basal cell carcinoma (BCC)

基底细胞癌 ( BCC )
  • 文章类型: Journal Article
    瘢痕组织内出现的基底细胞癌(BCC)是一种罕见但具有临床意义的现象。这篇全面的综述旨在提供关于病因因素的知识现状的简明概述。发病机制,临床表现,和BCC的管理。本研究构成了与BCC相关的文献综述,特别强调在瘢痕组织内发展的BCC。它还提供了在BCG疫苗接种后疤痕中发展为BCC的患者的临床病例介绍,并回顾了现有文献中的类似发现。尽管一系列机制在损伤相关的BCC生长中起作用,主要机制仍然模棱两可,有待阐明。该审查还包括对BCC可用的各种治疗选择的详细描述,从手术干预到新的药物治疗。通过检查这些交叉点,审查旨在阐明潜在的机制,识别风险因素,并提出临床实践的注意事项。研究结果强调了对疤痕组织患者和最近接种疫苗的患者进行警惕的皮肤病学评估的重要性,旨在提高BCC的早期检测和优化管理策略。
    Basal cell carcinoma (BCC) arising within scar tissue is a rare but clinically significant phenomenon. This comprehensive review aims to provide a succinct overview of the current state of knowledge regarding the etiological factors, pathogenesis, clinical presentation, and management of BCC. This study constitutes a literature review pertaining to BCC, with a particular emphasis on BCC developing within scar tissue. It also provides a clinical case presentation of a patient who had developed BCC in a BCG post-vaccination scar and a review of analogous findings available in the existing literature. Despite the fact that an array of mechanisms play a role in injury-related BCC growth, the main mechanism remains ambiguous and yet to be elucidated. The review also includes a detailed description of the various therapeutic options available for BCC, ranging from surgical interventions to novel pharmacological treatments. By examining these intersections, the review seeks to elucidate the potential mechanisms, identify risk factors, and suggest considerations for clinical practice. The findings underscore the importance of vigilant dermatological assessment in patients with scar tissue and those recently vaccinated, aiming to improve early detection and optimize management strategies for BCC.
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  • 文章类型: Journal Article
    由于THz辐射对极性分子的敏感性高,因此可以有效地探测生物组织的水分含量。皮肤和基底细胞癌(BCC),两者都富含水,在太赫兹范围内进行了广泛的研究。通常,双德拜模型用于研究它们的介电常数。这项工作的重点是多极子Cole-Cole模型作为替代介电模型的可行性。要确定最佳拟合参数,我们使用了基于遗传算法的方法,解决一个最小二乘问题。与双德拜模型相比,对于二阶和三阶Cole-Cole模型,已测量到RMSE值的最大降低超过50%,最大相对百分比误差为2.8%。由于二阶和三阶Cole-Cole模型的误差相似,两极模型足以描述从0.2THz到2THz的两个组织的行为。
    THz radiationeffectively probes biological tissue water content due to its high sensibility to polar molecules. Skin and basal cell carcinoma (BCC), both rich in water, have been extensively studied in the THz range. Typically, the Double Debye model is used to study their dielectric permittivity. This work focuses on the viability of the multipole Cole-Cole model as an alternative dielectric model. To determine the best fit parameters, we used a genetic algorithm-based approach, solving a least squares problem. Compared with the Double Debye model, a maximum reduction of the RMSE value up to more than 50% and maximum relative percentage errors of 2.8% have been measured for both second and third order Cole-Cole models. Since the errors of the second and third order Cole-Cole models are similar, a two-poles model is enough to describe the behaviour both tissues from 0.2 THz to 2 THz.
