Eichmann A
Ther Umsch. 1989 Feb;46(2):138-41.
The precancerous skin lesions are defined clinically. Sooner or later they show the tendency to develop into an actual cancer. The most common epithelial precancerous lesion is the actinic keratosis. Sun-exposure for many years and poor pigmentation of the skin predispose for developing actinic keratosis. For the efficient treatment of epithelial precancerous lesions primarily a clear diagnosis is needed. If the diagnosis is not clear a biopsy or excision followed by histological examination is necessary. The treatment modalities for office procedures are: excisional surgery, curettage, electrocoagulation, dermabrasion and cryosurgery. Ionizing radiation in the form of x-rays may be useful for treatment of elder patients with multiple actinic keratosis and large lentigo maligna. Topical chemotherapy (5-Fluorouracil, trichloroacetic-acid) requires good compliance and frequent follow-up. The follow-up of patients with precancerous skin lesions is mainly on the clinical level. These patients should use sun-protective agents.
癌前皮肤病变是根据临床定义的。它们迟早会显示出发展为实际癌症的趋势。最常见的上皮性癌前病变是光化性角化病。多年的阳光照射和皮肤色素沉着不良易引发光化性角化病。为有效治疗上皮性癌前病变，首先需要明确诊断。如果诊断不明确，则需要进行活检或切除，随后进行组织学检查。门诊手术的治疗方式有：切除手术、刮除术、电凝术、磨皮术和冷冻手术。X射线形式的电离辐射可能对患有多发性光化性角化病和大片恶性雀斑样痣的老年患者的治疗有用。局部化疗（5-氟尿嘧啶、三氯乙酸）需要良好的依从性和频繁的随访。癌前皮肤病变患者的随访主要在临床层面。这些患者应使用防晒剂。
