Harvard Medical School, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; Department of Pathology, Boston Children's Hospital, Boston, Massachusetts.
J Am Acad Dermatol. 2015 Nov;73(5):785-90. doi: 10.1016/j.jaad.2015.08.007. Epub 2015 Aug 29.
Pediatric and young adult nonmelanoma skin cancer (NMSC) is rare and traditionally associated with predisposing heritable or congenital conditions. Clinical characteristics, outcomes, and iatrogenic risk factors have not been well described.
We sought to characterize clinical features, potential risk factors, and gaps in care associated with NMSC in children and young adults.
This was a retrospective chart review of children and young adults with squamous and basal cell carcinoma.
We identified 28 patients with a total of 182 NMSC tumors. Of patients, 50% had predisposing conditions, and 46% had exposure to iatrogenic risk factors of prolonged immunosuppression, radiation therapy, chemotherapy, voriconazole use, or a combination of these. Of patients with iatrogenic risk factors, 62% developed subsequent cancerous or precancerous skin lesions. No patient was found to have chemotherapy or voriconazole exposure as a sole risk factor. Mean time to diagnosis of NMSC was 948 days with initial misdiagnosis in 36% of patients. The majority of patients underwent surgical excision.
This was a retrospective single institution study with a small number of cases.
Physicians should be aware of risk factors associated with NMSC in children and young adults to provide appropriate counseling and early diagnosis and treatment.
儿科和青年期非黑色素瘤皮肤癌（NMSC）较为罕见，传统上与遗传或先天性疾病相关。临床特征、结局和医源性风险因素尚未得到充分描述。
我们旨在描述儿童和青年期 NMSC 的临床特征、潜在风险因素和治疗缺口。
这是一项对患有鳞状细胞癌和基底细胞癌的儿童和青年期患者进行的回顾性图表审查。
我们共纳入了 28 例患者，总计有 182 个 NMSC 肿瘤。50%的患者存在易患疾病，46%的患者存在医源性风险因素，包括长期免疫抑制、放射治疗、化学治疗、伏立康唑使用或这些因素的联合。在存在医源性风险因素的患者中，62%发生了后续的癌前或癌性皮肤病变。没有患者被发现存在化疗或伏立康唑暴露作为唯一的风险因素。NMSC 的中位诊断时间为 948 天，36%的患者初始诊断有误。大多数患者接受了手术切除。
这是一项回顾性单中心研究，病例数较少。
医生应了解儿童和青年期 NMSC 的相关风险因素，以便提供适当的咨询、早期诊断和治疗。
