Roenigk R K, Roenigk H H
Department of Dermatology, Mayo Clinic, Rochester, MN 55905.
J Dermatol Surg Oncol. 1990 Feb;16(2):136-51. doi: 10.1111/j.1524-4725.1990.tb00034.x.
Skin cancer has become a major public health problem in the United States and worldwide. Epidemiologic studies confirm a continued increase in the number of basal cell carcinomas, squamous cell carcinomas, and malignant melanomas. Dermatologists, the primary caretakers of the skin, manage skin cancer with various modalities that have been time tested and found reliable, including excision, electrosurgery, cryosurgery, and Mohs micrographic surgery. Extirpative procedures for basal cell carcinoma and squamous cell carcinoma are considered with attention to cure, restoration of function, and cosmesis--in that order. The dermatologic management of melanoma is critical because early diagnosis and treatment of thin lesions has been the only effective improvement in melanoma management in the last several decades. Wide excision, with a 1-3-cm margin, of thin stage I melanoma has moved surgical management from the operating room to the outpatient surgical setting. Management of these increasingly common problems, as reviewed here, is principally responsible for the growth of surgical practice as a subspecialty of dermatology.
皮肤癌已成为美国乃至全球的一个主要公共卫生问题。流行病学研究证实，基底细胞癌、鳞状细胞癌和恶性黑色素瘤的数量持续增加。皮肤科医生作为皮肤的主要护理人员，采用各种经过时间检验且可靠的方式来治疗皮肤癌，包括切除、电外科手术、冷冻手术和莫氏显微外科手术。对于基底细胞癌和鳞状细胞癌的切除手术，会依次考虑治愈、功能恢复和美容效果。黑色素瘤的皮肤科管理至关重要，因为在过去几十年里，早期诊断和治疗薄型病变是黑色素瘤管理中唯一有效的改进措施。对薄型一期黑色素瘤进行1至3厘米切缘的广泛切除，已将手术管理从手术室转移到了门诊手术环境。正如本文所综述的，对这些日益常见问题的管理，主要推动了作为皮肤科亚专业的外科实践的发展。