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  • 文章类型: Journal Article
    背景关于印度患者的基底细胞癌(BCC)的数据很少。这项回顾性研究是为了探索流行病学,危险因素,临床和病理方面,以及北印度患者队列中BCC的长期治疗结果。方法收集2017年1月1日至2022年12月31日在皮肤科门诊登记的确诊为BCC的患者资料。结果83例患者中,56.6%为女性,中位年龄为62岁(6-85岁)。大多数患者(81.9%)有单个BCC病变,导致总共126个评估病变。BCC出现时的中位大小为1.90cm,结节性BCC是最常见的组织病理学亚型(39.7%)。在82.5%的患者中观察到头颈部受累,与马拉尔地区,鼻子,轨道周围区域是最常见的受影响的部位。在45.2%的病例中,色素沉着在临床上很明显。手术切除是主要的治疗方式(71.1%的患者)。中位随访时间为40个月(6~57个月)。5例患者复发,与接受药物或破坏性治疗的患者(43.6±3.482个月)相比,手术治疗组(55.58±0.98个月)的无病生存期更长(p=0.003)。结论这项基于医院的研究数据表明,北印度BCC患者对女性有轻微的偏爱,大多数病例发生在他们生命的第七个十年。这种情况通常发生在暴露于阳光的区域,如黄斑区域和鼻子,色素病变的比例很高。手术切除后复发罕见,总体治疗结果良好.
    Background There is scant data on basal cell carcinoma (BCC) in Indian patients. This retrospective study was conducted to explore epidemiology, risk factors, clinical and pathological aspects, and long-term treatment outcomes of BCC in a cohort of North Indian patients. Methods Data about patients registered in the dermatosurgery clinic between 01 January 2017 and 31 December 2022 with a confirmed diagnosis of BCC was collected. Results Among the 83 patients, 56.6% were females, and the median age was 62 years (6-85 years). Most patients (81.9%) had a single BCC lesion, resulting in a total of 126 assessed lesions. The median size of BCC at presentation was 1.90 cm, with nodular BCC being the most common histopathological subtype (39.7%). Head and neck region involvement was observed in 82.5% of patients, with the malar region, nose, and periorbital region being the most commonly affected sites. Pigmentation was clinically evident in 45.2% of cases. Surgical excision was the primary treatment modality (71.1% of patients). The median follow-up duration was 40 months (6-57 months). Recurrence occurred in five patients, with a longer disease-free survival period observed in the surgically treated group (55.58 ± 0.98 months) compared to patients treated with medical or destructive therapies (43.6 ± 3.482 months) (p = 0.003). Conclusion The data from this hospital-based study indicated a slight predilection for females among North Indian patients with BCC, with most cases occurring during their seventh decade of life. The condition commonly occurred on sun-exposed areas such as the malar region and nose, with a high percentage of pigmented lesions. Recurrence following surgical excision was rare, and overall treatment outcomes were favourable.
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  • 文章类型: Case Reports
    由于肿瘤的侵袭性和广泛转移的潜力,在Gorlin-Goltz综合征患者中管理晚期基底细胞癌(BCC)提出了独特的临床挑战。本案例研究详细介绍了一名68岁女性患者的序贯治疗方案,不可操作的BCC。采用整合放射治疗的多模式方法,Hedgehog通路抑制剂vismodegib,和高强度聚焦超声(HIFU),我们证明了晚期BCC患者几乎完全缓解的可能性.放疗和vismodegib的初始治疗显着减小了肿瘤大小,但是随着时间的推移,最大的质量显示出阻力,这表明需要创新疗法。随后的HIFU治疗针对个别病变,展示了一种非侵入性的方法,提供精确的治疗,同时减轻全身副作用。该案例强调了在治疗计划中持续适应以解决耐药性发展的必要性,并强调了为复杂的BCC病例纳入新技术和靶向治疗的重要性。这一综合战略的成功结果为未来的研究提出了一个有希望的方向,并强调了多学科方法的重要性,这些方法可以根据个人患者的需求进行治疗。肿瘤特征,和不断发展的治疗景观。
    Managing advanced basal cell carcinoma (BCC) in patients with Gorlin-Goltz syndrome presents unique clinical challenges due to the tumor\'s aggressive nature and potential for widespread metastasis. This case study details a sequential treatment regimen for a 68-year-old female patient with an extensive, inoperable BCC. Employing a multimodal approach that integrates radiotherapy, the Hedgehog pathway inhibitor vismodegib, and High-Intensity Focused Ultrasound (HIFU), we demonstrate the potential for nearly complete remission in a patient with advanced BCC. Initial treatment with radiotherapy and vismodegib reduced tumor size significantly, but the largest mass displayed resistance over time, signifying the need for innovative therapies. Subsequent HIFU treatment targeted individual lesions, showcasing a non-invasive method that provided precise treatment while mitigating systemic side effects. The case emphasizes the necessity of continual adaptation in treatment plans to address the development of resistance and underscores the importance of incorporating new technologies and targeted therapies for complex BCC cases. The successful outcome of this integrated strategy suggests a promising direction for future research and highlights the importance of multidisciplinary approaches that tailor treatment to individual patient needs, tumor characteristics, and evolving therapeutic landscapes.
