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”畆ˆŤŤŽîᇁ@`f—ĂƒKƒCƒhƒ‰ƒCƒ“

ƒKƒCƒhƒ‰ƒCƒ“•ś’†‚Ě•śŒŁ”ԍ†‚Š‚çCŠY“–‚ˇ‚é•śŒŁƒŠƒXƒg‚ɃŠƒ“ƒN‚ľ‚Ä‚˘‚Ü‚ˇ


Šî’ę×–EŠŕiBCCj

CQ1

Šî’ę×–EŠŕ‚Ě”­ś—\–h‚đ–Ú“I‚Ć‚ľ‚˝Ž‡ŠOü–hŒä‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

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C1

Šî’ę×–EŠŕ‚Ě”­ś—\–h‚Ě‚˝‚ß‚ĚŽ‡ŠOü–hŒä‚đl—ś‚ľ‚Ä‚ŕ‚悢‚ށC“ú–{l‚ɑ΂ˇ‚é—L‰vŤ‚Í•s–ž‚Ĺ‚ ‚éB

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”畆Šŕ‚Í”’l‚𒆐S‚ɐ˘ŠE“I‚É‹}‘ŒXŒü‚É‚ ‚čCŠî’ę×–EŠŕiBCCj‚ŕ—áŠO‚Ĺ‚Í‚Č‚˘B‰˘•Ä‚Ĺ‚ÍˆÜ“x‚̍ˇ‚É‚ć‚čBCC ‚ĚœëŠł—Ś‚Ş–ž‚ç‚Š‚ÉˆŮ‚Č‚čCŽ‡ŠOü‚̉e‹ż‚Ş‚ť‚ĚŽĺˆö‚ƍl‚Ś‚ç‚ę‚Ä‚˘‚éB

ƒI[ƒXƒgƒ‰ƒŠƒA‚ĆƒhƒCƒc‚ĚÇ—á‘ÎĆŒ¤‹†‚ł́CŠëŒŻˆöŽq‚Ć‚ľ‚Ä‚ĚŽ‡ŠOü–\˜I‚ĆBCC ”­ś‚Ć‚Ěˆö‰ĘŠÖŒW‚ŞŽŚ‚ł‚ę‚Ä‚˘‚é‚ŞCƒTƒ“ƒXƒNƒŠ[ƒ“Ü‚ĚŽg—p‚â–XŽq’…—p‚É‚ć‚é—\–hŒř‰Ę‚ÍŘ–ž‚ł‚ę‚Ä‚˘‚Č‚˘1, 2jBƒI[ƒXƒgƒ‰ƒŠƒA‚Ě’†‚Ĺ‚ŕĹ‚ŕ”畆ŠŕœëŠł—Ś‚ލ‚‚˘’nˆć‚Ěˆę‚‚ł ‚éNambour ‚É‚¨‚˘‚Ä‘ĺ‹K–͂ȉî“üŒ¤‹†‚ލs‚í‚ę‚˝3jBŒ’íl1,621 l‚đ‘ÎŰ‚Ć‚ľ‚ăTƒ“ƒXƒNƒŠ[ƒ“ÜŽg—pŒQ‚Ć”ńŽg—pŒQ‚ÉŠ„‚č•t‚Ż‚˝‚Ć‚ą‚ëCŠĎŽ@ŠúŠÔ4.5 ”N‚ĚŽž“_‚Ĺ‚ÍBCC ‚̐V‹K”­śŠłŽŇ”C•a‘ƒ”‚Ć‚ŕ‚É—LˆÓˇ‚Ş‚Ý‚ç‚ę‚Č‚Š‚Á‚˝B‚ľ‚Š‚ľC”Ţ‚ç‚Í‚ť‚ĚŒăC‘˝”­ś‘ś•ŞÍimultifailure survival analysisj‚ĚŽč–@‚đ—p‚˘‚ÄBCC ‚Ş‘˝”­E‘ą”­‚ˇ‚é‚Ü‚Ĺ‚ĚŽžŠÔˆöŽq‚đ‰Á–Ą‚ľ‚˝‰đÍ‚đs‚˘C“ŒvŠw“I‚Č—LˆÓˇ‚É‚ÍŽŠ‚ç‚Č‚Š‚Á‚˝‚ŕ‚̂́CƒTƒ“ƒXƒNƒŠ[ƒ“ÜŽg—pŒQ‚É‚¨‚˘‚ÄBCC ‚Ě“ńŽŸ”­śƒŠƒXƒN‚ŞŒ¸­ŒXŒü‚đŽŚ‚ľ‚˝‚Ć•ń‚ľ‚Ä‚˘‚é4jB‚˝‚ž‚ľCNambour ‚É‚¨‚Ż‚éBCC ‚ĚœëŠł—Ś‚͐lŒű10 –œl‘ΐ”ç‚Ć‚˘‚¤‚‚˘ƒŒƒxƒ‹‚Ĺ‚ ‚čC‚ą‚̉î“üŒ¤‹†‚ĚŒ‹‰Ę‚đ“ú–{l‚É‚ť‚Ě‚Ü‚Ü“K—p‚ˇ‚é‚Ě‚Í˘“ď‚Ĺ‚ ‚éB

“ú–{l‚É‚¨‚˘‚ÄBCC ‚Ě”­ś‚ÉŠÖ‚ˇ‚é‹Lq‰uŠwƒf[ƒ^‚Í–R‚ľ‚­CŽ‡ŠOü‚Ć‚ĚŠÖ˜A‚Í–žŠm‚É‚Í‚ł‚ę‚Ä‚˘‚Č‚˘5`7jBˆę•űC‘S‘8 ‘ĺŠw•a‰@‚Ě‹¤“Ż‚ōs‚í‚ę‚˝Ç—á‘ÎĆŒ¤‹†‚ł́CŹŽ™Šúi10 Î–˘–žj‚Ě–XŽq’…—pKŠľ‚Í—\–hˆöŽq‚Ć‚ľ‚Ä—LˆÓ‚ÉŽŠ‚ç‚Č‚Š‚Á‚˝‚ށCŒËŠO˜J“­ŽŇ‚̓IƒbƒY”ä4.78i95“ CI 2.39 ` 9.59j‚Ć—LˆÓ‚ÉBCC ”­śƒŠƒXƒN‚ލ‚‚Š‚Á‚˝8jB

ˆČă‚ć‚čCŽ‡ŠOü‚É‚ć‚錒N”íŠQ‚͔畆Šŕ‚ž‚Ż‚Ĺ‚Č‚­”’“ŕáC–Ɖu—}§‚É‚ć‚銴őÇ‚Č‚Ç‚ŕ‚ ‚é‚˝‚߁C‰ß“x‚Ě“úŒő—‚đ”đ‚Ż‚é‚Ć‚˘‚¤Žw“ą‚Í•K—v‚Ĺ‚ ‚é‚ŞCBCC ‚Ě”­ś—\–h‚Ě‚Ý‚đ–Ú“I‚Ć‚ľ‚˝Ž‡ŠOü–hŒä‚đ‹­‚­„§‚ˇ‚é‚ž‚Ż‚̉uŠw“IŞ‹’‚Í–R‚ľ‚˘B

•śŒŁ

1j Kricker A, Armstrong BK, English DR, et al: Does intermittent sun exposure cause basal cell carcinoma? A casecontrol study in Western Australia, Int J Cancer, 1995; 60: 489-494.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

2j Walther U, Kron M, Sander S, et al: Risk and protective factors for sporadic basal cell carcinoma: results of a two-centre case-control study in southern Germany. Clinical actinic elastosis may be a protective factor, Br J Dermatol, 2004; 151: 170-178.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

3j Green A, Williams G, Neale R, et al: Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial, Lancet, 1999; 354: 723-729.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

4j Pandeya N, Purdie DM, Green A, et al: Repeated occurrence of basal cell carcinoma of the skin and multifailure survival analysis: follow-up data from the Nambour Skin Cancer Prevention Trial, Am J Epidemiol, 2005; 161: 748-754.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j ˆŔźŽO˜YCŕF’J”Ž”üCŽ›Žt_l‚Ů‚ŠF‘ĺ•ŞŒ§‚É‚¨‚Ż‚é”畆ŠŕŒŸfC“ú”ç‰ďŽC2003; 113: 1553-1560.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

6j Nagano T, Ueda M, Suzuki T, et al: Skin cancer screening in Okinawa, Japan, J Dermatol Sci, 1999; 19: 161-165.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

7j Chuang TY, Reizner GT, Elpern DJ, et al: Nonmelanoma skin cancer in Japanese ethnic Hawaiians in Kauai, Hawaii: an incidence report, J Am Acad Dermatol, 1995; 33: 422-426.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

8j ”ö“Ą—˜Œ›CŽs‹´łŒőC_•ŰFˆę‚Ů‚ŠF‘S‘8 ‘ĺŠw”畆‰Č‚Ě‹¤“Ż‚É‚ć‚é”畆Šŕ‚Ě”­ÇˆöŽq‚Ć—\–hˆöŽq‚ĚÇ—á‘ÎĆŒ¤‹†‹y‚є畆ŠŕŒŸf10 ”NŠÔ‚ĚŒ‹‰ĘC‘ž—zŽ‡ŠOü–hŒäŒ¤‹†ˆĎˆő‰ďŠwp•ńC2004; 14: 13-19. iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj


CQ2

Šî’ę×–EŠŕ‚Ě”­ś—\–h‚đ–Ú“I‚Ć‚ľ‚˝Ž‰‘B•ę”Á‚̐؏œ‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

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C1

Šî’ę×–EŠŕiBCCj‚Ě”­ś—\–h‚Ě‚˝‚ß‚ÉŽ‰‘B•ę”Á‚đŘœ‚ľ‚˝•ű‚Ş‚ć‚˘‚Ć‚˘‚¤\•Ş‚ČƒGƒrƒfƒ“ƒX‚Í‘śÝ‚ľ‚Č‚˘B‚˝‚ž‚ľC–{•ę”Á‚́C’†”NˆČ~‚É‚Č‚Á‚Ä2 ŽŸŤ‚ÉŠeŽí‚Ě•t‘ŽŠíŽîᇂ𐶂ś‚é‚ą‚Ć‚Ş‚ ‚é‚̂ŁCŽ—e–Ę‚ŕŠ¨ˆÄ‚ľ‚Ä“K“–‚ČŽžŠú‚ɐ؏œ‚đl—ś‚ľ‚Ä‚ŕ‚悢B

