basal cell carcinoma) 可能會被誤認為疣。
relevance score : -100.0%
ReferencesBasal cell carcinoma (BCC) 是最常見的皮膚癌類型，主要原因是陽光曝曬。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、患者偏好及疾病程度，可選擇不同的治療方法。
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 是 50 歲以上、皮膚較白的成年人中最常見的皮膚癌類型。其發病率在全球持續上升，主要與日曬有關。某些遺傳因素會使年輕人更易罹患此癌。Basal cell carcinomas 的嚴重程度差異很大，從易於治療的淺表或結節性病變，到需要多學科醫療團隊討論的較廣泛病變。預後取決於腫瘤復發的可能性以及對鄰近組織的侵襲程度。手術是大多數病例的標準治療，可確保精確切除並降低復發風險。侵入性較低的治療方式亦能有效處理表淺病變。
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，建議採用顯微控製手術。低風險、表淺性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及低風險結節性基底細胞癌效果良好。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.
危險因子包括長期曝曬於紫外線、接受放射治療、長期接觸砷以及免疫功能不全（例如器官移植者）。兒童期的紫外線曝露尤為有害。
確診後通常以手術切除為主要治療方式。若腫瘤體積很小，可採用簡單切除；若腫瘤較大，則多建議進行莫氏手術。
基底細胞癌至少佔全球所有癌症的 32%。在除黑色素瘤以外的皮膚癌中，約 80% 為基底細胞癌。於美國，大約 35% 的白人男性與 25% 的白人女性在一生中的某個階段會受到基底細胞癌的影響。
○ 診斷與治療
#Dermoscopy
#Skin biopsy
#Mohs surgery