Stulberg Daniel L, Crandell Blain, Fawcett Robert S
Rose Family Medicine Residency Program, University of Colorado at Denver, 80222, USA.
Am Fam Physician. 2004 Oct 15;70(8):1481-8.
Rates of squamous cell and basal cell carcinomas have been increasing, possibly as a result of increased exposure to ultraviolet radiation. Primary care physicians can expect to diagnose six to seven cases of basal cell carcinoma and one to two cases of squamous cell carcinoma each year. Basal cell carcinomas may be plaque-like or nodular with a waxy, translucent appearance, often with ulceration and telangiectasia. They rarely metastasize and are treated with excision, cryotherapy, electrodesiccation and cautery, imiquimod, 5-fluorouracil, or photodynamic therapy (the latter is not approved for this purpose by the U.S. Food and Drug Administration), although surgery results in the fewest recurrences. Actinic keratoses are scaly keratotic patches that often are more easily felt than seen. They are amenable to any of the destructive techniques described above, with the exception of photodynamic therapy. Squamous cell carcinomas arise from keratotic patches and become more nodular and erythematous with growth, sometimes including keratin plugs, horns, or ulceration. Because they may metastasize, they often are treated with excisional biopsy.
鳞状细胞癌和基底细胞癌的发病率一直在上升，这可能是由于紫外线辐射暴露增加所致。初级保健医生预计每年会诊断出6至7例基底细胞癌和1至2例鳞状细胞癌。基底细胞癌可能呈斑块状或结节状，外观蜡样、半透明，常伴有溃疡和毛细血管扩张。它们很少发生转移，治疗方法包括切除、冷冻疗法、电干燥法和烧灼法、咪喹莫特、5-氟尿嘧啶或光动力疗法（美国食品药品监督管理局未批准光动力疗法用于此目的），不过手术治疗后的复发率最低。光化性角化病是鳞屑性角化斑块，通常摸起来比看起来更明显。除光动力疗法外，它们适用于上述任何一种破坏性技术。鳞状细胞癌起源于角化斑块，随着生长会变得更加结节状和红斑样，有时还会出现角质栓、角或溃疡。由于它们可能会转移，所以通常采用切除活检进行治疗。