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]—ˆCŽ‰‘B•ę”Ái—ފ튯•ę”Áj‚ÍŠî’ę×–EŠŕiBCCj‚đ‚Í‚ś‚ß‚Ć‚ˇ‚éŽíX‚ĚˆŤŤŽîᇂ̔­ś•ę’n‚Ć‚Č‚é‚˝‚ß‘Šú‚̐؏œ‚Ş•K—v‚Ć‚ł‚ę‚Ä‚˘‚˝B‚ľ‚Š‚ľĹ‹ßC]—ˆuŽ‰‘B•ę”Áă‚ɐś‚ś‚˝BCCv‚Ɛf’f‚ł‚ę‚˝•a•Ď‚Ě‘˝‚­‚ޗǐŤ‚̖щčŽî‚Ĺ‚ ‚é‰Â”\Ť‚ŞŽw“E‚ł‚ę‚Ä‚˘‚é1`3jB‹ß”N‚̐؏œ‚ł‚ę‚˝Ž‰‘B•ę”Á‚ˇ‚ׂĂ̕a—Šw“IŒŸ“˘i100 —áˆČă‚Ě•ńj‚Ĺ‚ŕCŽ‰‘B•ę”Áă‚ɐś‚ś‚˝BCC ‚Í0`2.2“‚Ƌɂ߂ĒႢ”­ś—Ś‚Ć‚Č‚Á‚Ä‚˘‚é1`4jB‚ą‚ę‚ç‚Ě•ńÇ—á‚Í”N—î‚đ–â‚킸‚ɏWĎ‚ł‚ę‚˝‚ŕ‚Ě‚Ĺ‚ ‚čC‚ť‚Ě”­ś—Ś‚Í’˛¸‘ÎŰ‚Ć‚Č‚Á‚˝”N—î‚ɉe‹ż‚ł‚ę‚é‚˝‚ß’ˆÓ‚Ş•K—v‚Ĺ‚ ‚éB16 ÎˆČ‰ş‚ĚÇ—á‚đ‘ÎŰ‚Ć‚ľ‚˝757 —á‚ĚŽ‰‘B•ę”Á‚̉đÍ‚Ĺ‚ŕBCC ‚Ě”­ś‚Í0“‚Ć•ń‚ł‚ę‚Ä‚¨‚čCŹŽ™Šú‚ɈŤŤŽîᇂޔ­Ç‚ˇ‚éŠëŒŻŤ‚͋ɂ߂ĒႢ‚Ć‚˘‚Ś‚é5jBˆę•űCŘœ‚ľ‚˝Ž‰‘B•ę”Á651 —á‚É5 —ái0.8“j‚ĚBCC ‚đ”F‚߁C‚ť‚Ě•˝‹Ď”N—î‚Ş12.5 Îi9.7`17.4 Îj‚Ĺ‚ ‚Á‚˝‚ą‚Ć‚Š‚çC—\–h“IŘœ‚đ„§‚ˇ‚é•ń‚ŕ‚ ‚é6jB

ˆČă‚ć‚čCŽ‰‘B•ę”Á‚Š‚çBCC ‚ސś‚ś‚é‰Â”\Ť‚Í’á‚­C—\–h“I‚ČŒŠ’n‚Š‚珬Ž™Šú‚É‚ą‚ę‚đŘœ‚ˇ‚é‚ą‚Ć‚Í‹­‚­‚͐„§‚Ĺ‚Ť‚Č‚˘B‚ľ‚Š‚ľCŽ‰‘B•ę”Á‚É‚Í’†”NˆČ~‚É‚Č‚Á‚ÄŠeŽí‚Ě•t‘ŽŠíŽîᇂ𐶂ś‚Ä‚­‚é‚ą‚Ć‚Ş’m‚ç‚ę‚Ä‚˘‚é‚̂ŁCŽ—e–Ę‚ŕŠ¨ˆÄ‚ľ‚Ä“K“–‚ČŽžŠú‚ɐ؏œ‚đl—ś‚ľ‚Ä‚ŕ‚悢B

•śŒŁ

1j Cribier B, Scrivener Y, Grosshans E: Tumors arising in nevus sebaceus: A study of 596 cases, J Am Acad Dermatol, 2000; 42: 263-268.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

2j Kaddu S, Schaeppi H, Kerl H, et al: Basaloid neoplasms in nevus sebaceus, J Cutan Pathol, 2000; 27: 327-337.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

3j Munoz-Perez MA, Garcia-Hernandez MJ, Rios JJ, et al: Sebaceus naevi: a clinicopathologic study, J Eur Acad Dermatol Venereol, 2002; 16: 319-324.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

4j Jaqueti G, Requena L, Sanchez Yus E: Trichoblastoma is the most common neoplasm developed in nevus sebaceus of Jadassohn: a clinicopathologic study of a series of 155 cases, Am J Dermatopathol, 2000; 22: 108-118. iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

5j Santibanez-Gallerani A, Marshall D, Duarte AM, et al: Should nevus sebaceus of Jadassohn in children be excised? A study of 757 cases, and literature review, J Craniofac Surg, 2003; 14: 658-660.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

6j Rosen H, Schmidt B, Lam HP, et al: Management of nevus sebaceous and the risk of basal cell carcinoma: an 18-year review, Pediatr Dermatol, 2009; 26: 676-681.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj


CQ3

Šî’ę×–EŠŕ‚̐f’f‚Ƀ_[ƒ‚ƒXƒRƒs[‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

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A

Šî’ę×–EŠŕ‚̓_[ƒ‚ƒXƒRƒs[‚É‚¨‚˘‚Ä“Á’Ľ“IŠŒŠ‚đ’ć‚ľC\•Ş‚Ȑ¸“x‚Ě‰ć‘œŒŸ¸‚Ć‚ľ‚Ä‹­‚­„§‚ł‚ę‚éB

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Šî’ę×–EŠŕiBCCj‚Í—Ő°Çó‚Ş‘˝—l‚Ĺ‚ ‚čC—Տ°f’f‚̐¸“x‚đ‚‚ß‚é‚˝‚߂ɕ⏕“Iî•ń‚đ‰Á‚Ś‚é‚ą‚Ć‚Ş•K—v‚Ĺ‚ ‚éB“ú–{l‚Ĺ‚Í90“‚ސF‘fŤŠî’ę×–EŠŕ‚Ĺ‚ ‚é‚˝‚߁C—Տ°“I‚ÉŠÓ•Ę‚ˇ‚ׂŤŽžŠł‚Ć‚ľ‚āCƒƒ‰ƒm[ƒ}‚đ‚Í‚ś‚ß‚Ć‚ˇ‚éˆŤŤŽîᇂâCF‘f×–E•ę”ÁCŽ‰˜RŤŠp‰ťÇCŽ‰‘B‘BÇC–щčŽî‚Ȃǂ̗ǐŤ‚̐F‘fŤ•a•Ď‚Ş‹“‚°‚ç‚ę‚éB

ƒ_[ƒ‚ƒXƒRƒs[‚͔畆‰Č“Á—L‚Ě—D‚ę‚˝‰ć‘œf’f–@‚Ěˆę‚‚Ƃľ‚Ä•]‰ż‚Ş“ž‚ç‚ę‚Ä‚˘‚éB–{‹@Ší‚É‚¨‚˘‚ẮCL‚­F‘fŤ•a•Ďiă”çŒnEƒƒ‰ƒmƒTƒCƒgŒnjC–ŹŠÇŤ•a•ĎCoŒŒŤ•a•Ď‚đ‘ÎŰ‚ÉCf’f¸“x‚đ‚‚ß‚éŒŸ“˘‚މÁ‚Ś‚ç‚ę‚Ä‚˘‚éB

ƒ_[ƒ‚ƒXƒRƒs[‚ĹBCC ‚đ‹^‚¤•a•Ď‚đŠĎŽ@‚ˇ‚éę‡C‚Ü‚¸pigment network ‚Ě—L–ł‚đŒŸ“˘‚ˇ‚éB‚ą‚ę‚Ş‘śÝ‚ˇ‚éę‡‚͈ŤŤ•FŽî‚âF‘f×–E•ę”Á‚Č‚Ç‚Ěƒƒ‰ƒmƒTƒCƒgŒnŽîᇂđl‚Ś‚éBPigment network ‚Ş”F‚ß‚ç‚ę‚Č‚˘ę‡‚́C—zŤŠŒŠ‚Ĺ‚ ‚éˆČ‰ş‚Ě6 €–Ú‚ĚŠŒŠ‚Ě—L–ł‚đŒŸ“˘‚ˇ‚éB①ulcerationi’×ᇉťjC②large blue-gray ovoid nestsiŠDÂF—މ~Œ`‘ĺŒ^–E‘ƒjC③multiple blue-gray globulesi‘˝”­ŠDÂFŹ‹…jC④multiple leaf-like areasi‘˝”­—tó—ĚˆćjC⑤spoke wheel areasiŽÔŽ˛ó—ĚˆćjC⑥arborizing vesselsiŽ÷Ž}óŒŒŠÇjB‚ą‚ę‚ç‚̏ŠŒŠ‚ވę‚Â‚Ĺ‚ŕŒŠo‚ł‚ę‚˝ę‡CBCC ‚Ĺ‚ ‚éŠm—Ś‚Í93`100“‚Ć•ń‚ł‚ę‚Ä‚˘‚é1, 2jBƒ_[ƒ‚ƒXƒRƒs[‚ÍBCC‚ƁC‘ź‚̐F‘fŤŽîᇂâ”ńF‘fŤ•a•Ď‚Ć‚ĚŠÓ•Ę‚É‚¨‚˘‚Ä‚ŕ—L‰v‚Ĺ‚ ‚é1, 3`7jB

•śŒŁ

1j Menzies SW, Westerhoff K, Rabinovitz H, et al: Surface microscopy of pigmented basal cell carcinoma, Arch Dermatol, 2000; 136: 1012-1016.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

2j ‚–Ř—TŽqCŒĂ‰ęOŽuCÖ“cr–ž‚Ů‚ŠFƒ_[ƒ‚ƒXƒRƒs[‚É‚ć‚éŠî’ę×–EŠŕf’fŠî€‚Ě“ú–{lŠłŽŇ‚É‚¨‚Ż‚é—L—pŤ‚ĚŒŸ“˘C“ú”ç‰ďŽC2006; 116: 2234-2236.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

3j —k@ ’BC—é–؁@łC“y“c“N–ç‚Ů‚ŠFŠî’ę×–EŠŕ‚É‚¨‚Ż‚éƒfƒ‹ƒ}ƒgƒXƒRƒs[ŠŒŠ‚ĚŒŸ“˘C“ú”ç‰ďŽC1998; 108: 1249-1256.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

4j Peris K, Altobelli E, Ferrari A, et al: Interobserver agreement on dermoscopic features of pigmented basal cell carcinoma, Dermatol Surg, 2002; 28: 643-645.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Demirtasoglu M, Ilknur T, Lebe B, et al: Evaluation of dermoscopic and histopathologic features and their correlations in pigmented basal cell carcinomas, J Eur Acad Dermatol Venereol, 2006; 20: 916-920.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

6j Scalvenzi M, Lemdo S, Francia MG, et al: Dermoscopic patterns of superficial basal cell carcinomas, Int J Dermatol, 2008; 47: 1015-1018.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

7j “y‰Ž˜a•vCŠFěłOC’|”V“ŕ’C–çFƒ_[ƒ‚ƒXƒRƒs[‚É‚ć‚éˆŤŤ•FŽî‚ĆŠî’ę×–EŠŕ‚Ě—Ő°f’f¸“x‚ĚŒŸ“˘C“ú”ç‰ďŽC2007; 117: 985-989.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj


CQ4

—Տ°“I‚ÉŠî’ę×–EŠŕ‚Ş‹^‚í‚ę‚é•a•Ď‚đCf’fŠm’č‚Ě‚˝‚߂ɐśŒŸ‚ˇ‚é‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

B

Ú×‚Č—Ő°“I•]‰ż‚Ćƒ_[ƒ‚ƒXƒRƒs[‚É‚ć‚Á‚Ä‚ŕŠî’ę×–EŠŕ‚Ɛf’f‚đŠm’č‚Ĺ‚Ť‚Č‚˘•a•Ď‚ɂ‚˘‚ẮCśŒŸ‚đŽŔŽ{‚ľ‚Đf’f‚đŠm’股‚é‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚éB

