51例基底细胞癌初诊误诊分析

Analysis of misdiagnosis in the first visit for 51 patients with basal cell carcinoma

目的分析51例基底细胞癌初诊误诊情况,提高诊断水平,避免误诊、漏诊。方法回顾性分析51例基底细胞癌初步诊断误诊病人临床及组织病理资料。结果 51例病人诊断为基底细胞癌待查3例,包块性质待查29例,皮肤溃疡5例,误诊色素痣4例,鳞状细胞癌3例,脂溢性角化症2例,血管瘤2例,恶性黑色素瘤2例,皮脂腺囊肿1例。临床分型:结节溃疡型37例,色素型11例,纤维上皮瘤型2例,浅表型1例。病理分型:实体型31例,色素型14例,浅表型1例,硬化型2例,囊样型2例,腺样型1例。结论基底细胞癌皮损多样,易误诊。积累临床经验,仔细查体,结合皮肤镜检查可减少误诊的发生,确诊需要行组织病理检查。

Objective To improve diagnosis level and avoid misdiagnosis and missed diagnosis by analyzing misdiagnosis in the first visit for 51 patients with basal cell carcinoma.Methods Clinical and histopathological information of 51 basal cell carcinoma patients with misdiagnosis in the first visit were analyzed retrospectively.Results Among 51 patients,3 were diagnosed as basal cell carcinoma to be checked,29 patients as mass property to be checked,5 patients as skin ulcer,4 patients as pigmented nevus,3 patients as squamous-cell carcinoma,2 patients as seborrheic keratosis,2 patients as hemangioma,2 patients as malignant melanin,and 1 patient as sebaceous cyst.Clinical classification:37 patients with nodular ulcerative type,11 patients with pigment type,2 patients with fibro-epithelioma type,and 1 patient with superficial type.Pathological type:31 patients with entity type,14 patients with pigment type,2 patients with sclerotic type,2 patients with cystoid type,1 patient with superficial type,and 1 patient with adenoid gland.Conclusions Diversified skin damages of basal cell carcinoma are easy to cause misdiagnosis.Combination of careful examination with dermatoscope observation for rash features can improve the diagnostic accuracy.Histopathology can be used to make a definite diagnosis.