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  • 文章类型: Journal Article
    背景:基底细胞癌(BCC)是最常见的皮肤恶性肿瘤,其高发病率和相关费用逐年上升。BCC的起源与环境有关,遗传,和表型因素。其中,最重要的危险因素是暴露于紫外线引发角质形成细胞癌变,造成累积细胞损伤,导致BCC发展。个人的教育背景和对皮肤癌危险因素的认识可能会影响BCC的发展。缺乏关于风险因素的知识(如慢性紫外线暴露,晒伤,人造太阳能床,和白皙的肤色),预防方法,涉及户外活动的工作可能与BCC形成有关。
    目的:本研究的目的是分析与BCC相关的近期趋势和危险因素,同时也揭示了BCC与患者的教育水平和对皮肤癌危险因素的认识之间的任何潜在联系。
    方法:进行了以医院为基础的病例对照研究,共涉及141人。其中,47例经临床和组织学证实的BCC患者,而其余参与者作为对照。对照组包括94名年龄和性别匹配的个体。包括性别在内的各种因素的数据,年龄,residence,教育水平,Fitzpatrick皮肤类型,户外活动,使用日光浴室,和紫外线疗法,以及对潜在BCC触发因素的认识,使用调整后的问卷收集并进行分析。收集的数据进行统计评估。
    结果:大多数BCC(n=52;71.2%)位于阳光照射区域(p<0.001),女性/男性比例为1.35比1。结节型BCC是最常见的形式(n=49;67.2%)。研究组中具有Fitzpatrick光型I和II的患者百分比(n=38;80.9%)显着高于对照组(n=50;53.2%,p=0.002)。受过高等教育的人的百分比(学士学位,硕士学位,和文凭后)在病例中的患病率明显低于对照组(n=20(42.6%)vs.n=58(61.7%),分别(p=0.033))。值得注意的是,教育水平低的BCC患者对遗传因素和慢性太阳辐射的认识明显减弱。结论:因素共存,比如皮肤癌的病史,有FitzpatrickI型和II型皮肤,从事暴露在阳光下的户外工作,遗传因素是皮肤癌的危险因素,知道压力是皮肤癌的危险因素,是疾病的重要预测因子。较低的教育水平和对风险因素的认识有限也可能是BCC的风险因素。必须提高人们对潜在诱因和预防措施的认识,以减少疾病的发病率。
    BACKGROUND: Basal cell carcinoma (BCC) stands as the most common skin malignancy, with its high incidence rate and associated costs rising annually. The origin of BCC is related to environmental, genetic, and phenotypic factors. Among these, the most important risk factor is exposure to UV light triggering keratinocyte carcinogenesis, causing cumulative cellular damage that leads to BCC development. Individuals\' educational background and awareness of skin cancer risk factors may influence the development of BCC. Lack of knowledge about risk factors (like chronic UV exposure, sunburn, artificial solar beds, and fair skin color), prevention methods, and jobs involving outdoor activities may be associated with BCC formation.