ƒAƒ‹ƒSƒŠƒYƒ€‚Ö


Ą‰đŕ

Šî’ę×–EŠŕiBCCj‚Ş‹^‚í‚ę‚é•a•Ď‚ɂ‚˘‚ẮCÚ×‚É—Ő°ŠŒŠ‚đ•]‰ż‚ˇ‚é‚ą‚Ć‚Ş‘ĺŘ‚Ĺ‚ ‚éBBCC ‚É‚Í‚ł‚Ü‚´‚Ü‚Č—Ő°•aŒ^‚Ş‘śÝ‚ˇ‚é‚ŞC“ú–{l‚ĚBCC ‚ĚŠî–{“I—Տ°‘œ‚́C•\–Ę‚ĚŠp‰ťŒXŒü‚Ş–R‚ľ‚˘C•˝ŠŠ‚Ĺ“§–žŠ´‚Ě‚ ‚éŠD•F‚ĚŒ‹ß‚Ĺ‚ ‚éB’×ᇕӉ•”‚ɏŹŒ‹ß‚Ş”z—ń‚ˇ‚é‚ą‚Ć‚ŕ‚ ‚éipearly borderjBŽÖsó‚Ě–Ń×ŒŒŠÇŠg’Ł‚đ‚—Ś‚É”ş‚¤‚ą‚Ć‚ŕf’f‚ĚŽQl‚É‚Č‚éBŠÓ•ĘŽžŠł‚Ć‚ľ‚ẮCƒƒ‰ƒm[ƒ}C•t‘ŽŠíŽîᇁCF‘f×–E•ę”ÁCŽ‰˜RŤŠp‰ťÇ‚Č‚Ç‚Ş‹“‚°‚ç‚ę‚éB‚Ü‚˝CBCC ‚Í‘˝”­‚ˇ‚é‚ą‚Ć‚â‰Ć‘°Ť”­ś‚ŕ‚ ‚é‚̂ŁC•a—đ’ŽŽć‚Ć‘Sg”畆‚̐fŽ@‚ŕ•K—v‚Ĺ‚ ‚é1j`3jB

–łěˆ×’Šo‚ľ‚˝Œ’ílŒQ‚đn—ű”畆‰Čˆă‚ރ_[ƒ‚ƒXƒRƒs[‚Č‚ľ‚ŐfŽ@‚ľ‚˝ę‡‚̔畆Šŕ‚̐f’f¸“x‚Í59`65“‚Ĺ‚ ‚Á‚˝4jBƒAƒƒŠƒJ‚Ě‘ĺŠw•a‰@”畆‰Čˆă‚É‚ć‚é—Տ°f’f¸“x‚Í70“‚Ĺ‚ ‚čC—Տ°f’f‚݂̂ł͐f’f‚Ě“ď‚ľ‚˘ƒP[ƒX‚ޏ­‚Č‚Š‚炸‚ ‚é5jBĹ‹ßC“ą“ü‚ł‚ę‚˝ƒ_[ƒ‚ƒXƒRƒs[‚ÍBCC ‚̐f’f‚É‚ŕ‹É‚ß‚Ä—L—p‚Ĺ‚ ‚éiBCC-CQ3 ŽQĆjB—Տ°ŠŒŠCƒ_[ƒ‚ƒXƒRƒs[ŠŒŠ‚Š‚çBCC ‚̐f’f‚ŞŠm’č“I‚Čę‡‚ɂ́CśŒŸ‚đŽŔŽ{‚ˇ‚é•K—v‚Í‚Č‚˘B‚ľ‚Š‚ľC‚ą‚ę‚ç‚Ě—Ő°î•ń‚݂̂ł͐f’f‚đŠm’č‚Ĺ‚Ť‚Č‚˘•a•Ď‚͐ϋɓI‚ɐśŒŸ‚ľC•a—‘gDŠw“I‚ɐf’f‚đŠm’股‚éBBCC ‚ÍŒ´‘Ľ‚Ć‚ľ‚Ä“]ˆÚ‚ľ‚Č‚˘‚̂ŁC•”•ŞśŒŸ‚đs‚Á‚Ä‚ŕ—\Œă‚đˆŤ‰ť‚ł‚š‚éŠëŒŻŤ‚Í‚Č‚˘B

•śŒŁ

1j Orengo IF, Salache SJ, Fewkes J, et al: Correlation of histologic subtypes of primary basal cell carcinoma and number of Mohs stages required to achieve a tumor-free plane, J Am Acad Dermatol, 1997; 37: 395-397.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj.

2j Sexton M, Jones DB, Maloney ME: Histologic pattern analysis of basal cell carcinoma, Study of a series of 1039 consecutive neoplasms, J Am Acad Dermatol, 1990; 23: 1118-1126.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

3j ÎŒ´˜a”VFŠî’ę×–EŠŕ@‘S‘ƒAƒ“ƒP[ƒg‚̏WŒv‚Ćŕ–ž, Skin Cancer, 1994; 9: 80-83. iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j Kricker A, English DR, Randell PL, et al: Skin cancer in Geraldton, West Australia: a survey of incidence and prevalence, Med J Aust, 1990; 152: 399-407.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

5j Presser SE, Taylor JR: Clinical diagnostic accuracy of basal cell carcinoma, J Am Acad Dermatol, 1987; 16: 988-990.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅲj


CQ5

Šî’ę×–EŠŕ‚ɑ΂ľ‚ÄŠO‰Č“IŘœ‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

A

Šî’ę×–EŠŕ‚ĚŽĄ—Ă‚Ě‘ćˆę‘I‘đ‚Ć‚ľ‚Ä‹­‚­ŠŠ‚ß‚ç‚ę‚éB

ƒAƒ‹ƒSƒŠƒYƒ€‚Ö


Ą‰đŕ

Šî’ę×–EŠŕiBCCj‚ĚŽĄ—Ă‚ĚŒ´‘Ľ‚ÍŠO‰Č“IŘœ‚ƍl‚Ś‚ç‚ę‚Ä‚¨‚čC‹É‚ß‚Ä—L—p‚Č‚ą‚Ć‚ŞŽŔŘ‚ł‚ę‚Ä‚˘‚éB–{–M‚Ĺ‚Í‚Ů‚Ć‚ń‚Ǎs‚í‚ę‚Ä‚˘‚Č‚˘Mohs Žčpip’†‚É‚ˇ‚×‚Ä‚ĚŘœ’f’[‚đ“€Œ‹Ř•Đ‚ĹŠm”F‚ľ‚Č‚Ş‚çŽčp‚đŽ{s‚ˇ‚éj‚đœ‚Ż‚΁C‘ź‚ĚŽĄ—Ă–@i•úŽËü—Ă–@C“€Œ‹—Ă–@C“d‹C‘~ংȂǁj‚É”ä‚×—LˆÓ‚ɋǏŠÄ”­‚đ—}§‚Ĺ‚Ť‚é1, 2jB

“Şčň•”‚Ě4 cm ˆČ‰ş‚ĚBCC 347 —á‚ɂ‚˘‚ÄŠO‰Č“IŘœ‚Ć•úŽËü—Ă–@‚đ”äŠr‚ľ‚˝ŽŽŒą‚ł́C4 ”NŒă‚ĚÄ”­—Ś‚ÍŠO‰Č“IŘœ‚Ş0.7“‚Ĺ‚ ‚é‚̂ɑ΂ľ‚Ä•úŽËü—Ă–@‚Ĺ‚Í7.5“‚Ć‚Č‚čC—LˆÓ‚ÉŠO‰Č“IŘœ‚Ş—D‚Á‚Ä‚˘‚˝3jBŽ—e–Ę‚Ĺ‚ŕŠO‰Č“IŘœ‚Í—D‚ę‚Ä‚¨‚čC—ǍD—á‚ŞŠO‰Č“IŘœ87“C•úŽËü—Ă–@69“‚Ĺ‚ ‚Á‚˝3jB‘ź•űCŠO‰Č“IŘœ‚Ć‘~ঁ{“€Œ‹—Ă–@‚đ”äŠr‚ľ‚˝2 ‚‚̕ńi0“ vs. 6.25“j4jCi8.4“ vs. 19.6“j5j‚Ĺ‚Í‚Ć‚ŕ‚ɋǏŠÄ”­—Ś‚É—LˆÓˇ‚Í‚Č‚Š‚Á‚˝‚Ć‚ľ‚Ä‚˘‚é‚ŞCŠO‰Č“IŘœ‚đ„§‚ľ‚Ä‚˘‚éB

‰˘•Ä‚Š‚ç‚Ě‘˝‚­‚Ě•ń‚ł́CMohs Žčp‚ŞĹ‚ŕBCC ‚Ě‹ÇŠÄ”­‚đ—}§‚Ĺ‚Ť‚鎥—Ă–@‚Ć‚ľ‚Đ„§‚ł‚ę‚Ä‚˘‚é‚ŞC“ú–{‚Ĺ‚ÍMohs Žčp‚Í‚Ů‚Ć‚ń‚ÇŽŔŽ{‚ł‚ę‚Ä‚˘‚Č‚˘B‚ľ‚Š‚ľC‹ß”NMohs Žčp‚Ɖi‹v•W–{‚Ĺ’f’[‚đŠm”F‚ˇ‚éŠO‰Č“IŘœ‚Ĺ, ‰‰ńŽĄ—Ă—á‚ÉŠÖ‚ľ‚Ă͍Ĕ­—Ś‚É—LˆÓˇ‚Ş‚Ý‚ç‚ę‚Č‚Š‚Á‚˝‚Ć‚ˇ‚é•ń‚Ş‚Č‚ł‚ę‚˝6, 7jBˆČă‚Ě‚ą‚Ć‚Š‚çC–{–M‚Ĺ‚ÍBCC ‚ĚŽĄ—Ă‚Ě‘ćˆę‘I‘đ‚ÍŠO‰Č“IŘœ‚Ĺ‚ ‚éB

•śŒŁ

1j Thissen MR, Neumann MH, Schouten LJ: A systematic review of treatment modalities for primary basal cell carcinomas, Arch Dermatol, 1999; 135: 1177-1183.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

2j Bath FJ, Perkins W, Bong J, et al: Interventions for basal cell carcinoma of the skin, Cochrane Database Syst Rev, CD003412, 2007;i1j.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

3j Avril MF, Auperin A, Margulis A, et al: Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study, Br J Cancer, 1997; 76: 100-106.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

4j Thissen MR, Nieman FH, Ideler AH, et al: Cosmetic results of cryosurgery versus surgical excision for primary uncomplicated basal cell carcinomas of the head and neck, Dermatol Surg, 2000; 26: 759-764.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

5j Kuijpers DI, Thissen MR, Berretty PJ, et al: Surgical excision versus curettage plus cryosurgery in the treatment of basal cell carcinoma, Dermatol Surg, 2007; 33: 579-587.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

6j Smeets NW, Krekels GA, Ostertag JU, et al: Surgical excision vs Mohsf micrographic surgery for basal-cell carcinoma of the face: randomised controlled trial, Lancet, 2004; 364: 1766-1772.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

7j Mosterd K, Krekels GA, Nieman FH, et al: Surgical excision versus Mohsf micrographic surgery for primary and recurrent basal-cell carcinoma of the face: a prospective randomised controlled trial with 5-yearsf follow-up, Lancet Oncol, 2008; 9: 1149-1156.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj


CQ6

Šî’ę×–EŠŕ‚ĚŒ´”­‘ƒ‚́C“÷Šá“I•Ó‰‚Š‚牽mm —Ł‚ľ‚Đ؏œ‚ˇ‚ׂŤ‚Š

 

’჊ƒXƒN‚ĚŠî’ę×–EŠŕ

„§“x

A

’჊ƒXƒN‚ĚŠî’ę×–EŠŕ‚́C4 mm ‚̐؏œƒ}[ƒWƒ“‚Ş‹­‚­ŠŠ‚ß‚ç‚ę‚éB

 

‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ

„§“x

B

‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ‚́C5`10 mm ‚̐؏œƒ}[ƒWƒ“‚ŞŠŠ‚ß‚ç‚ę‚éB

