Skip to main content
SpringerLink
Log in

Therapieoptionen bei epithelialen Hauttumoren

Aktinische Keratosen, Morbus Bowen, spinozelluläres Karzinom und Basalzellkarzinom

Therapeutic options for epithelial skin tumors

Actinic keratoses, Bowen disease, squamous cell carcinoma, and basal cell carcinoma

  • Leitthema
  • Published:
Der Hautarzt Aims and scope Submit manuscript

Zusammenfassung

Die Inzidenz epithelialer Tumoren und ihrer Vorstufen ist weltweit über die letzten Jahre stark angestiegen. Mittlerweile sind auch zunehmend jüngere Patienten betroffen, die Risikofaktoren sind bekannt. Die Wahl des für den jeweiligen Individualfall adäquaten Behandlungsverfahrens spielt daher eine große Rolle. Bei der Wahl der Therapie sollten die hohe therapeutische Effektivität, eine möglichst niedrige Langzeitrezidivrate und ein geringes Nebenwirkungsprofil der Behandlung ausschlaggebend sein. Im Folgenden werden unterschiedliche Therapieverfahren bei aktinischen Keratosen, Morbus Bowen, Basalzellkarzinom und spinozellulärem Karzinom dargestellt und kritisch gewürdigt.

Abstract

There has been worldwide a significant rise in the incidence of epithelial skin tumors and their precursors in the past years with an increased number of younger patients affected. The risk factors are identified. The choice of the appropriate treatment for each individual is crucial. Major consideration include high cure rate, low long-term recurrence rate and few side effects. In the following article different therapeutic approaches for actinic keratoses, Bowen’s disease, basal cell carcinoma and squamous cell carcinoma are presented and analysed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Arlette JP (2003) Treatment of Bowen’s disease and erythroplasia of Queyrat. Br J Dermatol 149 [Suppl 66]:43–47

    Google Scholar 

  2. Avril MF, Auperin A, Margulis A et al. (1997) Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study. Br J Cancer 76:100–106

    Google Scholar 

  3. Bell HK, Rhodes LE (1999) Bowen’s disease — a retrospective review of clinical management. Clin Exp Dermatol 24:338–339

    Google Scholar 

  4. Bianchi L, Orlandi A, Campione E et al. (2004) Topical treatment of basal cell carcinoma with tazarotene: a clinicopathological study on a large series of cases. Br J Dermatol 151:148–156

    Google Scholar 

  5. Cox NH, Eedy DJ, Morton CA (1999) Guidelines for management of Bowen’s disease. Br J Dermatol 141:633–641

    Google Scholar 

  6. Freeman M, Vinciullo C, Francis D et al. (2003) A comparison of photodynamic therapy using topical methyl aminolevulinate (Metvix) with single cycle cryotherapy in patients with actinic keratosis: a prospective, randomized study. J Dermatolog Treat 14:99–106

    CAS  PubMed  Google Scholar 

  7. Geisse J, Caro I, Lindholm J et al. (2004) Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: results from two phase III, randomized, vehicle-controlled studies. J Am Acad Dermatol 50:722–733

    Google Scholar 

  8. Giuffrida TJ, Jimenez G, Nouri K (2003) Histologic cure of basal cell carcinoma treated with cryosurgery. J Am Acad Dermatol 49:483–486

    Google Scholar 

  9. Hall VL, Leppard BJ, McGill J et al. (1986) Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy. Clin Radiol 37:33–34

    Google Scholar 

  10. Iyer S, Bowes L, Kricorian G et al. (2004) Treatment of basal cell carcinoma with the pulsed carbon dioxide laser: a retrospective analysis. Dermatol Surg 30:1214–1218

    Google Scholar 

  11. Iyer S, Friedli A, Bowes L et al. (2004) Full face laser resurfacing: therapy and prophylaxis for actinic keratoses and non-melanoma skin cancer. Lasers Surg Med 34:114–119

    Google Scholar 

  12. Karagas MR, Greenberg ER, Spencer SK et al. (1999) Increase in incidence rates of basal cell and squamous cell skin cancer in New Hampshire, USA. Int J Cancer 81:555–559

    Google Scholar 

  13. Kowalzick L, Rogozinski T, Wimheuer R et al. (2002) Intralesional recombinant interferon beta-1a in the treatment of basal cell carcinoma: results of an open-label multicentre study. Eur J Dermatol 12:558–561

    Google Scholar 

  14. Kraus S, Miller BH, Swinehart JM et al. (1998) Intratumoral chemotherapy with fluorouracil/epinephrine injectable gel: a nonsurgical treatment of cutaneous squamous cell carcinoma. J Am Acad Dermatol 38:438–442

