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Lez Precanceroase. Cancere
Lez Precanceroase. Cancere
(precancere cutanate)
Keratoze actinice
• Sin: keratoze solare, keratoze senile.
• Definiţie. Sunt precursori ai epiteliomului spinocelular care apar pe pielea
expusă cronic la soare.
• Epidemiologie. Persoanele cu fototipurile cutanate I şi II prezintă riscul cel
mai ridicat de a dezvolta keratoze actinice. Sunt mai expuşi cei care trăiesc
în aer liber şi la altitudini mari, datorită cantităţii crescute de ultraviolete
pe care o primesc. Prevalenţa keratozelor actinice creşte cu înaintarea în
vârstă.
• Manifestări clinice. Sunt de obicei leziuni multiple, eritemato-scuamoase,
keratozice sau verucoase, “aspre la palpare”, plane sau supradenivelate,
localizate pe zonele fotoexpuse (nas, lobii urechilor, obraji, dosul mâinilor).
Scuama este aderentă, se detaşează greu, dureros, cu o mică sângerare.
Pot avea limite precise sau difuze. Dimensiunile variază între câţiva mm şi
1-2 cm. Leziunile sunt asimptomatice, dar uneori se pot însoţi de
sensibilitate locală.
Keratoze actinice
A. Multiple punctate, tightly adherent and very hard keratoses on the palm. B. Arsenical keratoses on the back. Multiple lesions are seen here ranging from
red to tan, dark brown, and white. The brown lesions are a mix of arsenical keratoses (hard, rough) and small seborrheic keratoses (soft and smooth). The
difference can be better felt than seen. The red lesions are small Bowenoid keratoses and Bowen disease (see Fig. 11-4). The white macular areas are
slightly depressed and represent superficial atrophic scars from spontaneously shed or treated arsenical keratoses. The entire picture gives the impression
of “rain drops in the dust.”
Keratoze pe radiodermită cronică
This patient had breast cancer. She had a There is poikiloderma (brown: hyperpigmentation; white:
hypopigmentation; red: telangiectasia) combined with atrophy and
lumpectomy, methotrexate, and x-ray therapy sclerosis. Hairs are absent. These massive skin changes are the
and developed painful erythema and erosions result of overdosed irradiation the patient received as a child for
at the irradiated site fungal infection of the scalp. He is a candidate for SCC in the future.
Cornul cutanat
A hornlike projection of keratin on a slightly raised base in the setting of advanced dermatoheliosis on the upper eyelid in an 85-year-old female. Excision
showed invasive SCC at the base of the lesion.
PRECANCEROZE DE ORIGINE CONGENITALĂ
NEVI NEVOCELULARI