Department of Plastic and Reconstructive Surgery, Northwestern University, Chicago, Illinois.
Section of Plastic and Reconstructive Surgery, University of Michigan School of Medicine, University of Michigan, Ann Arbor, Michigan.
J Am Acad Dermatol. 2018 Mar;78(3):540-559. doi: 10.1016/j.jaad.2017.10.006. Epub 2018 Jan 10.
Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed.
基底细胞癌(BCC)是最常见的人类癌症,其在美国的年发病率持续上升。当早期诊断时,大多数 BCC 可以通过基于办公室的治疗方法进行治疗,该方法具有高度的治愈率。在这些基于证据的护理指南中,我们为 BCC 患者的管理提供了建议,并对支持这些建议的最佳可用文献进行了深入审查。我们讨论了临床可疑病变的活检技术,并为 BCC 的组织病理学解释提供了建议。在没有正式分期系统的情况下,根据复发风险进行了最佳的分层。关于治疗,我们提供了广泛治疗范围内的治疗方式建议,从局部药物和浅表破坏性方式到手术技术和全身治疗。最后,我们回顾了现有的文献,并为已诊断出患有 BCC 的患者提供了预防和最合适的随访建议。