    Google Scholar 

  15. Kurwa HA, Yong-Gee SA, Seed PT et al. (1999) A randomized paired comparison of photodynamic therapy and topical 5-fluorouracil in the treatment of actinic keratoses. J Am Acad Dermatol 41:414–418

    Google Scholar 

  16. Labandeira J, Pereiro M Jr, Valdes F, Toribio J (2004) Intermittent topical 5-fluorouracil is effective without significant irritation in the treatment of actinic keratoses but prolongs treatment duration. Dermatol Surg 30:517–520

    Google Scholar 

  17. Lebwohl M, Dinehart S, Whiting D et al. (2004) Imiquimod 5% cream for the treatment of actinic keratosis: results from two phase III, randomized, double-blind, parallel group, vehicle-controlled trials. J Am Acad Dermatol 50:714–721

    Article  Google Scholar 

  18. Loven K, Stein L, Furst K, Levy S (2002) Evaluation of the efficacy and tolerability of 0.5% fluorouracil cream and 5% fluorouracil cream applied to each side of the face in patients with actinic keratosis. Clin Ther 24:990–1000

    Google Scholar 

  19. Lubritz RR, Smolewski SA (1982) Cryosurgery cure rate of actinic keratoses. J Am Acad Dermatol 7:631–632

    CAS  PubMed  Google Scholar 

  20. Mackenzie-Wood A, Kossard S, de Launey J et al. (2001) Imiquimod 5% cream in the treatment of Bowen‚s disease. J Am Acad Dermatol 44:462–470

    Article  Google Scholar 

  21. Marks R, Owens M, Walters SA (2004) Efficacy and safety of 5% imiquimod cream in treating patients with multiple superficial basal cell carcinomas. Arch Dermatol 140:1284–1285

    Google Scholar 

  22. Miller BH, Shavin JS, Cognetta A et al. (1997) Nonsurgical treatment of basal cell carcinomas with intralesional 5-fluorouracil/epinephrine injectable gel. J Am Acad Dermatol 36:72–77

    Google Scholar 

  23. Morse LG, Kendrick C, Hooper D et al. (2003) Treatment of squamous cell carcinoma with intralesional 5-Fluorouracil. Dermatol Surg 29:1150–1153

    Google Scholar 

  24. Morton CA, Whitehurst C, Moseley H et al. (1996) Comparison of photodynamic therapy with cryotherapy in the treatment of Bowen’s disease. Br J Dermatol 135:766–771

    Google Scholar 

  25. Nagore E, Grau C, Molinero J, Fortea JM (2003) Positive margins in basal cell carcinoma: relationship to clinical features and recurrence risk. A retrospective study of 248 patients. J Eur Acad Dermatol Venereol 17:167–170

    Google Scholar 

  26. Nelson C, Rigel D, Smith S et al. (2004) Phase IV, open-label assessment of the treatment of actinic keratosis with 3.0% diclofenac sodium topical gel (Solaraze). J Drugs Dermatol 3:401–407

    Google Scholar 

  27. Plaza Lanza M, Ralphs I, Dawber RPR (1980) Cryosurgery for Bowen’s disease of the skin. Br J Dermatol 103 [Suppl 18]:14

  28. Reyman F (1979) Treatment of basal cell carcinoma of the skin with 5-Fluorouracil ointment. A 10-year follow-up study. Dermatologica 158:368–372

    Google Scholar 

  29. Rowe DE, Carroll RJ, Day CL Jr (1989) Mohs surgery is the treatment of choice for recurrent (previously treated) basal cell carcinoma. J Dermatol Surg Oncol 15:424–431

    Google Scholar 

  30. Salim A, Leman JA, McColl JH et al. (2003) Randomized comparison of photodynamic therapy with topical 5-fluorouracil in Bowen’s disease. Br J Dermatol 148:539–543

    Google Scholar 

  31. Salim A, Morton CA (2000) Comparison of photodynamic therapy with topical 5-fluorouracil in Bowen’s disease. Br J Dermatol 143 [Suppl 57]:114 (Abstr)

  32. Seegenschmiedt MH, Oberste-Beulmann S, Lang E et al. (2001) Strahlentherapie des Basalzellkarzinoms. Lokale Kontrolle und kosmetisches Ergebnis. Strahlenther Onkol 177:240–246

    Google Scholar 

  33. Sheridan AT, Dawber RP (2000) Curettage, electrosurgery and skin cancer. Australas J Dermatol. 41:19–30

    Google Scholar 

  34. Shumack S, Gebauer K, Quirk C et al. (2004) 5% imiquimod cream for the treatment of large superficial basal cell carcinoma. Arch Dermatol 140:1286–1287

