Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria 3199, Australia.
Department of Plastic Surgery, Peninsula Health, Melbourne, Victoria 3199, Australia; Department of Plastic Surgery, Bendigo Hospital, Bendigo, Victoria 3500, Australia.
J Plast Reconstr Aesthet Surg. 2024 Aug;95:340-348. doi: 10.1016/j.bjps.2024.06.010. Epub 2024 Jun 12.
Amyloidosis is characterized by extracellular amyloid protein deposition. When amyloidosis intersects with basal cell carcinoma (BCC), it introduces complex diagnostic challenges. This study explored the overlap between primary localized cutaneous amyloidosis (PLCA) and BCC, examining amyloid deposits in BCC, systemic amyloidosis risk in PLCA, and various treatment methods.
Two case studies were discussed, followed by a literature review, in which PubMed, Web of Science, EMBASE, and the Cochrane Library databases were utilized. The search, covering studies from infinity up to January 2024, focused on "cutaneous amyloidosis," "basal cell carcinoma," and related terms. Articles in English detailing the clinical presentation, diagnostic methods, treatment, and outcomes of cutaneous amyloidosis mimicking BCC were included. Data extraction and synthesis were performed by two independent reviewers.
This study highlighted two cases exemplifying the complexity of diagnosing BCC and PLCA. The first case (a 64-year-old with a nodule on the cheek) and the second (a 67-year-old with a nodular lesion on the upper lip cheek) were initially suspected as BCC and were later identified as PLCA upon histopathological examination.
The diagnosis of amyloidosis within BCC nodules remains a diagnostic challenge. Although their coexistence is relatively prevalent, their local recurrence rates remain debatable. Various diagnostic and therapeutic approaches have been suggested, such as topical creams and phototherapy. However, none have garnered conclusive and consistent evidence to establish reliable clinical application.
The findings emphasized the importance of considering alternative pathologies in differential diagnoses. Future research should focus on understanding systemic amyloidosis risks and optimizing care for both conditions.
淀粉样变性的特征是细胞外淀粉样蛋白沉积。当淀粉样变性与基底细胞癌(BCC)相交时,它会带来复杂的诊断挑战。本研究探讨了原发性局限性皮肤淀粉样变性(PLCA)和 BCC 之间的重叠,研究了 BCC 中的淀粉样沉积物、PLCA 中的系统性淀粉样变性风险以及各种治疗方法。
讨论了两个案例研究,并进行了文献回顾,使用了 PubMed、Web of Science、EMBASE 和 Cochrane Library 数据库。该搜索从无限期到 2024 年 1 月,重点关注“皮肤淀粉样变性”、“基底细胞癌”和相关术语。包括详细描述模仿 BCC 的皮肤淀粉样变性临床表现、诊断方法、治疗和结局的英文文章。数据提取和综合由两名独立审查员进行。
本研究强调了两个病例,这些病例说明了诊断 BCC 和 PLCA 的复杂性。第一个病例(一名 64 岁的患者,脸颊上有一个结节)和第二个病例(一名 67 岁的患者,上唇脸颊有一个结节性病变)最初被怀疑为 BCC,后来通过组织病理学检查被确定为 PLCA。
在 BCC 结节内诊断淀粉样变性仍然是一个诊断挑战。尽管它们的共存相对普遍,但它们的局部复发率仍存在争议。已经提出了各种诊断和治疗方法,如局部乳膏和光疗。然而,没有一种方法获得了确凿一致的证据来建立可靠的临床应用。
研究结果强调了在鉴别诊断中考虑替代病理学的重要性。未来的研究应侧重于了解系统性淀粉样变性的风险并优化对这两种疾病的护理。