Medical III Department, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Department of Mother and Child, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Int J Mol Sci. 2023 Jul 6;24(13):11176. doi: 10.3390/ijms241311176.
Skin cancers require a multidisciplinary approach. The updated guidelines introduce new insights into the management of these diseases. Melanoma (MM), the third most common skin cancer, a malignant melanocytic tumor, which is classified into four major histological subtypes, continues to have the potential to be a lethal disease. The mortality-incidence ratio is higher in Eastern European countries compared to Western European countries, which shows the need for better prevention and early detection in Eastern European countries. Basal cell carcinoma (BCC) and squamous cell carcinoma (cSCC) remain the top two skin cancers, and their incidence continues to grow. The gold standard in establishing the diagnosis and establishing the histopathological subtype in BCC and SCC is a skin biopsy. Sebaceous carcinoma (SeC) is an uncommon and potentially aggressive cutaneous malignancy showing sebaceous differentiation. It accounts for 0.7% of skin cancers and 3-6.7% of cancer-related deaths. Due to the rapid extension to the regional lymph nodes, SeC requires early treatment. The main treatment for sebaceous carcinoma is surgical treatment, including Mohs micrographic surgery, which has the advantage of complete margin evaluation and low recurrence rates. Primary cutaneous lymphomas (PCLs) are a heterogeneous group of lymphoproliferative diseases, with no evidence of extracutaneous determination at the moment of the diagnosis. PCLs have usually a very different evolution, prognosis, and treatment compared to the lymphomas that may secondarily involve the skin. The aim of our review is to summarize the important changes in the approach to treating melanoma, non-melanoma skin, cutaneous T and B cell lymphomas, and other types of skin cancers. For all skin cancers, optimal patient management requires a multidisciplinary approach including dermatology, medical oncology, and radiation oncology.
皮肤癌需要多学科的方法。更新的指南为这些疾病的管理引入了新的见解。黑色素瘤(MM),第三大常见的皮肤癌,是一种恶性黑素细胞肿瘤,分为四个主要组织学亚型,仍然有致命的可能性。与西欧国家相比,东欧国家的死亡率与发病率之比更高,这表明东欧国家需要更好的预防和早期发现。基底细胞癌(BCC)和鳞状细胞癌(cSCC)仍然是排名前两位的皮肤癌,其发病率持续增长。在 BCC 和 SCC 中建立诊断和建立组织病理学亚型的金标准是皮肤活检。皮脂腺癌(SeC)是一种罕见且具有潜在侵袭性的皮肤恶性肿瘤,具有皮脂腺分化。它占皮肤癌的 0.7%,占癌症相关死亡的 3-6.7%。由于快速向区域淋巴结扩展,SeC 需要早期治疗。皮脂腺癌的主要治疗方法是手术治疗,包括 Mohs 显微外科手术,该手术具有完全边缘评估和低复发率的优势。原发性皮肤淋巴瘤(PCLs)是一组异质性的淋巴增生性疾病,在诊断时没有明确的皮肤外表现。PCLs 的演变、预后和治疗通常与可能继发于皮肤的淋巴瘤有很大不同。我们综述的目的是总结治疗黑色素瘤、非黑色素瘤皮肤、皮肤 T 和 B 细胞淋巴瘤以及其他类型皮肤癌的方法的重要变化。对于所有皮肤癌,最佳的患者管理需要包括皮肤科、肿瘤内科和放射肿瘤学在内的多学科方法。