Skin cancers are the most common cancers. There are more than 100,000 new annual cases of cancer of the skin in France. The most common and less serious skin cancers are basal cell and squamous cell carcinomas. Basal cell carcinoma is four to five times more common than squamous cell carcinoma. These skin carcinomas most often affect topics white skin after the age of 40 years, but they can be younger. Malignant melanoma are more rare skin cancer (4 000 to 5 000 new cases per year in France) but more serious; they can permanently cure if the treatment is implemented early.
What is a skin Carcinoma?
Carcinomas develop from cells of the superficial portion of the skin (the epidermis).
The epidermis consists of several varieties of cells; keratinocytes, which form the main contingent, originally are basal cell and squamous cell carcinoma.
That is what causes basal cell and squamous cell carcinomas?
Excessive sun exposure is the key factor responsible for the development of skin cancer. Patients
to white skin of European origin are the main victims of skin
carcinomas, which are more rare in pigmented skin patients.
Basal cell carcinomas. In
susceptible subjects, several environmental factors (solar exposure
acute intermittent and repeated, but also ionizing radiation, exposure
to arsenic, chronic wounds) are involved in the formation of this
carcinoma.
Squamous cell carcinoma. Sun
exposure (chronic exposure) is the risk factor essential for Squamous
Cell Carcinoma, but family factors (genetic), exposure to ionizing
radiation (x-rays), some virus (human papilloma virus), chemicals (coal
tar, arsenic) were involved in the formation of certain squamous cell
carcinoma. Burn or persistent wound scars are also a factor of risk for these cancers. Some drugs that depress the defenses of the body promote the occurrence of epidermic carcinomas.
What are the signs of basal cell and squamous cell carcinomas?
Basal cell carcinomas. Three times out of four, they are located at the level of the head and neck. The
common locations are the face (nose, eyelids, lips, cheeks, forehead,
temples), scalp and the top of the trunk, but they can be find on other
areas of the body. They can take the appearance
of a button highlight color red or pink, a small stain red or white with
a raised edge, or a wound that does not heal.
Squamous cell carcinoma. They
are often at the level of areas exposed to the Sun (head and neck,cleavage , top of the body, front-arm, hands and nail), but can affect
other areas such as the mouth or genitals. On the
skin exposed to the Sun, they often begin as a white crust (Keratosis)
which gradually thickens and ulcer to form an irregular wound elevated
border.
What are the signs of basal cell and squamous cell carcinomas warning?
In all cases one must be wary of a button, a crust, a patch that persists and changes or a wound that does not heal quickly.
What are the subjects at risk?
Topics in white skin of European origin.
Subjects
with undergoes a significant sun exposure for several years (white skin
topics having lived in countries with strong sunshine, farmers,
marine...)
Patients
who have been exposed to ionizing radiation or ultraviolet radiation
for therapeutic reasons, in contact with the coal tar, which have
undergone treatment depressing immunity (grafted cardiac or renal) or
who have Burns scars.
Patients that have already submitted one basal cell carcinoma or squamous cell have an increased risk to develop another.
How to prevent skin carcinomas?
Avoid sun exposure, it is the best way to avoid skin cancer. Exposure to the Sun and ultraviolet radiation are essential risks of skin carcinoma. Therefore
prohibit Sun baths, avoid sun exposure to the hours or the solar
radiation are the most intense (from 11 to 16 hours), apply a protective
sunscreen (index at least 20) renew every two hours and after each
bath, wear protective clothing and a hat.
It is important to detect new cancers and precancerous lesions, because early treatment to ensure complete healing. A
regular inspection of the skin (self-examination) all to quickly detect
a spot or a small button that changes, a wound or a crust that
persists. A review in the dermatologist allows to obtain an accurate diagnosis, and to if necessary a questionable lesion analysis. Individuals at risk should include regular visits to the dermatologist. Actinic
Keratoses are pre-cancerous lesions that translate into a small thick
crust that persists, they locate areas normally exposed to the Sun
(head, neck, forearms especially). Actinic Keratoses are evolving in squamous cell carcinoma in a variable time, their destruction avoids this transformation.
How is the diagnosis of basal cell and squamous cell carcinomas?
The
dermatologist may suspect a basal cell carcinoma or squamous cell the
appearance, but of a fragment of skin (biopsy) followed by its review
under the microscope (histology) is often necessary for confirmation of
the diagnosis.
What are the treatments for basal cell and squamous cell carcinomas?
Treatment of cutaneous carcinomas most often involves surgery. The
dermatologist or surgeon practice excision of the lesion with a
variable safety margin based on the type of carcinoma and its
evolutionary stage. Analysis to the microscope of the tumour, after his removal, to ensure that it was completely removed. Certain squamous cell carcinoma may require the removal of nearby lymph nodes. Electrocoagulation,
C02 laser, liquid nitrogen application, radiation therapy, the
application of a cream that modulates the immunity (imiquimod or aldara
®) or more recently the dynamic phothérapie are sometimes used for the
treatment of some superficial basal cell carcinomas, but these methods
have the disadvantage of not allowing an analysis of the treated lesion.Precancerous Keratoses (actinic keratoses)
can be processed by the application of nitrogen, of cream of fluoroscopic, by electrocoagulation with C02 laser with dynamic photo-therapy or sometimes surgically.
What is the evolution of basal cell and squamous cell carcinomas?
In the absence of treatment, the basal cell and squamous cell carcinomas extend locally and can have a destructive development. The
risk of location remotely (metastasis) is almost non-existent for
basal-cell and rare carcinomas for squamous cell carcinoma. In all cases, the risk of metastasis is all the more important that the lesion is advanced. The mucous membranes (lips) and genital epidermic carcinomas have a greater risk.
Basal cell or squamous cell carcinomas early permanently recover in more than 90% of cases. After treatment, extended monitoring is required to detect recurrence and to ensure that there is no other suspicious lesions.
New therapeutic: dynamic photo-therapy
Dynamic photo-therapy (application of a substance that reacts to light, followed
by a light exposure of particular wavelength) is already used in the
treatment of superficial basal cell carcinomas outside of. Source
No comments:
Post a Comment