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Ą‰đŕ

ŠO‰Č“IŽĄ—Ă‚ÍŠî’ę×–EŠŕiBCCj‚ɑ΂ˇ‚éĹ‚ŕŠmŽŔ‚ČŽĄ—Ă‚Ĺ‚ ‚éiBCC-CQ5 ŽQĆj1jB“KŘ‚Ȑ؏œƒ}[ƒWƒ“‚đÝ’股‚é‚˝‚߂ɂ́C•aŒ^C‘gD‘œC‘ĺ‚Ť‚łC•”ˆĘ‚Č‚ÇÄ”­—Ś‚ɉe‹ż‚ˇ‚郊ƒXƒNˆöŽq‚đl—ś‚ľ‚Č‚Ż‚ę‚΂Ȃç‚Č‚˘BŘœƒ}[ƒWƒ“‚ÉŠÖ‚ˇ‚錤‹†‚ÍŽĺ‚ɒ჊ƒXƒNÇ—á‚đ‘ÎŰ‚És‚í‚ęCƒAƒEƒgƒJƒ€‚Ć‚ľ‚Ä‚ÍŘœ’f’[—zŤ—Ś‚ŕ‚ľ‚­‚͍Ĕ­—Ś‚Ş—p‚˘‚ç‚ę‚éB

BCC ‚Í•s‹K‘Ľ‚Č•a•Ď‚ĚŠg‚Ş‚č‚đŽŚ‚ˇ‚ą‚Ć‚Ş‚ ‚čC’ˆÓ[‚­Řœ‚ľ‚Ä‚ŕ1/3 ‚ĚÇ—á‚Ĺ‚ÍŘœ’f’[‹ßÚ‚Ć‚Č‚čC‚ŕ‚ľ‚­‚Í—zŤ‚Ć‚Č‚éB‘gDŠw“I‚ČŠg‚Ş‚č‚ÉŠÖ‚ľ‚ẮC“€Œ‹Ř•Đ‚đ—p‚˘‚éŽčp‚É‚ć‚錤‹†‚ލs‚í‚ę‚Ä‚˘‚éB‚ť‚ę‚É‚ć‚é‚Ć20 mm ˆČ‰ş‚Ě‹ŤŠE–ž—Ä‚ČBCC ‚É‚¨‚˘‚ẮCŘœƒ}[ƒWƒ“3 mm ‚Ĺ85“‚ĚÇ—á‚ĹŽîᇂ̊Ž‘SŘœ‚މ”\‚Ĺ‚ ‚Á‚˝B‚ł‚ç‚É4 ` 5 mm ‚Ěƒ}[ƒWƒ“‚đ‚Ć‚ę‚΁C–ń95“‚ĚÇ—á‚ĹŽîᇂ̎c‘ś‚Í‚Č‚˘B‹ŤŠE–ž—Ä‚ČŹ‚ł‚ČBCC ‚Ĺ‚ŕC–ń5“‚É‚¨‚˘‚Ä4 mm ˆČă‚̐öÝ“I‚Č•a•Ď‚ĚŠg‚Ş‚č‚đ”F‚ß‚é2, 3jBBCC 91 —ái‘˝‚­‚ŞŒ‹ßŒ^j‚ɑ΂ˇ‚éƒpƒ‰ƒtƒBƒ“Ř•Đ‚đ—p‚˘‚˝“Ż—l‚ĚŒ¤‹†•ń‚Ĺ‚ŕCŘœƒ}[ƒWƒ“‚đ4 mm ‚Ɖź’č‚ľ‚˝ę‡‚ĚŠŽ‘SŘœ—Ś‚Í96“‚ĆŽZo‚ľ‚Ä‚˘‚é4jBŠç–Ę‚Ĺ10 mm –˘–ž‚Ě‹ŤŠE–ž—Ä‚ČŒ‹ßŒ^BCC 134 —á‚đ‘ÎŰ‚É‚ľ‚Đ؏œƒ}[ƒWƒ“‚đ1C2C3 mm ‚É•Ş‚Ż‚˝”äŠrŽŽŒą‚ł́CŘœ’f’[—zŤ—Ś‚Í‚ť‚ę‚ź‚ę16C24C13“‚Ĺ‚ ‚čC’჊ƒXƒNÇ—á‚Ĺ‚ ‚Á‚Ä‚ŕ4 mm ˆČă‚Ěƒ}[ƒWƒ“‚Í•K—v‚ĆŒ‹˜_‚Ă‚Ż‚Ä‚˘‚é5jB‚Ü‚˝CŘœƒ}[ƒWƒ“‚ÉŠÖ‚ˇ‚é89 ˜_•ś‚Š‚ç‚Č‚éƒƒ^ƒAƒiƒŠƒVƒX‚ŞĹ‹ß•ń‚ł‚ęC”Áó‹­”çÇŒ^‚âÄ”­—á‚đœ‚­‚ƁCŘœƒ}[ƒWƒ“5C4C3C2 mm ‚Ĺ‚Ě’f’[—zŤ—Ś‚Í‚ť‚ę‚ź‚ę5C5C5C8“CÄ”­—Ś‚Í0.39C1.62C2.56C3.96“‚Ĺ‚ ‚Á‚˝6jBˆČă‚ć‚čC’჊ƒXƒNÇ—á‚ɑ΂ľ‚Ä‚Í4 mm ‚̐؏œƒ}[ƒWƒ“‚ō‚‚˘ŠŽ‘SŘœ—Ś‚ĆŽĄ–ü—Ś‚ŞŠú‘Ň‚Ĺ‚Ť‚é3, 6`9jB

“KŘ‚Ȑ؏œƒ}[ƒWƒ“‚Í‘gDŒ^‚É‚ć‚Á‚Ä‚ŕˆŮ‚Č‚čC”Áó‹­”çÇŒ^‚ł́C3 mm ‚̐؏œƒ}[ƒWƒ“‚Ĺ66“‚ĚŠŽ‘SŘœ—Ś‚Ş“ž‚ç‚ęC5 mm ‚Ĺ‚Í82“C13`15 mm —Ł‚š‚Î95“‚ĚŠŽ‘SŘœ—Ś‚Ĺ‚ ‚Á‚˝2jB‚ą‚Ěƒ^ƒCƒv‚Í‘gDŠw“I‚É•a•Ď‚ĚŠg‚Ş‚č‚Ş‘ĺ‚Ť‚­Cłí”畆‚đŠÜ‚ß‚˝\•Ş‚Ȑ؏œ‚đs‚¤•K—v‚Ş‚ ‚éBÄ”­—á‚Ĺ‚Í‘S‘Ě‚Ě5 ”NŽĄ–ü—Ś‚Ş83“‚Ĺ‚ ‚čC‚ł‚ç‚ÉŒ´”­‘ƒ‚Ě’źŒa‚Ş15 mm ˆČăC20 mm ˆČăC30 mm ˆČă‚É‹ć•Ş‚ľ‚Ä’˛¸‚ˇ‚é‚ƁCŠeXŽĄ–ü—Ś‚Í88C83C77“‚ƒቺ‚ˇ‚é8, 10jBŽîᇌa20 mm ˆČă‚ĚBCC ‚Ě‘gDŠw“IZ“x‚đŒv‘Ş‚ľC7 mm ˆČă‚̐؏œƒ}[ƒWƒ“‚đ„§‚ľ‚˝–{–M‚Š‚ç‚Ě•ń‚ŕ‚ ‚é11jB

‘ź•ű‚ƒŠƒXƒN•”ˆĘ‚Ĺ‚ ‚éŒűOC•@C•@ŽüˆÍCŠááَüˆÍCŽ¨C”핢“Ş•”‚Ĺ‚Í57`82“‚Ü‚ĹŽĄ–ü—Ś‚Ş’á‰ş‚ˇ‚é7, 8, 10, 12, 13jB612 —á‚ĚŠç–ʍ‚ƒŠƒXƒNÇ—ái408 —á‚ĚŒ´”­‘ƒ‚Ć204 —á‚ĚÄ”­—áj‚ɑ΂ľ‚āC•W€“I‚ČŠO‰Č“IŽčp‚ĆMohs Žčp‚đ‘I‘đ‚ľ‚Ä”äŠr’ǐՒ˛¸‚đs‚Á‚˝‚Ć‚ą‚ë14, 15jCŽčp—Ă–@‚É‚¨‚Ż‚é5 ”NÄ”­—Ś‚ÍŒ´”­‘ƒi199 —áj‚ĆÄ”­‘ƒi102 —áj‚ĹŠeX4.1“C12.1“‚Ĺ‚ ‚Á‚˝B‚ť‚Ě’†‚ŁCŘœƒ}[ƒWƒ“3 mm ‚Őݒ肳‚ę‚˝Žčp—Ă–@‚É‚¨‚Ż‚鏉‰ńŘœ‚Ě’f’[—zŤ—Ś‚ÍŒ´”­‘ƒ‚Ĺ18“CÄ”­‘ƒ‚Ĺ30“‚Ĺ‚ ‚Á‚˝B‚ƒŠƒXƒNÇ—á‚ɑ΂ľ‚ẮC•Ó‰‚̐؏œ”͈͂đ\•Ş‚ÉŠm•Ű‚ľCp’†v‘Ź•a—ŒŸ¸‚â“ńŠú“IŽčp‚đ•š—p‚ľ‚čĔ­—Ś‚̒ቺ‚đ}‚é‚ׂŤ‚Ĺ‚ ‚é11, 16`18jB

•śŒŁ

1j Avril MF, Auperin A, Margulis A, et al: Basal cell carcinoma of the face: surgery or radiosurgery? Results of a randomized study, Br J Cancer, 1997; 76: 100-106.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

2j Breuninger H, Dietz K: Prediction of subclinical tumor infiltration in basal cell carcinoma, J Dermatol Surg Oncol, 1991; 17: 574-578.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

3j Wolf DJ, Zitelli JA: Surgical margins for basal cell carcinoma, Arch Dermatol, 1987; 123: 340-344.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

4j Thomas DJ, King AR, Peat BG: Excision margins for nonmelanotic skin cancer, Plast Reconstr Surg, 2003; 112: 57-63.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Kimyai-Asadi A, Alam M, Goldberg LH, et al: Efficacy of narrow-margin excision of well-demarcated primary facial basal cell carcinomas, J Am Acad Dermatol, 2005; 53: 464-468.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅲj

6j Gulleth Y, Goldberg N, Silverman RP, et al: What is the best surgical margin for a basal cell carcinoma: A metaanalysis of the literature, Plast Reconstr Surg, 2010; 126: 1222-1231.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

7j Dubin N, Kopf AW: Multivariate risk score for recurrence of cutaneous basal cell carcinomas, Arch Dermatol, 1983; 119: 373-377.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

8j Silverman MK, Kopf AW, Bart RS, et al: Recurrence rates of treated basal cell carcinomas. Part 3: Surgical excision, J Dermatol Surg Oncol, 1992; 18: 471-476.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

9j Bart RS, Schranger D, Kopf AW, et al: Scalpel excision of basal cell carcinoma, Arch Dermatol, 1978; 114: 739-742.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

10j Rowe DE, Carrol RJ, Day CL: Mohs surgery is the treatment of choice for recurrentipreviously treatedjbasal cell carcinoma, J Dermatol Surg Oncol, 1989; 15: 424-431.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

11j LŁ—ž“ńCŹo@—˛Ch—Ö“Nś‚Ů‚ŠFĹ‘ĺŒa20 mm ‚đ’´‚Ś‚éŠî’ę×–EŠŕ‚̐؏œ”ÍˆÍ‚ĚŒŸ“˘, Skin Cancer, 1994; 9: 189-193.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

12j Ceilley RI, Anderson RL: Microscopically controlled excision of malignant neoplasms on and around eyelids followed by immediate surgical reconstruction, J Dermatol Surg Oncol, 1978; 4: 55-62.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

13j Auw-haedrich C, Frick S, Boehringer D, et al: Histologic safety margin in basal-cell carcinoma of the eyelid, Ophthalmol, 2009; 116; 802-806.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

14j Smeets NW, Krekels GA, Ostertag JU, et al: Surgical excision vs Mohsf micrographic surgery for basal-cell carcinoma of the face: randomized controlled trial, Lancet, 2004; 364: 1766-1772.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

15j Mosterd K, Krekels GA, Nieman FH, et al: Surgical excision versus Mohsf micrographic surgery for primary and recurrent basal-cell carcinoma of the face: a prospective randomised controlled trial with 5-yearsf follow-up, Lancet Oncol, 2008; 9: 1149-1156.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

