Medizinische Universität Graz

Meine Abschlussarbeiten - Publikationen

Abschlussarbeit(en) (Universitätslehrgang) - Detailansicht

Gehe zu

Betreute Abschlussarbeiten

Sprachversion

Deutsch Englisch (Sprache des Volltextes)

Bibliografische Informationen

Titel

Bowen's disease in private practice: frequency, diagnosis and management

Kurzfassung

Background: Bowen’s disease or cutaneous squamous cell carcinoma in situ (cSCC in situ), is a slow growing, well-demarceted erythematous or scaly patch on the skin. It is a precursor lesion of invasive squamous cell carcinoma (SCC). This precursor lesion has a significant morbidity and is a challenge to public healthcare systems due to escalating economic costs for diagnostics and treatments.

Aim: Key Objectives

1.To determine the frequency of cSCC in situ:

Estimate the annual incidence of cSCC in situ presenting to a private dermatology practice over a one-year period.

2.To evaluate diagnostic modalities for cSCC in situ:

Asses the utilization and effectiveness of various diagnostic techniques (clinical examination, dermoscopy, biopsy) in confirming the diagnosis

3.To investigate treatment approaches for cSCC in situ: Determine the types of treatment administered for bowen’s disease within the private practice and compare the efficacy and recurrence rates associated with different treatment modalities

Method:Our study objective is to investigate the frequency, diagnosis and management of Bowen’s disease, also called cutaneous squamous cell carcinoma in situ, in a private dermatology practice over a period of one year. We choose for a retrospective study of cases diagnosed with cSCC in situ at a private dermatology practice in Belgium between January 2023 and December 2023. This is a private practice in a rural area with is equipped with one dermatologist and one general practitioner specialised in dermatology and dermoscopy for the triage of skin lesions.

Result:

Frequency: Over a 12-month period, 4.736 patients consulted for a dermatological problem. Of this total patient population, 138 individuals presented with various clinical scenarios related to cSCC in situ, including follow-up treatments and primary diagnoses. This represents 2.9% of the total patient population over a one-year period. Further analyse of the data revealed that among the 138 patients with cSCC in situ, 37 cases (26.8%) were newly diagnosed during this period.

Diagnostic modalities: Dermoscopy played a major role in the diagnostic process identificating 19 cases, which constituted 51.35 % of the total sample. Clinical examinations and diagnosis, conducted without the assistance of dermatoscopy or histopathology, led to a diagnosis in 14 cases, representing 37.84%. When clinical and dermoscopic evaluations where inconclusieve, a biopsy was performed, accounting for 4 cases or 10.81 %.

Treatment modalities: The predominant treatment option in our practice was cryotherapy, being utilized in 27 cases, which constitutes 72.97% of the cases. This was followed by the application of 5-fluorouracil (5-FU) in 4 cases (10.81%).

Treatment efficacy: Evaluation of the treatment efficacy in this cohort reveals that complete remission was achieved in 59.46% of the cases, while partial remission was achieved in 37.84% of the cases. A minimal proportion, 2.7% of the patients, exhibited no remission.

Conclusion: We focused on the frequency, diagnosis and treatment of cSCC in situ in a private dermatological practice. Despite limited literature on the epidemiology of cSCC in situ, with existing studies often dating back to the previous century and conducted on small populations, we found that 2.9% of our consultations over a one-year period were related to cSCC in situ (including both follow-up and primary diagnoses).

While histopathological examination of a biopsy remains the gold standard for confirming cSCC in situ diagnosis, an analysis of data in our practice indicates that most diagnoses are made through dermoscopy.

A wide range of therapeutic modalities exists for treating cSCC in situ. Treatment selection is influenced by clinician expertise, patient preferences, and various patient and lesion factors. These factors include the patient's age, comorbidities, immune status, medication regimen, treatment adherence, as well as lesion size, thickness, and anatomical location. Both literature and our practice demonstrate that cryotherapy is a frequently employed treatment option.

Schlagwörter

Anzahl Seiten

Publikationsjahr

2024

Volltext

Volltext downloaden