    OBJECTIVE: The aim of the study was to analyze recent trends and the risk factors associated with BCC, while also revealing any potential link between BCC and the patient\'s education level and awareness of skin cancer risk factors.
    METHODS: A hospital-based case-control study was conducted, involving a total of 141 individuals. Among them, 47 were clinically and histologically confirmed BCC patients, while the remaining participants served as controls. The control group comprised 94 individuals matched for age and gender. Data on various factors including gender, age, residency, education level, Fitzpatrick skin type, outdoor activities, use of solariums, and UV therapy, as well as awareness of potential BCC triggers, were collected using an adapted questionnaire and subjected to analysis. The collected data underwent statistical evaluation.
    RESULTS: Most of the BCCs (n = 52; 71.2%) were located in sun-exposed areas (p < 0.001), with a female/male ratio of 1.35 to 1. The nodular type of BCC was the most common form (n = 49; 67.2%). The percentage of patients in the study group with Fitzpatrick phototypes I and II (n = 38; 80.9%) was significantly higher than in controls (n = 50; 53.2%, p = 0.002). The percentage of persons with higher education levels (bachelor\'s degree, master\'s degree, and post-diploma) was significantly less prevalent among cases compared to controls (n = 20 (42.6%) vs. n = 58 (61.7%), respectively (p = 0.033)). Notably, BCC patients with low education levels exhibited significantly lesser awareness concerning genetic factors and chronic solar radiation.  Conclusions: Coexistence of factors, such as a medical history of skin cancer, having Fitzpatrick skin types I and II, engaging in outdoor work exposed to the sun, knowledge that genetic factors are risk factors of skin cancer, and knowledge that stress is a risk factor of skin cancer, are significant predictors of the disease. A lower level of education and limited awareness about risk factors can also be a risk factor for BCC. It is essential to raise awareness about potential triggers and preventive measures within the population to reduce the incidence of the disease.
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  • 文章类型: Case Reports
    基底细胞癌(BCC)是全球最常见的癌症类型。虽然BCC的治疗有几种治疗选择,选择眶周BCC的最佳治疗方案具有挑战性,并且因病例而异。超过一半的眼周BCC病例最初发生在内角和下眼睑。BCC的治疗选择包括使用Mohs显微成像技术进行根治性手术切除,放射治疗,新辅助药物vismodegib,咪喹莫特,和联合治疗,然后重建功能和美学结果。每种治疗的选择根据BCC的严重程度和扩展而变化。
    我们报告了一名50岁的高加索男性的眶周BCC侵入左下眼睑的病例,该病例最初是几年前切除的,and,复发后,患者接受了Mohs显微手术.由于Mohs显微手术后复发,开始口服vismodegib治疗,导致肿瘤几乎完全缩小。为了确定使用vismodegib治疗的眶周BCC的结果,我们回顾了用vismodegib治疗眶周BCC的文献,他们的随访期,结果,以及它们是否转移或复发。
    新佐剂vismodegib,然后是手术切除,比如Mohs显微外科手术,在眶周BCC的治疗中显示出有希望的临床和美学结果。
    UNASSIGNED: Basal cell carcinoma (BCC) is the most common cancer type worldwide. Although there are several treatment options for the treatment of BCC, selecting the best treatment option for periorbital BCC is challenging and it varies case by case. More than half of periocular BCC cases initially occur on the inner angle and lower lid. The treatment options for BCC include radical surgical excision using Mohs micrographic technique, radiotherapy, neoadjuvant vismodegib, imiquimod, and combination therapy followed by reconstruction for functionality and aesthetic outcome. Selection of each treatment varies based on the severity and extension of BCC.
