The "black mole" on the nose affects the aesthetics, and everything will be fine if you shoot it off with a laser? It's not that simple. In this case, doctors often require surgical removal for pathological examination. Because this may not be a mole, it may be a malignant tumor of the skin - basal cell carcinoma. Since most of the basal cell carcinomas in Chinese groups are black, it is easy to be misdiagnosed as melanin nevi in the early stage.
This malignancy is associated with long-term sun exposure
What is basal cell carcinoma? Basal cell carcinoma is the most common type of skin malignancy, with no symptoms, slow growth, and less metastasis. However, severe cases can damage local tissues and organs, especially those that occur on the face, seriously affecting the patient's appearance, and even endangering life. The disease tends to occur in the elderly, and the proportion of men and women is comparable.
The pathogenesis of basal cell carcinoma is complex and closely related to long-term sun exposure, so it tends to occur in exposed parts such as the face, the most common is the nose and cheeks; High-dose X-ray irradiation, physical and chemical damage, genetics, immunosuppression, trauma, scarring, etc. are also important pathogenesis factors of this disease; In addition, skin hamartomas such as verrucous epidermal nevi and sebaceous nevus also participate in the occurrence and development of the disease to a certain extent.
Most of the disease is single, but there are also sporadic or multiple, which can be accompanied by actinic keratosis, sunspots, and telangiectasias.
It has different shapes, and it has different locations
Basal cell carcinoma can be clinically divided into the following types
Nodular type This type is the most common, more common on the face and face, the skin lesions are initially gray-white or waxy small nodules, hard, slowly enlarged and ulcerated, around the pearl-like inward curled raised edge, called erosive ulcer; Occasionally, nodular basal cell carcinoma is aggressively enlarged, growing deeply, destroying the eyes, nose, and even penetrating the skull, invading the dura mater, causing the death of the patient.
Pigmented type is a variant of nodular type, the skin lesions are brown or dark black, the marginal part is darker, and the center is punctate or reticular, which is easily misdiagnosed as malignant melanoma.
Superficial Usually occurs on the trunk, the lesion is one or more mildly infiltrate red scaly patches, which can slowly expand around, are well defined, often wrapped around a thin linear pearl-like edge, and small superficial ulcers and crusts are visible on the surface. Heals with smooth atrophic scarring.
Morphea type is rare, usually isolated on the head and face, and the lesions are flat or mildly depressed yellow-white waxy sclerotic plaques without raised margins, ulcers, and crusts, and the course of the disease is slow.
Cystic type is a clear, dome-shaped, blue-gray cystic nodule.
Pinkus fibroepithelioma type tends to occur on the back, with one or several highly raised nodules, moderate hardness to the touch, and smooth surface.
Surgical resection is preferred and cure rates are high
If you have high-risk factors (history of sun exposure, skin tumor history, history of radiation and long-term chemical exposure, etc.) and unexplained new organisms appear on the skin, especially the head and face, and suddenly grow rapidly, ulceration, bleeding, etc., it is recommended to go to the dermatology clinic for early detection and early diagnosis.
Clinically, we can screen for the disease through non-invasive examinations such as dermoscopy; Of course, histopathological examination remains the gold standard for diagnosing basal cell carcinoma.
Surgical resection is the preferred treatment for basal cell carcinoma, with a high cure rate; For those who are unsuitable or refusal to undergo surgery, non-surgical treatments are considered, including topical treatments (electrodrying, curettage, topical agents, intralesional injections, cryotherapy, photodynamic therapy, laser therapy, etc.), radiation therapy, targeted therapy, or immunotherapy.
The recurrence rate of basal cell carcinoma after surgery is low, and regular outpatient follow-up is recommended, and it is recommended to review every six months after surgery, and then once a year thereafter.
Avoid sun exposure and maintain a healthy lifestyle
Of course, we must correctly understand basal cell carcinoma, although it is called cancer, but its differentiation is good, growth is slow, and the degree of malignancy is low, so do not panic too much. The prognosis of this disease is good, if unfortunately diagnosed, you must adjust your mentality and choose a regular medical institution and professional doctor.
So, how to prevent the disease from occurring? It is recommended to do a good job of self-protection in daily life, try to avoid sun exposure, and wear sunscreen, sun protection hats, sunscreen clothing, umbrellas, etc. when going out; Avoid exposure to other factors that induce basal cell carcinoma, such as avoiding ionizing radiation and long-term exposure to harmful chemicals such as asphalt and tar; Actively treat chronic skin ulcers, seborrheic keratosis and other chronic skin diseases.
In addition, a healthy lifestyle also plays a vital role in the prevention and treatment of the disease, such as eating fresh fruits and vegetables, maintaining proper exercise, regular work and rest and a happy mood.
Text/Jia Hongxia (Beijing Chaoyang Hospital) (Source: Beijing Youth Daily)