    Google Scholar 

  35. Silverman MK, Kopf AW, Grin CM et al. (1991) Recurrence rates of treated basal cell carcinomas. Part 2: Curettage-electrodesiccation. J Dermatol Surg Oncol 17:720–726

    Google Scholar 

  36. Smeets NW, Krekels GA, Ostertag JU et al. (2004) Surgical excision vs Mohs‘ micrographic surgery for basal-cell carcinoma of the face: randomised controlled trial. Lancet 364:1766–1772

    Google Scholar 

  37. Smeets NW, Kuijpers DI, Nelemans P et al. (2004) Mohs‘ micrographic surgery for treatment of basal cell carcinoma of the face — results of a retrospective study and review of the literature. Br J Dermatol 151:141–147

    Google Scholar 

  38. Smith KJ, Germain M, Skelton H (2001) Bowen’s disease (squamous cell carcinoma in situ) in immunosuppressed patients treated with imiquimod 5% cream and a cox inhibitor, sulindac: potential applications for this combination of immunotherapy. Dermatol Surg 27:143–146

    Google Scholar 

  39. Stockfleth E, Meyer T, Benninghoff B et al. (2002) A randomized, double-blind, vehicle-controlled study to assess 5% imiquimod cream for the treatment of multiple actinic keratoses. Arch Dermatol 138:1498–1502

    Article  Google Scholar 

  40. Szeimies RM, Gerritsen MJ, Gupta G et al. (2004) Imiquimod 5% cream for the treatment of actinic keratosis: results from a phase III, randomized, double-blind, vehicle-controlled, clinical trial with histology. J Am Acad Dermatol 51:547–555

    Google Scholar 

  41. Szeimies RM, Karrer S, Radakovic-Fijan S et al. (2002) Photodynamic therapy using topical methyl 5-aminolevulinate compared with cryotherapy for actinic keratosis: a prospective, randomized study. J Am Acad Dermatol 47:258–262

    Google Scholar 

  42. Thai KE, Fergin P, Freeman M et al. (2004) A prospective study of the use of cryosurgery for the treatment of actinic keratoses. Int J Dermatol 43:687–692

    Google Scholar 

  43. Thissen MR, Nieman FH, Ideler AH et al. (2000) Cosmetic results of cryosurgery versus surgical excision for primary uncomplicated basal cell carcinomas of the head and neck. Dermatol Surg 26:759–764

    Google Scholar 

  44. Turner RJ, Leonard N, Malcolm AJ et al. (2000) A retrospective study of outcome of Mohs‘ micrographic surgery for cutaneous squamous cell carcinoma using formalin fixed sections. Br J Dermatol 142:752–757

    Google Scholar 

  45. Varma S, Wilson H, Kurwa HA et al. (2001) Bowen’s disease, solar keratoses and superficial basal cell carcinomas treated by photodynamic therapy using a large-field incoherent light source. Br J Dermatol 144:567–574

    Google Scholar 

  46. Wang I, Bendsoe N, Klinteberg CA et al. (2001) Photodynamic therapy vs. cryosurgery of basal cell carcinomas: results of a phase III clinical trial. Br J Dermatol 144:832–840

    Article  CAS  PubMed  Google Scholar 

  47. Wolf JE Jr, Taylor JR, Tschen E, Kang S (2001) Topical 3.0% diclofenac in 2.5% hyaluronan gel in the treatment of actinic keratoses. Int J Dermatol 40:709–713

    Article  Google Scholar 

  48. Zeitouni NC, Shieh S, Oseroff AR (2001) Laser and photodynamic therapy in the management of cutaneous malignancies. In: Ellerin B (ed) Clinics in dermatology. Elsevier, New York, NY, pp 328–339

Download references

Interessenkonflikt:

Der korrespondierende Autor hat an zahlreichen klinischen Studien von im Artikel aufgeführten Produkten als Prüfarzt oder LKP teilgenommen (ALA, MAL, Imiquimod, Lichtquellen zur PDT), ist Vizepräsident der EURO-PDT und fungiert als wissenschaftlicher Berater der Firmen Biocam und Waldmann Medizintechnik.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Dermatologie, Klinikum der Universität Regensburg

    R.-M. Szeimies, S. Karrer & H. Bäcker

  2. Klinik und Poliklinik für Dermatologie, Klinikum der Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053 , Regensburg

    R.-M. Szeimies

Authors
  1. R.-M. Szeimies
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Karrer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. Bäcker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R.-M. Szeimies.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Szeimies, RM., Karrer, S. & Bäcker, H. Therapieoptionen bei epithelialen Hauttumoren. Hautarzt 56, 430–440 (2005). https://doi.org/10.1007/s00105-005-0950-5

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00105-005-0950-5

Schlüsselwörter

Keywords

Search

Navigation