对前瞻性收集的老年男性人群中经活检证实的黑色素瘤、基底细胞癌、鳞状细胞癌和脂溢性角化病的体征/症状进行评估。

Evaluation of prospectively collected presenting signs/symptoms of biopsy-proven melanoma, basal cell carcinoma, squamous cell carcinoma, and seborrheic keratosis in an elderly male population.

作者信息

Askari Sharone K, Schram Sarah E, Wenner Rachel A, Bowers Sacharitha, Liu An, Bangerter Ann K, Warshaw Erin M

机构信息

Department of Dermatology at Minneapolis Veterans Affairs Medical Center, MN 55417, USA.

出版信息

J Am Acad Dermatol. 2007 May;56(5):739-47. doi: 10.1016/j.jaad.2006.11.032. Epub 2007 Jan 26.

DOI:10.1016/j.jaad.2006.11.032

PMID:17258839

Abstract

BACKGROUND

Presenting signs/symptoms of skin cancer may aid in earlier detection and diagnosis.

OBJECTIVE

We sought to compare prospectively collected, presenting signs/symptoms of malignant melanoma (MM), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and seborrheic keratosis (SK).

METHODS

This analysis was part of a larger study on teledermatology involving 3039 skin neoplasms in 2152 patients at a Department of Veterans Affairs medical center. At presentation, participants were asked about signs/symptoms of specific skin lesions. In all, 912 biopsy-proven MM (39), BCC (411), SCC (238), and SK (224) were included in this analysis. Pearson chi(2) analyses were used to test associations of lesion type and specific signs/symptoms in pairwise comparisons.

RESULTS

"No symptoms" was reported more often with MM (82%) as compared with BCC (relative risk [RR] 2.26, confidence interval [CI] 1.86, 2.75), SCC (RR 3.31, CI 2.54, 4.32), or SK (RR 2.0, CI 1.61, 2.48; all P < .0001). Tenderness was more commonly reported with SCC (40%) as compared with MM (RR 15.9, CI 2.28, 110.69), SK (RR 3.0, CI 2.11, 4.39), or BCC (RR 2.6, CI 1.97, 3.38; all P < .0001). Bleeding was more commonly reported with BCC (37%) as compared with SK (RR 2.3, CI 1.67, 3.20), SCC (RR 1.6, CI 1.22, 2.05), or MM (RR 29.8, CI 1.89, 469.65; all P <or= .007).

LIMITATIONS

The small number of MM and study population characteristics (elderly, Caucasian, male) limit generalizability.

CONCLUSION

This study describes common signs/symptoms of BCC, SCC, and SK. Our findings suggest that MM may be asymptomatic more often than previously recognized.

摘要

背景

皮肤癌的现有体征/症状可能有助于早期检测和诊断。

目的

我们试图前瞻性地比较收集到的恶性黑色素瘤（MM）、基底细胞癌（BCC）、鳞状细胞癌（SCC）和脂溢性角化病（SK）的体征/症状。

方法

该分析是一项关于远程皮肤病学的大型研究的一部分，涉及一家退伍军人事务医疗中心的2152名患者的3039例皮肤肿瘤。就诊时，询问参与者特定皮肤病变的体征/症状。本分析共纳入912例经活检证实的MM（39例）、BCC（411例）、SCC（238例）和SK（224例）。采用Pearson卡方分析在两两比较中检验病变类型与特定体征/症状的相关性。

结果

与BCC（相对风险[RR]2.26，置信区间[CI]1.86，2.75）、SCC（RR 3.31，CI 2.54，4.32）或SK（RR 2.0，CI 1.61，2.48；所有P <.0001）相比，MM患者报告“无症状”的情况更多见。与MM（RR 15.9，CI 2.28，110.69）、SK（RR 3.0，CI 2.11，4.39）或BCC（RR 2.6，CI 1.97，3.38；所有P <.0001）相比，SCC患者更常报告压痛（40%）。与SK（RR 2.3，CI 1.67，3.20）、SCC（RR 1.6，CI 1.22，2.05）或MM（RR 29.8，CI 1.89，469.65；所有P≤.007）相比，BCC患者更常报告出血（37%）。