16j Leibovitch I, Huilgol SC, Selva D, et al: Basal cell carcinoma treated with Mohs surgery in Australia Ⅱ Outcome at 5-year follow-up, J Am Acad Dermatol, 2005; 53: 452-457.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

17j Orengo IF, Salache SJ, Fewkes J, et al: Correlation of histologic subtypes of primary basal cell carcinoma and number of Mohs stages required to achieve a tumor-free plane, J Am Acad Dermatol, 1997; 37: 395-397.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

18j Thissen MR, Neumann MH, Schouten LJ: A systematic review of treatment modalities for primary basal cell carcinoma, Arch Dermatol, 1999; 135: 1177-1183.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj


CQ7

Šî’ę×–EŠŕ‚͂ǂ̐[‚ł‚Ĺ‚ĚŘœ‚ŞŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

B

‘˝‚­‚Ěę‡C”牺Ž‰–bD‚đ\•ŞŠÜ‚ß‚ÄŘœ‚ˇ‚é‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚é‚ŞC‘gDŒ^‚ލ‚ƒŠƒXƒNi”Áó‹­”çÇŒ^CZŒ^C”÷ŹŒ‹ßŒ^j‚ŕ‚ľ‚­‚ÍŽîᇌa‚Ş‘ĺ‚Ť‚˘ę‡‚É‚Í‚ć‚č[•”‚Ü‚Ĺ‚ĚŘœ‚đ—v‚ˇ‚é‚ą‚Ć‚Ş‚ ‚éB

ƒAƒ‹ƒSƒŠƒYƒ€‚Ö


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Šî’ę×–EŠŕiBCCj‚ĚŠO‰Č“IŘœ‚É‚¨‚˘‚Đ؏œƒ}[ƒWƒ“‚đÝ’股‚éŰ‚ɂ́C‘¤•ű‚Ĺ‚ ‚ę‚Δç]‚Ě—Ő°“I‹ŤŠE‚đŒŠ‹É‚ß‚˝ă‚Ĺ‚ť‚ą‚Š‚ç4`10 mm —Ł‚ľ‚Ä”çŘ‚ˇ‚é‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚éiBCC-CQ6 ŽQĆjB‚ľ‚Š‚ľC[•”•űŒü‚ɂ‚˘‚Ă͊‚Ć‚ˇ‚ׂŤ‹ŤŠE‚Ş‚Č‚˘‚˝‚߁Cp‘O‚̐؏œ”͈͐ݒč‚É‹ę—ś‚ˇ‚é‚ą‚Ć‚Ş‘˝‚˘B’´‰š”gŒŸ¸‚É‚ć‚é[•”‹ŤŠE‚Ě•]‰ż‚ŕ‚ ‚é’ö“x‚Í—L—p‚Ĺ‚ ‚éB

BCC ‚̐[•”Z‚đ—\‘Ş‚ˇ‚éˆöŽq‚Ć‚ľ‚ẮC‘gDŒ^‚ĆŽîᇌa‚Ş‹“‚°‚ç‚ę‚é1jB‘gDŒ^•Ę‚É‚Ý‚é‚ƁC’ʏí‚ĚŒ‹ßŒ^‚ĚBCC ‚Ěę‡‚Ĺ‚ ‚Á‚Ä‚ŕ33“‚͐^”ç“ŕ‚É—Ż‚܂炸‚ɔ牺‚֐Z‚ˇ‚é‚Ş2jCMohs Žčp‚Ěƒf[ƒ^‚Ĺ‚Í78`89“‚ĚÇ—á‚Ş”牺Ž‰–bD‚Ü‚Ĺ‚Ěœ‹Ž‚ĹŠŽ‘SŘœ‚ÉŽŠ‚Á‚Ä‚˘‚é3, 4jB‘ź•űC‚ƒŠƒXƒN‚Č‘gDŒ^‚Ć‚ł‚ę‚éZŒ^C”÷ŹŒ‹ßŒ^C”Áó‹­”çÇŒ^‚Ě3 Œ^‚ł̔牺Z—Ś‚Í‚˘‚¸‚ę‚ŕ50“‚đ’´‚Ś‚Ä‚¨‚č2jC‘O“ńŽŇ‚Ĺ‚ÍMohs Žčp‚É‚¨‚˘‚Ĕ牺Ž‰–bDƒŒƒxƒ‹‚Ĺ‚Ěœ‹Ž‚ĹŠŽ‘SŘœ‚Ĺ‚Ť‚˝Ç—á‚Í”ź”’ö“x‚É‚ˇ‚Ź‚Č‚˘3, 4jB‚Ü‚˝C51 —á‚Ě”Áó‹­”çÇŒ^BCC ‚ĚŒŸ“˘‚ł́C7 —ái14“j‚ɓ–ŒC‹Ř‘w‚Ȃǂւ̐[•”Z‚Ş‚Ý‚ç‚ę‚˝5jB

‘gDŒ^ˆČŠO‚ÉBCC ‚̐[•”Z‚ɉe‹ż‚ˇ‚éˆöŽq‚Ć‚ľ‚Ä‚ÍŽîᇌa‚Ş‚ ‚é1jBŽîᇌa‚Ş‘ĺ‚Ť‚Ż‚ę‚ΐ[•”•űŒü‚Ö‚Ě‘gDŠw“IZsubclinical extension ‚ŕ‘ĺ‚Ť‚˘‚̂ŁC‚ť‚ę‚đl—ś‚É“ü‚ę‚˝Řœ[“x‚̐ݒ肪•K—v‚Ć‚Č‚éB‚Ü‚˝CBCC ‚̍D”­•”ˆĘ‚Ĺ‚ ‚é•@•”‚É‚¨‚˘‚ẮC•@—ƒ‚¨‚ć‚Ń•@—ƒa‚Ĺ‚Í‹Ř‘w‚܂ŐZ‚ˇ‚é—á‚Ş‘˝‚­C”S–Œ‚Ě‚Ý‚đŽc‚ˇ‚ŠCę‡‚É‚ć‚Á‚Ä‚Í‘S‘wŘœ‚đ—v‚ˇ‚é6jB

ˆČă‚ć‚čCBCC ‚ĚŠŽ‘Sœ‹Ž‚É•K—v‚Ȑ؏œ[“x‚đˆę—Ľ‚É‹K’股‚é‚ą‚Ć‚Í‚Ĺ‚Ť‚Č‚˘‚ށCŒ‹ßŒ^C•\ÝŒ^‚Ĺ‚ÍŽ‰–bD‚đ\•ŞŠÜ‚ß‚é[‚ł‚Ő؏œ‚ˇ‚ę‚΁C‘˝‚­‚Ěę‡‚ĹŞŽĄ‚ŞŠú‘Ň‚Ĺ‚Ť‚éB‚ľ‚Š‚ľCŽîᇌa‚Ě‘ĺ‚Ť‚ČÇ—á‚Ĺ‚ÍŽ‰–bD‘S‘wC‚Ü‚˝‚͉ş•”‘gD‚ŕŠÜ‚ß‚˝Řœ‚đ—v‚ˇ‚éę‡‚Ş‚ ‚éB‚ƒŠƒXƒN‘gDŒ^‚Ĺ‚ ‚éZŒ^C”÷ŹŒ‹ßŒ^C”Áó‹­”çÇŒ^‚ɂ‚˘‚ẮC­‚Č‚­‚Ć‚ŕŽ‰–bD‘S‘w‚Ü‚Ĺ‚ĚŘœ‚Ş•K—v‚Ĺ‚ ‚čC‰ş°‚Ě‹Ř‘wC““™‚̍‡•šŘœ‚đ—v‚ˇ‚éŠm—Ś‚ÍŒ‹ßŒ^‚ć‚č‚ŕ–ž‚ç‚Š‚ɍ‚‚˘B‰ş°’f’[‚đŠm”F‚ˇ‚é‚ɂ͏p’†v‘Ź•a—ŒŸ¸‚đ•š—p‚ˇ‚é‚ŠC‘ŚŽžÄŒš‚đs‚킸CŠŽ‘SŘœ‚đ‘gDŠw“I‚ÉŠm”F‚ľ‚Ä‚Š‚ç‚Ě“ńŠú“IŽčp‚Ć‚ˇ‚é•ű–@‚ŕ—L—p‚Ĺ‚ ‚éB

•śŒŁ

1j Takenouchi T, Nomoto S, Ito M: Factors influencing the linear depth of invasion of primary basal cell carcinoma, Dermatol Surg, 2001; 27: 393-396.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

2j ’|”V“ŕ’C–çCŽR“c@ăŕC–ě–{d•q‚Ů‚ŠFŠî’ę×–EŠŕ‚Ě‘gDŒ^‚Ɛ[•”ZC—Ő”çC2000; 54: 481-484.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

3j Hendrix JD Jr, Parlette HL, et al: Duplicitous growth of infiltrative basal cell carcinoma: Analysis of clinically undetected tumor extent in a paired case-control study, Dermatol Surg, 1996; 22: 535-539.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j Hendrix JD Jr, Parlette HL: Micronodular basal cell carcinoma. A deceptive histologic subtype with frequent clinically undetected tumor extension, Arch Dermatol, 1996; 132: 295-298.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Salasche SJ, Amonette RA: Morpheaform basal-cell epitheliomas. A study of subclinical extensions in a series of 51 cases, J Dermatol Surg Oncol, 1981; 7: 387-394.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

6j Terashi H, Kurata S, Hashimoto H, et al: Adequate depth of excision for basal cell carcinoma of the nose, Ann Plast Surg, 2002; 48: 214-216.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj


CQ8

Šî’ę×–EŠŕ‚̐؏œŽž‚ɁCŘœ’f’[‚̐v‘Ź•a—ŒŸ¸‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

B

Ä”­Ç—á‚⍂ƒŠƒXƒN‘gDŒ^‚ĚŠî’ę×–EŠŕ‚É‚¨‚˘‚ẮC“€Œ‹Ř•Đ‚É‚ć‚ép’†v‘Ź•a—ŒŸ¸‚É‚ć‚éŘœ’f’[‚ĚŠm”F‚ŞŠŠ‚ß‚ç‚ę‚éB