    UNASSIGNED: We report a case of periorbital BCC invading the left lower eyelid in a 50-year-old Caucasian male which was initially excised a few years ago, and, following recurrence, the patient underwent Mohs micrographic surgery. Due to a recurrence after Mohs micrographic surgery, treatment with oral vismodegib was started, which led to near-total tumor shrinkage. To determine the outcome of periorbital BCC treated with vismodegib, we reviewed the literature on the periorbital BCC treated with vismodegib, their follow-up period, outcome, and whether they were metastatic or had recurrence.
    UNASSIGNED: Neoadjuvant vismodegib, followed by surgery excision, such as Mohs micrographic surgery, has shown a promising clinical and aesthetic outcome in the treatment of periorbital BCC.
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  • 文章类型: Journal Article
    背景:基底细胞癌(BCC)的发病率上升,尤其是在有大量阳光照射的个体中,强调了对有效和微创治疗替代方案的需求。传统的手术方法,虽然有效,通常会导致明显的化妆品和功能限制,特别是位于面部的病变。这项研究探讨了高强度聚焦超声(HIFU)作为一种有前途的,旨在克服这些挑战的非侵入性治疗选择,通过在疗效和美容结果之间提供平衡,可能彻底改变BCC治疗。方法:我们的调查纳入了8例患者,总共有15个BCC病变,用20MHzHIFU装置处理。治疗参数的选择是精确的,利用0.8mm至2.3mm的探头深度和每个脉冲0.7至1.3焦耳(J)的能量设置,根据术前超声评估的病变浸润深度确定。我们方法的一个关键组成部分包括皮肤镜监测,这允许随着时间的推移详细观察病变对治疗的反应。系统记录患者报告的结果和满意度水平,提供对HIFU比较优势的见解。结果:HIFU治疗后的初始反应包括美白和水肿,指示成功的病灶消融。治疗后的早期观察显示,不适程度最小,恢复迅速,对于大多数病变,地壳形成在两周内解决。在三到六个月的时间里,患者报告显着改善,病变变得更轻,并混入周围的皮肤,展示有效和美观的结果。治疗后六个月进行的患者满意度调查显示满意度很高,75%的参与者报告非常高的满意度,由于最小的疤痕和程序的非侵入性。未发现BCC复发,证明HIFU作为治疗选择的有效性。结论:这项研究的结果证实,基于皮肤镜分析,HIFU是基底细胞癌的一种非常有效且患者首选的非侵入性治疗方式。HIFU为传统手术和非手术治疗提供了一个有希望的替代方案,减少与BCC管理相关的化妆品和功能影响。鉴于其功效,安全,和良好的患者满意度评分,HIFU值得进一步研究和考虑在BCC治疗中更广泛的临床应用,可能在皮肤科肿瘤护理中树立新标准。这项工作代表了一项初步研究,该研究首次描述了HIFU在BCC治疗中的用途。
    Background: The rising incidence of Basal Cell Carcinoma (BCC), especially among individuals with significant sun exposure, underscores the need for effective and minimally invasive treatment alternatives. Traditional surgical approaches, while effective, often result in notable cosmetic and functional limitations, particularly for lesions located on the face. This study explores High-Intensity Focused Ultrasound (HIFU) as a promising, non-invasive treatment option that aims to overcome these challenges, potentially revolutionizing BCC treatment by offering a balance between efficacy and cosmetic outcomes. Methods: Our investigation enrolled 8 patients, presenting a total of 15 BCC lesions, treated with a 20 MHz HIFU device. The selection of treatment parameters was precise, utilizing probe depths from 0.8 mm to 2.3 mm and energy settings ranging from 0.7 to 1.3 Joules (J) per pulse, determined by the lesion\'s infiltration depth as assessed via pre-procedure ultrasonography. A key component of our methodology included dermatoscopic monitoring, which allowed for detailed observation of the lesions\' response to treatment over time. Patient-reported outcomes and satisfaction levels were systematically recorded, providing insights into the comparative advantages of HIFU. Results: Initial responses after HIFU treatment included whitening and edema, indicative of successful lesion ablation. Early post-treatment observations revealed minimal discomfort and quick recovery, with crust formation resolving within two weeks for most lesions. Over a period of three to six months, patients reported significant improvement, with lesions becoming lighter and blending into the surrounding skin, demonstrating effective and aesthetically pleasing outcomes. Patient satisfaction surveys conducted six months post-treatment revealed high levels of satisfaction, with 75% of participants reporting very high satisfaction due to minimal scarring and the non-invasive nature of the procedure. No recurrences of BCC were noted, attesting to the efficacy of HIFU as a treatment option. Conclusions: The findings from this study confirm that based on dermoscopy analysis, HIFU is a highly effective and patient-preferred non-invasive treatment modality for Basal Cell Carcinoma. HIFU offers a promising alternative to traditional surgical and non-surgical treatments, reducing the cosmetic and functional repercussions associated with BCC management. Given its efficacy, safety, and favorable patient satisfaction scores, HIFU warrants further investigation and consideration for broader clinical application in the treatment of BCC, potentially setting a new standard in dermatologic oncology care. This work represents a pilot study that is the first to describe the use of HIFU in the treatment of BCC.
