Tangshan People's Hospital Radiochemotherapy Department
Skin cancer is a malignant tumor of the skintumor cellIt has different names due to different sources, including epidermisSkin appendage, Skinsoft tissue、peripheral nerve、Melanocyte, skin lymphatic reticular tissue andHematopoietic tissueEtc.Another part is the metastatic tumor that occurs in other tissues and metastasizes to the skin.
In September 2022, the mechanism of skin cancer metastasis to the brain was first deciphered[1]。
TCM disease name
Skin cancer
Foreign name
skin cancer
Visiting department
Dermatology, Oncology
Common causes
Ultraviolet radiation, chemical carcinogens, chronic inflammation, etc
common symptom
It is easy to bleed and ulcerate, and has pus associated with infection, with foul smell and pain
Malignant skin tumors include squamous cell carcinoma, basal cell carcinoma, malignant melanoma, and malignantlymphomaIdiopathic hemorrhagic sarcomaSweat gland carcinoma、AngiosarcomaEtc.Skin cancerPrimaryCancer and metastasis to skin from other partssecondaryCancer.Basic cell carcinoma and squamous cell carcinoma in situ are common primary skin cancer（Bowen disease）Squamous cell carcinoma, eczema like carcinoma and malignant melanoma.
clinical manifestation
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Malignant skin tumors are relatively easy to bleed, and basal cell carcinoma and squamous cell carcinoma are common.
1. Squamous cell carcinoma
May be determined byKeratosis、Leukoplakia mucosaAnd othersPrecancerous diseaseTransformed.Fast growth, early formationulcer。Some are nodular, milky orcauliflower The invasion to the deep is small, the base is movable, some are butterfly shaped, and the invasion to the deep is obvious, destructive, often involving bones.Squamous cell carcinoma with infection is stickyPurulent fluid, accompanied by odor and pain.Squamous cell carcinoma has a high degree of malignancy and is easy to metastasize. Regional lymph node metastasis is common.
2. Basal cell carcinoma
The onset of the disease is often asymptomatic, and at the initial stage, the base is usually hard and patchypapule, some presentedverrucate Protrusion and then ulceration is the change of ulcer focus, which is irregular, the edge is raised, the bottom is uneven, the growth is slow, and many of them occur singly, most often in the cheek, bridge of nose and both sides of nose. This tumor often has no conscious discomfort. Although the basal cell carcinoma is malignant, it rarely metastasizes. First, the edge of the translucent nodule is raised shallowly in the ulcer, and then gradually expands,It can invade surrounding tissues and organs and becomeInvasivenessUlcer.According to its shape andpathological change Basal cell carcinoma can be divided into 4 types, namely nodular ulcer type, pigmented type, hard scar type orFibrotic typeAnd shallow phenotype.
It is a skin cancer with high malignancy and rapid metastasis.Chinese people have more pigments in their skinultraviolet raysIt has good protective effect.At the same time, pay more attention to sunscreen, so it is malignantMelanomaIt is rare in China.Because melanoma is a dark color, it is easy to find itNail bed、Instep、PalmOr black spots found in other parts of the body, which are obviously enlarged in the near future and easily broken, or half a nailBlackeningShould be checked in the hospital in time.
It often occurs in women's unilateral breast.Symptoms andeczemaSimilar, red or dark red skin changes, the surface is prone to exudation or bleeding, and most of them are on one side at the beginningAreolaThe Ministry of Finance has developed slowly in the future, somepapillaThere may be overflow.It is easy to be misdiagnosed as eczema.Middle aged women, long lasting singleLateralityEczema of breastGo to the hospital for inspection in time.
inspect
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Biopathological examination is very important for the classification and treatment of skin malignant tumors.
The therapeutic effect of skin malignant tumor is closely related to its early diagnosis, and highly suspicious signs of early malignant disease should be paid attention to: ① those who do not heal for a long time, sometimes occur at good times, or have a small amount of bleedingSkin ulcer；②allActinic keratosisBleeding, festering orAsymmetryNodule and other symptoms; ③The skin or old scars irradiated in the past, and the sinus has ulceration or nodules; ④Persistent red skinscarBe alert when it shows mild erosioncarcinoma in situThe possibility of.
differential diagnosis
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Should be associated with chronicgranuloma、SpecificityIt can be differentiated from non-specific ulcer and actinic keratosis.
Squamous cell carcinomaThe choice of regional lymph node dissection after surgical resection is difficult to decide.Preventive cleaning is not the most necessary choice, but should be based on the age of the patient, the location of cancer, the degree of invasion andcancer cellMake the best decision on the degree of differentiation.
3. Radiotherapy
Malignant tumors of the skin, especiallybasal cell carcinomaIt is very sensitive to radiation and moderately sensitive to squamous cell carcinoma.This method is also applicable to the sites where there is or may be lymph metastasis, as an auxiliary treatment before and after surgery.
It is the application of electrocoagulationElectrocautery, frozenphotodynamic therapy Or the laser can burn the cancer to make it necrotic, fall off or vaporize.
6. Corrosive therapy
Apply highly corrosiveChemicalsAs a local cautery or application.
prognosis
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If skin malignant tumor is found and treated earlier, it is appropriate. Generally speaking, the efficacy andprognosisGood, but if regionalLymph node metastasisOtherwise, the prognosis is poor.
scientific research
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September 2022, IsraelTEL AVIV University Researchers first deciphered a mechanism that makes skin cancer metastasize to the brain, and successfully suppressed the spread of 60% to 80% by using existing treatment methods.The research results were published in the latest scientific journal JCI Insight[1]。