ƒAƒ‹ƒSƒŠƒYƒ€‚Ö


Ą‰đŕ

”’l‚ɐś‚ś‚éŠî’ę×–EŠŕiBCCj‚Ě‘˝‚­‚Í–łF‘fŤ‚ŁC•a—Šw“I‚É‚ŕ‚ƒŠƒXƒNŒ^‚Ě•p“x‚Ş”äŠr“I‚‚˘B‚ť‚̂悤‚Č”wŒi‚Š‚çCF‘fŤ‚Ĺ’áƒŠƒXƒN•a—Œ^‚Ě‘˝‚˘–{–M‚ĚBCC ‚É”ä‚ׁCpŒăÄ”­—Ś‚ލ‚‚˘B‚ľ‚˝‚Ş‚Á‚āC‰˘•Ä‚Ĺ‚ÍMohs ŽčpiŘœ”͈͂đĹŹ‚É‚ľC‚Š‚Ĕ­—Ś‚đ—}‚Ś‚éŽčp–@Bp’†‚É‚ˇ‚×‚Ä‚ĚŘœ’f’[‚đ“€Œ‹Ř•Đ‚ĹŠm”F‚ˇ‚éŽč–@B2 mm ƒ}[ƒWƒ“‚Š‚çŽn‚߁C2 mm ‚¸‚’ljÁ‚ވę”Ę“IB‚“x‚Č‹Zp‚Ən—ű‚ľ‚˝ƒXƒ^ƒbƒt‚Ş•K—vBj‚ŞĹ‚ŕ’ႢÄ”­—Ś‚đŽŚ‚ľC„§‚ł‚ę‚Ä‚˘‚é1, 2jB–{–M‚Ĺ‚ÍMohs Žčp‚Í‚Ů‚Ć‚ń‚Ǎs‚í‚ę‚Ä‚˘‚Č‚˘‚ށC–{–M‚Ĺ‚ĚŠO‰Č“IŘœÇ—áiŘœƒ}[ƒWƒ“3`10 mmC‰i‹v•W–{‚Ĺ’f’[Šm”Fj‚ƁC•Ä‘‚Ĺ‚ĚMohs ŽčpÇ—á‚đ”äŠr‚ľ‚˝•ń‚Ş‚ ‚éiŠłŽŇ”wŒi‚ÉŠÖ‚ľ‚āCŽîᇐF‘f‚Ě—L–ł‚Ş81“ vs. 20“ˆČŠO‚Í—LˆÓˇ‚Č‚ľjBŘœ”͈͂ŞMohs Žčp4.6 mm ‚ɑ΂ľ‚āCŠO‰Č“IŘœ5.3 mm ‚Ć—LˆÓ‚É‘ĺ‚Ť‚Š‚Á‚˝‚ށCÄ”­—Ś‚͍ˇ‚Ş‚Č‚Š‚Á‚˝3jB‰˘•Ä‚Ĺ‚ŕMohs Žčp‚ć‚č‚ŕ’f’[‚ĚŠm”F‰ÓŠ‚ޏ­‚Č‚˘C–{–M‚ōs‚í‚ę‚é‚悤‚ȏp’†“€Œ‹Ř•Đ‚Ĺ‚Ě’f’[Šm”F‚Ě•ń‚ŕ‚ ‚éB‚ť‚ĚŠm”F•ű–@‚Ş•ń–ˆ‚ÉˆŮ‚Č‚Á‚Ä‚˘‚é‚ŕ‚̂́CŘœ–Ę‚Ě‚ˇ‚×‚Ä‚đŒŸ“˘‚ˇ‚éen face section technique ‚đ—p‚˘‚Ä‚˘‚é•ń‚Ş‘˝‚˘B—Տ°“I‹ŤŠE‚Š‚ç2 mm ƒ}[ƒWƒ“‚Ő؏œ‚ľ‘S‘¤•ű’f’[‚Ć’†‰›•”‚̐[•”’f’[‚đŠm”F‚ľ‚˝p’†v‘Ź–@‚đŒŸ“˘‚ľ‚˝•ń‚ł́C‚ƒŠƒXƒNÇ—á‚̏‰”­—á‚Ĺ21“CÄ”­—á‚Ĺ‚Í45“‚Ć‚˘‚¤‚‚˘’f’[—zŤ—Ś‚đŽŚ‚ľC‚ƒŠƒXƒNCÄ”­Ç—á‚ɑ΂ľ‚Ă͏p’†v‘Ź‚đ•š—p‚ˇ‚ׂŤ‚Ĺ‚ ‚é‚ĆŒ‹˜_‚Ă‚Ż‚Ä‚˘‚é4jB557 —á‚đŒŸ“˘‚ľ‚˝•ń‚ł́Cp’†’ˇŽ˛C’ZŽ˛‚Ě4 •űŒü‚Ĺ’f’[Šm”F‚ľC—zŤ‚Ĺ‚ ‚ę‚Α¤•űŘœ–Ę‘S‘Ě‚Ě“€Œ‹•W–{‚đŒŸ“˘‚ˇ‚é‚Ć‚˘‚¤•ű–@‚ŁCMohs Žčp‚É•C“G‚ˇ‚éÄ”­—Ś’ቺ‚đ’BŹ‚Ĺ‚Ť‚˝‚Ć‚ľ‚Ä‚˘‚é5jBŠáˆÍ‚ĚŽîᇂŐ؏œ–Ę‚Ě‚ˇ‚ׂĂđp’†‚ÉŒŸ“˘‚ˇ‚é•ű–@‚ŕÄ”­—Ś‚Í’á‚Š‚Á‚˝6jB‰i‹v•W–{‚đ—p‚˘‚˝pŒă•a—ŒŸ¸‚É‚ć‚éŘœ’f’[‚ĚŠm”F‚É‚ć‚Á‚āC‰‰ńŽĄ—Ă—á‚Ĺ‚ÍMohs Žčp‚Ć“Ż“™‚̒ႢÄ”­—Ś‚ŞŽŚ‚ł‚ę‚Ä‚˘‚é‚ŞCÄ”­—á‚Ĺ‚Í5 ”NŒă‚ĚÄ”­—Ś‚ÉŠÖ‚ľ‚Ä–ž‚ç‚Š‚ÉMohs Žčp‚̐ŹŃ‚ޗǍD‚Ĺ‚ ‚Á‚˝7, 8jB

ˆČă‚Š‚çCBCCC“Á‚ɍ‚ƒŠƒXƒN•a•ĎiÄ”­C•a—Œ^C”­Ç•”ˆĘj‚ĚŽčp‚É‚¨‚˘‚ẮCp’†“€Œ‹Ř•Đ‚É‚ć‚éŘœ’f’[‚ĚŠm”F‚ސ„§‚ł‚ę‚é‚ŞCŠm”F‚͉”\‚ČŒŔ‚čŘœ–Ę‚Ě‘˝”‚Ě•”ˆĘ‚đs‚¤‚ą‚Ć‚Ş•K—v‚Ĺ‚ ‚éB‚˝‚ž‚ľCŘœŒăŠJ•ú‘n‚Ć‚ľ‚āC‰i‹v•W–{‚Ĺ‚Ě’f’[Šm”FŒă‚ɍČš‚ˇ‚é“ńŠú“IŽčp‚ÉŠÖ‚ľ‚Ä‚ÍBCC-CQ9 ‚đŽQĆB

•śŒŁ

1j Thissen MR, Neumann MH, Schouten LJ: A systematic review of treatment modalities for primary basal cell carcinomas, Arch Dermatol, 1999; 135: 1177-1183.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

2j Bath FJ, Perkins W, Bong J, et al: Interventions for basal cell carcinoma of the skin, Cochrane Database Syst Rev, CD003412, 2007;i1j.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

3j Â–ö@“NCNouri KCŕV‘ş‘ĺ•ă‚Ů‚ŠF•Ä‘‚¨‚ć‚Ń–{–M‚É‚¨‚Ż‚éŠî’ę×–EŠŕŽĄ—Ă‚Ě”äŠrŒŸ“˘C“ú”ç‰ďŽC2008: 118: 1713-1717.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j Cataldo PA, Stoddard PB, Reed WP: Use of frozen section analysis in the treatment of basal cell carcinoma, Am J Surg, 1990; 159: 561-563.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Bentkover SH, Grande DM, Soto H, et al: Excision of head and neck basal cell carcinoma with a rapid, crosssectional, frozen-section technique, Arch Facial Plast Surg, 2002; 4: 114-119.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

6j Wong VA, Marshall JA, Whitehead KJ, et al: Management of periocular basal cell carcinoma with modified en face frozen section controlled excision, Ophthal Plast Reconstr Surg, 2002; 18: 430-435.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

7j Smeets NW, Krekels GA, Ostertag JU, et al: Surgical excision vs Mohsf micrographic surgery for basal-cell carcinoma of the face: randomised controlled trial, Lancet, 2004; 364: 1766-1772.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

8j Mosterd K, Krekels GA, Nieman FH, et al: Surgical excision versus Mohsf micrographic surgery for primary and recurrent basal-cell carcinoma of the face: a prospective randomised controlled trial with 5-yearsf follow-up, Lancet Oncol, 2008; 9: 1149-1156.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj


CQ9

Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä“ńŠú“IŽčp‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

B

‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ‚ɑ΂ľ‚ẮC‰i‹v•W–{‚É‚ć‚č’f’[‰AŤ‚đŠm”F‚ľ‚˝ă‚ĹÄŒš‚ˇ‚é“ńŠú“IŽčp‚ÍŠŠ‚ß‚ç‚ę‚éB

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Ą‰đŕ

Šî’ę×–EŠŕiBCCj‚ĚŠO‰Č“IŽĄ—Ă‚É‚¨‚˘‚ẮC—Տ°“I•Ó‰‚đ‰z‚Ś‚˝‘gDŠw“IZisubclinical extensionj‚đŠŽ‘S‚ÉŠÜ‚ß‚˝Žîᇐ؏œ‚Ş•K—v‚Ĺ‚ ‚éB‰˘•Ä‚ōL‚­s‚í‚ę‚Ä‚˘‚éMohs Žčp‚́Cłí‘gD‚Ě‹]ľ‚đĹŹŒŔ‚É‚ľ‚Č‚Ş‚ç‘SŘœ’f’[–Ę‚ĚŽîᇏÁŽ¸‚đŠm”F‚ˇ‚éŽč–@‚Ĺ‚ ‚é‚ŞCŘœŽžŠÔ‚̉„’ˇCę”C‚Ě‹ZŽt‚Ş•K—v‚Č‚Ç‚ĚŽ–î‚Š‚çC‰˘•Ä‚Ć”äŠr‚ľ‚Ĉł“|“I‚ɔ畆ŠŕœëŠł”‚̏­‚Č‚˘–{–M‚Ĺ‚Ě•‹y‚Í“ď‚ľ‚˘B

Mohs Žčp‚Ě‘ă‘Ö–@‚Ć‚ľ‚āCƒzƒ‹ƒ}ƒŠƒ“ŒĹ’čƒpƒ‰ƒtƒBƒ“•ď–„Ř•Đ‚đ—p‚˘‚Đ؏œ’f’[‚Ě‘gDf’f‚đs‚˘CŠŽ‘SŘœ‚đŠm”F‚ľ‚˝ă‚Ĺ“ńŠú“I‚ÉŒ‡‘š‚ĚÄŒš‚đs‚¤Žčp–@‚ށC‰˘•Ä‚É‚¨‚˘‚Ä‚ŕustaged surgeryv‚âuslow Mohs surgeryv‚Č‚Ç‚Ě–źĚ‚Ĺ•ń‚ł‚ę‚Ä‚˘‚éBŠç–ĘBCC 279 —ái‰”­191 —áCÄ”­88 —áj‚ɑ΂ˇ‚é“ńŠú“IŽčp‚ĚÄ”­—Ś‚Í•˝‹Ď5 ”NŠĎŽ@‚Ĺ3“1jC“Şčň•”BCC 281 —á‚Ĺ3.6“2j‚ĆŽŚ‚ł‚ę‚Ä‚˘‚éB‚ƒŠƒXƒN•”ˆĘ‚É‘ÎŰ‚đi‚Á‚˝•ń‚ŕ‚Ý‚ç‚ęCŠáˆÍBCC 93 —ái‰”­86 —áCÄ”­7 —áj‚ɑ΂ˇ‚é5 ”NÄ”­—Ś‚͏‰”­—á‚Ĺ1.2“CÄ”­—á‚Ĺ12.5“3jCŠáˆÍŒ‹ßE’×ᇌ^BCC 31 —á‚Ĺ‚Í•˝‹Ď3 ”NŠĎŽ@‚ĹÄ”­—Ś0“4jC•@•”BCC 17 —á‚ɑ΂ľ‚ÄŠĎŽ@ŠúŠÔ‚Í2 ”N’ö“x‚Ĺ‚ ‚é‚ŞÄ”­—Ś0“5j‚Ĺ‚ ‚Á‚˝B‚Ü‚˝Cslow Mohs ‚ĆĚ‚ľ‚āC’ʏí‚ĚMohs Žčp‚ɏ€‚ś‚Đ؂čo‚ľ‚˝‰i‹v•W–{‚É‚ć‚éf’fŒă‚ɍČš‚đs‚Á‚˝•ń‚ł́C‚ƒŠƒXƒNÇ—á1,085 —á‚Ĺ‚Ě5 ”NÄ”­—Ś2.8“6jCŠáˆÍ278 —á‚ɑ΂ľ‚Ä‚Í0.54“7j‚Ĺ‚ ‚Á‚˝B–{–M‚Š‚ç‚ŕŽĺ‚ÉŠç–ʐł’†•”‚ĚBCC 27 —á‚đ‘ÎŰ‚É‚ľ‚˝“ńŠú“IŽčp‚Ě•ń‚Ş‚ ‚čC2 ”N”ź`9 ”N‚ĚŠĎŽ@‚ĹÄ”­‚đ”F‚ß‚Ä‚˘‚Č‚˘8jBMohs Žčp‚ŕ‚ľ‚­‚͏p’†v‘Ź•a—ŒŸ¸‚đ•š—p‚ľ‚˝ŠO‰Č“IŘœ‚Ć‚Ě”äŠrŽŽŒą‚͍s‚í‚ę‚Ä‚˘‚Č‚˘‚ށC‚˘‚¸‚ę‚Ě“ńŠú“IŽčp‚Ě•ń‚ŕ‚ƒŠƒXƒNÇ—á‚đ‘ÎŰ‚É‚ľ‚Ä‚˘‚Č‚Ş‚çCMohs Žčp‚Ć‘ťF‚Ě‚Č‚˘ŽĄ—ÐŹŃ‚đŽŚ‚ľ‚Ä‚˘‚éB

