Burghout K.,Afdeling Dermatologie venereologie allergologie |
Sigurdsson V.,Afdeling Dermatologie venereologie allergologie |
Toonstra J.,Afdeling Dermatologie venereologie allergologie
Huisarts en Wetenschap | Year: 2013
The increasing prevalence of skin cancer constitutes a growing problem in the Western world. Most cases (80%) concern non-melanoma skin cancer. The main risk factor for this type of cancer is exposure to UV radiation, and the cancer occurs most often in areas of the body exposed to the sun. The two most common types of nonmelanoma skin cancer are basal cell carcinoma and squamous cell carcinoma, in this order. Basal cell carcinoma has different clinical and histological presentations and growth patterns, and because treatment is dependent on the type of carcinoma, histopathological investigation is always necessary if basal cell carcinoma is suspected. Squamous cell carcinoma can develop de novo from actinic keratosis or Bowen's disease, and high-risk and low-risk forms can be distinguished on the basis of clinical and histopathological investigations. This distinction is important for further management. © 2013 Bohn, Stafleu van Loghum.
Burghout K.,afdeling Dermatologie venereologie allergologie
Huisarts en Wetenschap | Year: 2014
Burghout KA, Sigurdsson V, Toonstra J. Melanoma: diagnosis. Huisarts Wet 2014;57(9):482-5.Melanoma accounts for about 20[%] of all skin cancers. It is an aggressive cancer and has the tendency to metastasize – melanomas are responsible for about 800 deaths a year. The 5-year survival rate for all melanomas is 81[%] for men and 90[%] for women but worsens dramatically if the cancer has metastasized. The prognosis is mainly determined by the Breslow thickness of the primary tumour, and for this reason it is important to diagnose and treat melanomas in an as early stage as possible. Although there is no reason for population screening for melanoma, certain groups of patients should be screened annually. The clinical diagnosis ‘atypical naevus’ is established with the help of the ABCDE rule (asymmetry, border, colour, diameter, and evolving). The dermascope is suitable only for those general practitioners who are experienced users. If melanoma is suspected, a skin biopsy should be taken, preferably by a dermatologist or surgeon. If melanoma is verified, there is always a need for re-excision with sentinel node biopsy to establish the prognosis. © 2014, Bohn, Stafleu van Loghum.