Cheilitis

唇炎
  • 文章类型: Journal Article
    光化性角化病(AK)是浅色皮肤个体的常见病变,可能会发展为皮肤鳞状细胞癌(cSCC)。这两种情况都可能与显著的发病率相关,并构成主要的疾病负担。尤其是老年人。建立基于证据的临床决策框架,指南"光化性角化病和皮肤鳞状细胞癌"在主题皮肤鳞状细胞原位癌(Bowen病)和光化性唇炎中得到了更新和扩展.该指南针对皮肤科医生,全科医生,耳鼻喉专家,外科医生,肿瘤学家,医院和办公室环境中的放射科医生和放射肿瘤学家,以及其他医学专业,参与AK和cSCC患者诊断和治疗的政策制定者和保险基金。对于患者及其亲属存在单独的指南。在这一部分,我们将讨论与AK有关的方面,光化性唇炎,Bowen病,职业病和护理结构。
    Actinic keratosis (AK) are common lesions in light-skinned individuals that can potentially progress to cutaneous squamous cell carcinoma (cSCC). Both conditions may be associated with significant morbidity and constitute a major disease burden, especially among the elderly. To establish an evidence-based framework for clinical decision making, the guideline “actinic keratosis and cutaneous squamous cell carcinoma” was updated and expanded by the topics cutaneous squamous cell carcinoma in situ (Bowen\'s disease) and actinic cheilitis. The guideline is aimed at dermatologists, general practitioners, ear nose and throat specialists, surgeons, oncologists, radiologists and radiation oncologists in hospitals and office-based settings, as well as other medical specialties, policy makers and insurance funds involved in the diagnosis and treatment of patients with AK and cSCC. A separate guideline exists for patients and their relatives. In this part, we will address aspects relating to AK, actinic cheilitis, Bowen\'s disease, occupational disease and care structures.
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  • 文章类型: Journal Article
    OBJECTIVE: To discuss the terminology to define and classify actinic cheilitis (AC) and to build a consensus on the diagnostic and therapeutic approaches to AC.
    METHODS: Two-round Delphi study using a questionnaire including 34 closed sentences (9 on terminology and taxonomy, 5 on potential for malignant transformation, 12 on diagnostic aspects, 8 on treatment) and 8 open questions. Experts\' agreement was rated using a Likert scale (1-7).
    RESULTS: A consensus was reached on 24 out 34 statements (73.5%) and on 5 out of 8 (62.5%) close-ended questions. The response rate was identical in both rounds (attrition of 0%). AC is the term with the highest agreement (median of 7 (strongly agree; IQR: 6-7)) and the lowest dispersion (VC = 21.33). \'Potentially malignant disorder\' was the preferred classification group for AC (median of 7) and 85.6% of participants showing some level of agreement (CV < 50). Experts (66.75%) consider AC a clinical term (median: 7; IQR: 4-7) and believe definitive diagnosis can be made clinically (median: 6; IQR: 5-7), particularly by inspection and palpation (median: 5; IQR: 4-6). Histopathological confirmation is mandatory for the management of AC (median: 5; IQR: 2.5-7), even for homogeneous lesions (median: 5; IQR: 3.5-6). Consensus was reached on all treatment statements (VC < 50).
    CONCLUSIONS: AC is a potentially malignant disorder with a significant lack of agreement on diagnostic criteria, procedures, biopsy indications and the importance of techniques to assist in biopsy. A consensus was reached on nomenclature and management of this disorder.
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  • 文章类型: Journal Article
    背景:美国皮肤外科学会(ASDS)定期为其成员制定有关皮肤外科各个方面的共识文件。光动力疗法(PDT)的进展已经很多,并且已经在各种皮肤状况中建立了PDT使用。
    目的:ASDS董事会提议成立该领域的专家委员会,以就不同的治疗方法制定共识文件。专家小组回顾了有关PDT的文献并讨论了研究结果。关于PDT的不同临床应用的循证建议达成了共识。
    方法:本共识文件包括有关PDT的讨论,包括不同的光敏剂和各种光源活化剂,历史视角,作用机制,各种治疗适应症和预期结果,护理前和护理后,以及不良后果的管理。
    结果:光动力疗法对癌前病变非常有效,浅表性非黑色素瘤皮肤癌,炎性寻常痤疮和其他疾病。包括激光介导的PDT在内的新方案显着改善了几种适应症的结果。
    结论:关于PDT的ASDS共识文件将有助于对成员进行安全有效的PDT治疗各种适应症的教育。
    BACKGROUND: The American Society of Dermatologic Surgery (ASDS) periodically develops consensus documents for its members concerning various aspects of dermatologic surgery. Advances in photodynamic therapy (PDT) have been many and PDT use has been established in a variety of skin conditions.
    OBJECTIVE: The ASDS board of directors proposed a committee of experts in the field to develop consensus documents on different treatments. An expert panel reviewed the literature on PDT and discussed the findings. The consensus was reached with evidence-based recommendations on different clinical applications for PDT.
    METHODS: This consensus document includes discussions regarding PDT, including different photosensitizers and various light source activators, historical perspective, mechanism of action, various therapeutic indications and expected outcomes, pre- and post-care, and management of adverse outcomes.
    RESULTS: Photodynamic therapy is highly effective for pre-cancerous lesions, superficial nonmelanoma skin cancers, inflammatory acne vulgaris and other conditions. New protocols including laser mediated PDT significantly improve results for several indications.
    CONCLUSIONS: The ASDS consensus document on PDT will be helpful for educating members on safe and effective PDT for a variety of indications.
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