“ńŠú“IŽčp‚ĚƒƒŠƒbƒg‚Ć‚ľ‚ẮC“ÁŽę‚Č‹Zp‚đ—v‚ł‚Č‚˘‚ą‚ƁC‰i‹v•W–{‚É‚ć‚é‘gDf’f‚Í’f’[Šm”F‚ž‚Ż‚Ĺ‚Č‚­C‘ź‚̔畆ŽîᇂƂ̊ӕʂ̏ă‚Ĺ‚ŕłŠm‚Ĺ‚ ‚é‚ą‚Ć‚Ş‹“‚°‚ç‚ę‚éBˆę•űC•Ą”‰ń‚ĚŽčp‚đ—v‚ˇ‚é‚ą‚ƁCŘ‚čo‚ľ•ű‚É‚ŕ‚ć‚é‚ŞMohs Žčp‚̂悤‚ČŠŽ‘S‚Č’f’[Šm”F‚Í‚Ĺ‚Ť‚Č‚˘‚ą‚Ć‚ŞƒfƒƒŠƒbƒg‚Ć‚Č‚éB

ˆČă‚ć‚čC‚‚˘ƒŒƒxƒ‹‚Ĺ‚ĚƒGƒrƒfƒ“ƒX‚Í–R‚ľ‚˘‚ŕ‚̂́C‚ƒŠƒXƒNBCC ‚ɑ΂ˇ‚é‰i‹v•W–{‚đ—p‚˘‚˝“ńŠú“IŽčp‚́CMohs Žčp‚Ş•‹y‚ľ‚É‚­‚˘–{–M‚É‚¨‚˘‚Ă͐„§‚ł‚ę‚éŽč–@‚Ĺ‚ ‚éB

•śŒŁ

1j Niederhagen B, von Lindern JJ, Bergé S, et al: Staged operations for basal cell carcinoma of the face, Br J Oral Maxillofac Surg, 2000; 38: 477-479.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

2j Hüsler R, Schlittler FL, Kreutziger J, et al: Staged surgical therapy of basal cell carcinoma of the head and neck region: an evaluation of 500 procedures, Swiss Med Wkly, 2008; 138: 746-751.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

3j Khandwala MA, Lalchan SA, Chang BY, et al: Outcome of periocular basal cell carcinoma managed by overnight paraffin section, Orbit, 2005; 24: 243-247.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j David DB, Gimblett ML, Potts MJ, et al: Small margini2 mmjexcision of peri-ocular basal cell carcinoma with delayed repair, Orbit, 1999; 18: 11-15.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Eskiizmir G, Gençoğlan G, Temiz P, et al: Staged-surgery with permanent pathology for the management of high-risk nonmelanoma skin cancer of the nose, Eur Arch Otorhinolaryngol, 2011; 268: 117-121.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

6j Lawrence CM, Haniffa M, Dahl MG: Formalin-fixed tissue Mohs surgeryislow Mohsjfor basal cell carcinoma: 5-year follow-up data, Br J Dermatol, 2009; 160: 573-580.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

7j Morris DS, Elzaridi E, Clarke L, et al: Periocular basal cell carcinoma: 5-year outcome following Slow Mohs surgery with formalin-fixed paraffin-embedded sections and delayed closure, Br J Ophthalmol, 2009; 93: 474-476. iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

8j ŽR“c@ăŕC’|”V“ŕ’C–çC–ě–{d•q‚Ů‚ŠFŠî’ę×–EŠŕ‚ɑ΂ˇ‚é“ńŠú“IŽčp‚Ě—L—pŤC”畆—Տ°C1999; 38: 2055-2058.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj


CQ10

Žčp‚Ő؏œ’f’[—zŤ‚ĚŠî’ę×–EŠŕ‚ɏpŒă‚̒ljÁŽĄ—Ă‚đs‚¤‚ą‚Ć‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

B

‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ‚Í’f’[‰AŤ‚É‚Č‚é‚悤‚ɍĐ؏œ‚đs‚¤‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚éB•sŠŽ‘SŘœ—á‚ĹŽčp‚ލ˘“ď‚Š‚ŕ‚ľ‚­‚ÍŠó–]‚ľ‚Č‚˘ŠłŽŇ‚ɑ΂ľ‚ẮC•úŽËüŽĄ—Ă‚đl—ś‚ľ‚Ä‚ŕ‚悢B

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‚ƒŠƒXƒN•”ˆĘ‚ĚŠî’ę×–EŠŕiBCCj‚É‚¨‚˘‚ẮC\•Ş‚Ȑ؏œƒ}[ƒWƒ“‚ŞŠm•Ű‚Ĺ‚Ť‚¸C‘gDŠw“I‚ÉŽîᇂ̎c‘ś‚ŞŽw“E‚ł‚ę‚éę‡‚Ş‚ ‚éB‚ą‚Ěę‡‚Í•sŠŽ‘SŘœ‚ĚBCC ‚Ć’č‹`‚ł‚ęCÄ”­‚ĚƒŠƒXƒN‚ŕ‚‚­C’ljÁŽĄ—Ă‚đŒŸ“˘‚ˇ‚é•K—v‚Ş‚ ‚éB‚ť‚ą‚ĹŽŔŰ‚ɍĔ­‚ľ‚˝Ç—á‚ŕŠÜ‚߂āi‚ƒŠƒXƒNÇ—ájC’ljÁŽĄ—Ă‚đs‚¤‚Š‚Ç‚¤‚Š‚ŞŒŸ“˘‚ł‚ę‚éB•sŠŽ‘SŘœ‚ĚBCC 43 —á‚ɍĐ؏œ‚đs‚Á‚Ä‘gDŠw“I‚ÉŒŸ“˘‚ľ‚˝‚Ć‚ą‚ëCŽîᇍזE‚ĚŽc‘ś‚͂킸‚Š‚É7“‚Ĺ‚ ‚Á‚˝‚Ć‚˘‚¤•ń‚Ş‚ ‚é1jB‘ź•űC78 —á‚Ě•sŠŽ‘SŘœ—á‚đMohs –@‚ĹŒŸ“˘‚ľ‚˝‚Ć‚ą‚ëC55“‚ĹŽîᇍזE‚ĚŽc‘ś‚Ş”F‚ß‚ç‚ę‚˝‚Ć‚˘‚¤•ń‚ŕ‚ ‚é2jB

•ń‚ł‚ę‚Ä‚˘‚é•sŠŽ‘SŘœ—á‚ĚÄ”­—Ś‚ɂ‚˘‚ẮC•sŠŽ‘SŘœ—á60 —á’†‚Ě35 —ái58“jC34 —á’†‚Ě14 —ái41“j‚Ĺ‚ ‚Á‚˝B‘ź•űCÄŽĄ—Ă‚đs‚í‚Č‚Š‚Á‚˝•sŠŽ‘SŘœ—á‚Ě3 •Ş‚Ě2 ˆČă‚ĹÄ”­‚Ş”F‚ß‚ç‚ę‚Č‚Š‚Á‚˝‚Ć‚˘‚¤•ń‚ŕ‚ ‚éBÄ”­‚ĚƒŠƒXƒN‚ލ‚‚˘‚̂́C‘gDŠw“I‚ÉŽîᇕӉ‚Ɛ[•”’[‚Ě—ź•ű‚ÉŽîᇍזE‚ŞŽc‘ś‚ľ‚Ä‚˘‚éę‡‚ƁCÄ”­•a‘ƒ‚ɑ΂ľ‚Ä‚ł‚ç‚É•sŠŽ‘SŘœ‚ލs‚í‚ę‚˝ę‡‚Ĺ‚ ‚éB‚ť‚ĚŒ¤‹†‚É‚ć‚ę‚΁CŽîᇕӉ‚ÉŽc‘ś‚ˇ‚ę‚Î17“C[•”’f’[—zŤ‚Ěę‡‚Í33“‚Ĺ‚ ‚éBÄ”­‚Ě‘˝‚­‚Í3 ”NˆČ“ŕ‚É‹N‚ą‚čCĹ‰‚Ě5 ”N‚Ĺ82“CŽc‚č18“‚Ş‚ť‚ĚŒă‚Ě5 ”N‚ɐś‚ś‚é3`7jB

Ä”­—Ⴈ‚ć‚Ń•sŠŽ‘SŘœ‚̍‚ƒŠƒXƒNBCC ‚ɑ΂ľ‚Ä‚ÍˆČ‰ş‚̂悤‚Č‘Îˆ–@‚ލl‚Ś‚ç‚ę‚éB①ÄŘœF‘Ź‚â‚Š‚ɒljÁŽĄ—Ă‚đs‚¤2`4, 8jB‚ą‚ę‚ÍŠO‘¤•Ó‰‚Ě‚Ý‚ÉŽć‚čŽc‚ľ‚Ş‚ ‚čC‘gDŠw“I‚É‚ŕZŒXŒü‚Ş‚Č‚­C‚ł‚ç‚ɍĔ­•a‘ƒ‚Ĺ‚Č‚˘‚ą‚ƁC‚ƒŠƒXƒN•”ˆĘˆČŠO‚ĚÇ—á‚É“–‚Ä‚Í‚Ü‚é‚ƍl‚Ś‚ç‚ę‚é9, 10jB‘Ź‚â‚Š‚ɍĐ؏œ‚ľ‚˝BCC ‚Ě10 ”N‚Ĺ‚Ě”ńÄ”­—Ś‚Í91“C—Տ°“I‚ɍĔ­‚ľ‚Ä‚Š‚ç‚̐؏œŒă‚Ě‚ť‚ę‚Í40“‚Ĺ‚ ‚Á‚˝3jBŽc‘ś•a•Ď‚ĚŽĄ—Ă‚É‚Í“ńŠú“IŽčp‚ŕ‚ľ‚­‚͏p’†v‘Ź•a—ŒŸ¸‚đ•š—p‚ľ‚˝’ʏí‚̐؏œ–@‚Ş—LŒř‚Ĺ‚ ‚éB②•úŽËüŽĄ—ÁF“KŘ‚Ȑ؏œ’f’[‚ŞŠm•Ű‚ł‚ę‚Ä‚˘‚Č‚˘Ç—á‚ɑ΂ľpŒă‘Šú‚ɍĐ؏œ‚â•úŽËü—Ă–@‚đs‚¤‚ą‚Ć‚ĹÄ”­—Ś‚đ9“ˆČ‰ş‚É—}‚Ś‚é‚ą‚Ć‚Ş‚Ĺ‚Ť‚é11jB‚Ü‚˝C_ŒoŽüˆÍZ‚Ş’˜–ž‚ČÇ—áCT4 Ç—áCÄ”­—á‚ɑ΂ľ‚Ä‚ŕpŒă•úŽËü—Ă–@‚ލl—ś‚ł‚ę‚éBpŒă•úŽËü—Ă–@‚ĚƒXƒPƒWƒ…[ƒ‹‚Ć‚ľ‚āC50 Gy/20 •ŞŠ„/4 TŠÔ‚Ü‚˝‚Í60 Gy/30 •ŞŠ„/6 TŠÔ‚Ş—p‚˘‚ç‚ę‚éB③Œo‰ßŠĎŽ@FŽc‘ś•a•Ď‚Ş‚ ‚Á‚Ä‚ŕÄ”­‚ˇ‚éŠm—Ś‚Ş’á‚˘‚Ć‚˘‚¤——R‚Š‚çC‚ŕ‚ľ[•”’f’[‰AŤ‚ĹŠˆ“ŽŤ‚Ş’á‚˘‘gDŒ^‚Ĺ‚ ‚ę‚΁CŒo‰ßŠĎŽ@‚Ć‚˘‚¤‘I‘đŽˆ‚ŕl‚Ś‚ç‚ę‚éB‚ľ‚Š‚ľC‚ą‚̂悤‚Č•Ű‘ś“I•űj‚Ş“K‰ž‚Ć‚Č‚é‘Ώ۩łŽŇ‚Ě‘I‘đŠî€‚Í•s–ž‚Ĺ‚ ‚é12jB

