Mirela Krišto, MD, Department of Dermatology and Venereology Sestre milosrdnice University Hospital Center , Vinogradska cesta 29, 10 000 Zagreb, Croatia;
Acta Dermatovenerol Croat. 2020 Dec;28(3):157-165.
Nonmelanoma skin cancers (NMSC), basal cell carcinoma (BCC), and cutaneous squamous cell carcinoma (cSCC) are the most common neoplasms worldwide. Their incidence has been continually rising. This is due to several risk factors such as chronic sun exposure, longer life expectancy, sun-damaged skin, genetic predisposition, and immunosuppression. NMSCs are curable cancers if detected early and treated appropriately. Clinical examination is the first step towards their diagnosis, with accuracy depending on clinician expertise. Dermoscopy has become an irreplaceable diagnostic procedure for clinical examination and improving diagnostic accuracy of skin cancers. However, skin biopsy with histopathological analysis remains the gold standard in establishing a definite diagnosis. Repeated biopsies, however, are not acceptable in patients with multiple suspicious lesions and are often redundant in cases of lesions that are challenging to identify, as they are often benign. Several medical imaging technologies are available as additional tools for noninvasive examination of NMSCs and include reflectance confocal microscopy (RCM), high-frequency ultrasound (HFUS), optical coherence tomography (OCT), Raman spectroscopy, fluorescence polarization, and others. These methods enable clinicians to establish more rapid and accurate diagnoses without the need for invasive biopsies and to achieve optimal treatment for NMSC. RCM an HFUS are discussed along with their clinical applications.
非黑色素瘤皮肤癌（NMSC）、基底细胞癌（BCC）和皮肤鳞状细胞癌（cSCC）是全球最常见的肿瘤。它们的发病率一直在持续上升。这是由于多种风险因素，如慢性阳光暴露、预期寿命延长、日光损伤皮肤、遗传易感性和免疫抑制。如果早期发现并适当治疗，NMSC 是可治愈的癌症。临床检查是诊断的第一步，其准确性取决于临床医生的专业知识。皮肤镜检查已成为临床检查和提高皮肤癌诊断准确性不可或缺的诊断程序。然而，皮肤活检和组织病理学分析仍然是确定诊断的金标准。然而，对于有多个可疑病变的患者，多次活检是不可接受的，而且对于难以识别的病变往往是多余的，因为它们通常是良性的。有几种医学成像技术可作为 NMSC 无创检查的附加工具，包括反射共聚焦显微镜（RCM）、高频超声（HFUS）、光相干断层扫描（OCT）、拉曼光谱、荧光偏振等。这些方法使临床医生能够在无需进行有创活检的情况下更快、更准确地诊断，并为 NMSC 提供最佳治疗。本文讨论了 RCM 和 HFUS 及其临床应用。