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  • 文章类型: Journal Article
    皮肤癌是全球最常见的癌症之一,它可以影响所有年龄段的人,种族,和性别。Mohs显微外科手术(MMS),一种特殊类型的皮肤癌手术,拥有各种皮肤恶性肿瘤的最高治愈率。慢速Mohs手术(SMS)是MMS的一种有条理和细致的方法,涉及对组织样本进行仔细和仔细的检查,以确保完全切除皮肤癌,同时保留尽可能多的健康组织。SMS和MMS都被证明是皮肤癌的有效治疗选择,取决于癌症的类型和阶段。本病例对照研究分析比较了SMS对黑色素瘤的疗效与MMS对鳞状细胞癌(SCC)和基底细胞癌(BCC)的疗效。我们分析了过去二十年的数据,以评估复发率和治疗相关并发症。我们的发现表明,在SCC和BCC中,黑色素瘤的SMS与MMS的结果相当。两种方法都显示出相似的治愈率和并发症情况。然而,需要进一步的前瞻性研究来巩固这些发现,并完善SMS在黑色素瘤治疗中的具体作用.
    Skin cancer is one of the most common types of cancer worldwide, and it can affect people of all ages, races, and genders. Mohs micrographic surgery (MMS), a specialized type of skin cancer surgery, boasts the highest cure rates for various types of skin malignancies. Slow Mohs surgery (SMS) is a methodical and meticulous approach to MMS that involves careful and deliberate examination of tissue samples to ensure the complete removal of skin cancer while preserving as much healthy tissue as possible. Both SMS and MMS have been indicated to be effective treatment options for skin cancer, depending on the type and stage of cancer. This case-control study analysis compares the efficacy of SMS for melanoma with that of MMS for squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). We analyzed data from the past two decades to assess recurrence rates and treatment-related complications. Our findings suggest that SMS for melanoma achieves comparable outcomes to MMS in SCC and BCC. Both approaches demonstrated similar cure rates and complication profiles. However, further prospective studies are necessary to solidify these findings and refine the specific role of SMS in melanoma therapy.
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  • 文章类型: Journal Article
    基底细胞癌是世界上最常见的癌症。大多数基底细胞癌可以在早期阶段检测到,并且通常通过局部切除得到很好的控制。尽管BCC的发病率很高,粘膜内BCC是一种非常罕见的临床实体。我们在此介绍一例罕见的软腭色素性BCC病例报告,并回顾该实体的文献。
    Basal cell carcinoma is the most common cancer worldwide. Most of basal cell carcinoma can be detected in the early stages and are generally well controlled with local resection. Despite the high incidence of BCC, intramucosal BCC is a very rare clinical entity. We hereby present a rare case report of pigmented BCC on soft palate and review the literature of this entity.
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  • 文章类型: Journal Article
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