Fontaine J, Mielczarek S, Meaume S, Senet P
Université Pierre-et-Marie-Curie-Paris-VI, Paris, France.
Ann Dermatol Venereol. 2008 Oct;135(10):651-5. doi: 10.1016/j.annder.2008.06.005. Epub 2008 Sep 14.
The incidence of non melanoma skin cancers is closely correlated with age. The aim of this prospective study was to evaluate the prevalence of undiagnosed skin cancers among patients hospitalized in rehabilitation and long-term care units in a geriatric hospital.
All the patients, resident in four rehabilitation and long-term care units and for whom no dermatological advice had been given, were systematically examined by a dermatologist. Clinical data included patient age at the time of the study, gender, relevant historical information, skin phototype and description of the cutaneous lesions. Biopsies were performed for all lesions of suspicious appearance.
Three hundred and six patients (79.4% women and 20.6% men aged from 55 to 103 years) were included in the study. Among all the patients, 69.3% were hospitalized for more than one year. Skin phototype was clear for 93.5% of the patients. Thirty-two out of 306 patients (10.5%) presented 42 suspicious lesions and these were diagnosed by histological examination as 16 basal-cell carcinomas, seven squamous cell-carcinomas and two in situ melanomas. Skin cancers were localised on the head and neck in 80% of cases. The prevalence of patients with skin cancers was 5.6% in this population.
The prevalence of skin cancers among patients hospitalized in geriatric hospitals justifies improved training of geriatricians regarding early recognition and dermatological assessment of cutaneous tumours.
非黑色素瘤皮肤癌的发病率与年龄密切相关。这项前瞻性研究的目的是评估一家老年医院康复和长期护理病房住院患者中未被诊断出的皮肤癌患病率。
对居住在四个康复和长期护理病房且未接受皮肤科建议的所有患者,由皮肤科医生进行系统检查。临床数据包括研究时患者的年龄、性别、相关病史、皮肤光类型以及皮肤病变描述。对所有外观可疑的病变进行活检。
306名患者(79.4%为女性,20.6%为男性,年龄在55至103岁之间)纳入研究。所有患者中,69.3%住院时间超过一年。93.5%的患者皮肤光类型明确。306名患者中有32名(10.5%)出现42个可疑病变,经组织学检查诊断为16例基底细胞癌、7例鳞状细胞癌和2例原位黑色素瘤。80%的皮肤癌病例位于头颈部。该人群中皮肤癌患者的患病率为5.6%。
老年医院住院患者中皮肤癌的患病率表明,有必要加强老年病医生在皮肤肿瘤早期识别和皮肤科评估方面的培训。