Rose L C
Department of Family Practice, University of Texas Health Science Center at San Antonio 78284, USA.
Am Fam Physician. 1998 Sep 15;58(4):873-84, 887-8.
Malignant lesions of the skin are common. Patients who develop squamous cell carcinoma and malignant melanoma often have recognizable precursor conditions. A few skin lesions resemble malignancies. Lesions that are growing, spreading or pigmented, or those that occur on exposed areas of skin are of particular concern. Knowing the similarities and differences between these lesions allows the primary physician to make a diagnosis in most cases by simple inspection and palpation. When in doubt, it is appropriate to perform an excisional biopsy of small lesions or punch biopsy of larger lesions. Removal of premalignant lesions will reduce the occurrence of malignant disease. Almost all skin cancers can be cured by early excision or destruction. For these reasons, physicians should be aware of the risk factors for skin cancer, educate patients about risk reduction and include skin inspection for premalignant and malignant lesions as a part of routine health maintenance examinations.
皮肤恶性病变很常见。发生鳞状细胞癌和恶性黑色素瘤的患者通常有可识别的前驱病症。一些皮肤病变类似恶性肿瘤。正在生长、扩散或有色素沉着的病变,或发生在皮肤暴露部位的病变尤其值得关注。了解这些病变之间的异同能使初级医生在大多数情况下通过简单的检查和触诊做出诊断。存疑时,对小病变进行切除活检或对大病变进行穿刺活检是合适的。切除癌前病变将减少恶性疾病的发生。几乎所有皮肤癌都可通过早期切除或破坏治愈。出于这些原因,医生应了解皮肤癌的风险因素,对患者进行降低风险的教育,并将皮肤癌前和恶性病变检查纳入常规健康维护检查的一部分。