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距癌症仅15英寸:牙医对面部病变的早期识别

Fifteen inches from cancer: early recognition of facial lesions by the dentist.

作者信息

Kutcher Mark J, Rubenstein David

机构信息

School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

出版信息

Compend Contin Educ Dent. 2004 Dec;25(12):939-42, 946, 948 passim; quiz 959, 973.

Abstract

Skin cancer is an increasing malignancy worldwide, and dentists are in a good position to observe their patients' faces for worrisome lesions. Most skin cancers are caused by actinic damage. The dentist must appreciate the characteristics of sun damage and be familiar with the clinical signs and symptoms of the more common premalignant and malignant facial lesions to appropriately evaluate the face. We review the features of freckles and moles, as well as those of seborrheic keratosis. Sun damage is discussed to aid in understanding the etiological role of ultraviolet exposure in the development of actinic keratosis and cheilitis, basal cell carcinoma, squamous cell carcinoma, and melanoma. The signs and symptoms of each condition are discussed, paying particular attention to their diagnostic features, as well as the clinical hallmarks that enable the practitioner to differentiate among the various lesions. In addition, considerations in referring a patient with a worrisome lesion to the appropriate health care practitioner are provided.

摘要

皮肤癌在全球范围内是一种日益常见的恶性肿瘤,而牙医很适合观察患者面部是否有令人担忧的病变。大多数皮肤癌是由光化性损伤引起的。牙医必须了解阳光损伤的特征,熟悉较常见的癌前和恶性面部病变的临床体征和症状,以便对面部进行适当评估。我们将回顾雀斑、痣以及脂溢性角化病的特征。讨论阳光损伤有助于理解紫外线暴露在光化性角化病和唇炎、基底细胞癌、鳞状细胞癌及黑色素瘤发生过程中的病因学作用。将讨论每种病症的体征和症状,特别关注其诊断特征以及使从业者能够区分各种病变的临床特征。此外,还提供了将有令人担忧病变的患者转诊给合适医疗从业者时的注意事项。

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