•śŒŁ

1j Sarma DP, Griffing CC, Weilbaecher TG: Observation on the incompletely excised basal cell carcinomas, J Surg Oncol, 1984; 25: 79-80.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

2j Bieley HC, Kirsner RS, Reyes BA, et al: The use of Mohs micrographic surgery for determination of residual tumor in incompletely excised basal cell carcinoma, J Am Acad Dermatol, 1992; 26: 754-756.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

3j Richmond JD, Davie RM: The significant of incomplete excision in patients with basal cell carcinoma, Br J Plast Surg, 1987; 40: 63-67.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j DeSilva SP, Dellon AL: Recurrence rate of positive margin basal cell carcinoma: results of a five-year prospective study, J Surg Oncol, 1985; 28: 72-74.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Dellon AL, DeSilva SP, Connolly M, et al: Prediction of recurrence in incompletely excised basal cell carcinoma, Plast Reconstr Surg, 1985; 75: 860-871.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

6j Liu FF, Maki R, Warde P, et al: A management approach to incompletely excised basal cell carcinoma of skin, Int J Radiat Oncol Biol Phys, 1991; 20: 423-428.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

7j Silverman M, Kopf A, Gladstein A, et al: Recurrence rates of treated basal cell carcinomas. Part 4: X-ray therapy, J Dermatol Surg Oncol, 1992; 18: 549-554.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

8j Koplin I, Zarem HA: Recurrent basal cell carcinoma. A review concerning the incidence, behavior, and management of recurrent basal cell carcinoma, with emphasis on the incompletely excised lesion, Plast Reconstr Surg, 1980; 65: 656-664.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

9j Rippey JJ, Rippey R: Characteristic of incompletely excised basal cell carcinoma of the skin, Med J Aust, 1997; 166: 581-583.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

10j Rogalski C, Kauer F, Simon JC, et al: Meta-analysis of published data on incompletely excised basal cell carcinomas of the ear and nose with introduction of an innovative treatment strategy, J Dtsch Dermatol Ges, 2007; 5: 118-126.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

11j Hall VL, Leppard BJ, McGill J, et al: Treatment of basalcell carcinoma: comparison of radiotherapy and cryotherapy, Clin Radiol, 1986; 37: 33-34.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

12j Sussman LA, Liggins DF: Incompletely excised basal cell carcinoma: a management dilemma? Aust N Z J Surg, 1996; 66: 276-278.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj


CQ11

Šî’ę×–EŠŕ‚ɑ΂ˇ‚鍪ŽĄŽĄ—Ă‚Ć‚ľ‚Ä•úŽËü—Ă–@‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

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B

‹@”\‚␎—eŤ‚đl—ś‚ľ‚˝ę‡C•úŽËü—Ă–@‚ÍŠî’ę×–EŠŕ‚ĚŞŽĄŽĄ—Ă‚Ěˆę‚‚Ƃľ‚ÄŠŠ‚ß‚ç‚ę‚éB

ƒAƒ‹ƒSƒŠƒYƒ€‚Ö


Ą‰đŕ

Šî’ę×–EŠŕiBCCj‚͏Š‘ŽƒŠƒ“ƒpß“]ˆÚ‚≓Šu“]ˆÚ‚𐜂ś‚é‚ą‚Ć‚Í‹H‚Ĺ‚ ‚čCŽčp—Ă–@‚𒆐S‚Ć‚ľ‚˝‹ÇŠ—Ă–@‚É‚ć‚Á‚Ä90`99“‚ĚÇ—á‚ŞŽĄ–ü‚ˇ‚é1`4jB‚ľ‚Š‚ľCŽčp—Ă–@‚É”ş‚¤‹@”\’ቺ‚␎—eŤ‚̒ቺ‚ŞŒœ”O‚ł‚ę‚éę‡‚É‚Í•úŽËü—Ă–@‚ލs‚í‚ęC90“ˆČă‚ĚÇ—á‚Ĺ‹ÇŠ§Œä‚Ş“ž‚ç‚ę‚é1, 3`7jB•úŽËü—Ă–@‚Í’áNP‚Ĺ—ÇD‚ȐŹŃ‚đ“ž‚é‚ą‚Ć‚Ş‚Ĺ‚Ť‚鎥—Ă–@‚Ĺ‚ ‚é‚ŞC•p‰ń‚̒ʉ@‚â“ńŽŸ”­‚Ş‚ń‚Č‚Ç‚Ě–â‘č‚ŕ‚ ‚čC’x”­Ť—LŠQŽ–Ű‚đl—ś‚ľ60 ÎˆČăi‚Ü‚˝‚Í70 ÎˆČăj‚ĚÇ—á‚𒆐S‚ɍs‚¤‚ׂŤ‚ƍl‚Ś‚ç‚ę‚Ä‚˘‚é8jB

BCC ‚ɑ΂ˇ‚鎥—Ă–@‚𒟐ڔäŠr‚ľ‚˝ƒ‰ƒ“ƒ_ƒ€‰ť”äŠrŽŽŒą‚ɂ́C’ʏí‚̐؏œ‚ĆMohs ŽčpCŽčp‚Ć•úŽËü—Ă–@C•úŽËü—Ă–@‚Ć“€Œ‹—Ă–@‚đ”äŠr‚ľ‚˝ŽŽŒą‚Č‚Ç‚Ş‚ ‚é‚ŞCŽŽŒąƒfƒUƒCƒ“‚Č‚Ç‚É–â‘č“_‚ŞŽw“E‚ł‚ę‚Ä‚¨‚čŒŸŘ“IŽŽŒą‚Ć‚ľ‚Ä‚ĚˆĘ’u•t‚Ż‚͒Ⴂ1, 4, 9`11jBŒă‚ëŒü‚ŤŒ¤‹†‚Ĺ‚Í‚ ‚é‚Ş—ǍD‚ČŽĄ—ÐŹŃ‚Ş“ž‚ç‚ę‚Ä‚˘‚é‚ą‚ƁC‚Ü‚˝ŠłŽŇ‚É—^‚Ś‚éNP“x‚â—˜•ÖŤ‚Č‚Ç‚Şl—ś‚ł‚ęŽĺ‚ÉŽčp—Ă–@‚Ş‘I‘đ‚ł‚ę‚é‚ŞCˆČ‰ş‚ÉŽŚ‚ˇđŒ‚ɍ‡’v‚ľ‚˝ę‡‚É‚Í•úŽËü—Ă–@‚ލl—ś‚ł‚ę‚éB

•úŽËü—Ă–@‚đl—ś‚ˇ‚ׂŤó‹ľ‚Ć‚ľ‚ẮCŽîá‡‚Ş‘ĺ‚Ť‚­\•Ş‚Ȑ؏œ’f’[‚ŞŠm•Ű‚Ĺ‚Ť‚Č‚˘Ç—áCT4 Ç—áCÄ”­‚đŒJ‚č•Ô‚ˇÇ—áC“ŕ‰Č“I——R‚É‚ć‚čŽčp‚ލ˘“ď‚ČÇ—áCŽčp‹‘”Ű—áCŒűO‚âŠááفC•@CŽ¨‰îŽüˆÍ‚ĚŽîá‡‚Č‚Ç‚Ş‹“‚°‚ç‚ę‚é3, 8, 12jB•úŽËü—Ă–@‚Ě“K‰ž‚É‚ ‚˝‚Á‚Ă͈ŤŤŽîᇂđę–ĺ‚Ć‚ˇ‚é”畆‰Čˆă‚Ć•úŽËüŽĄ—Ðę–ĺˆă‚É‚ć‚éTd‚ČŒŸ“˘‚ޏd—v‚Ĺ‚ ‚éBŒťÝ‚Ĺ‚Í•\ÝŤŽîᇂɂ͎ĺ‚É“dŽqü‚Ş—p‚˘‚ç‚ęCŽîᇂ̐i“W”͈͂â[‚ł‚É‚ć‚Á‚Ä‚Í’´‚ˆłX ü‚đ‘g‚ݍ‡‚í‚š‚ÄŽĄ—Ă‚ˇ‚é6jB‰ß‹Ž‚ĚŒĂ‚˘•ń‚Ĺ‚Í1 ‰ńü—Ę‚Ş‚‚­’ZŠúŠÔ‚ĹĆŽË‚đI—š‚ł‚š‚éƒXƒPƒWƒ…[ƒ‹‚ŞŽĺ‚É—p‚˘‚ç‚ę‚Ä‚˘‚˝‚ށC1 ‰ńü—Ę‚Ş‚‚˘ę‡‚É‚Í’x”­Ť—LŠQŽ–Ű‚␎—eŤ‚̒ቺ‚Ş–â‘č‚Ć‚Č‚éBNCCN *’j‚ĚƒKƒCƒhƒ‰ƒCƒ“‚ł́C2 cm –˘–ž‚ĚŽîᇂɑ΂ľ‚Ă̓}[ƒWƒ“1`1.5 cm ‚đ‚‚Ż‚˝ĆŽË–ě‚Ĺ64 Gy/32 •ŞŠ„/6.4 TŠÔC55 Gy/20 •ŞŠ„/4 TŠÔC50 Gy/15 •ŞŠ„/3 TŠÔC35 Gy/5 •ŞŠ„/1 TŠÔ‚ĚƒXƒPƒWƒ…[ƒ‹‚ސ„§‚ł‚ę‚Ä‚˘‚éBŽîᇌa2 cm ˆČă‚Ěę‡‚É‚Í1.5`2.0 cm ‚Ěƒ}[ƒWƒ“‚đ‚‚Ż‚˝ĆŽË–ě‚Ĺ66 Gy/33 •ŞŠ„/6.6 TŠÔ‚Ć55 Gy/20 •ŞŠ„/4 TŠÔ‚ĚƒXƒPƒWƒ…[ƒ‹‚ސ„§‚ł‚ę‚Ä‚˘‚éBL”ÍˆÍ‚ÉĆŽË‚ˇ‚éę‡‚É‚Í1 ‰ńü—Ę‚đ2 Gy ’ö“x‚ɒቺ‚ł‚š‚˝ƒXƒPƒWƒ…[ƒ‹‚Ş–]‚Ü‚ľ‚˘B

•úŽËü—Ă–@‚Ě”ń“K‰ž‚Ć‚ľ‚ẮCŠî’ę×–E•ę”ÁÇŒóŒQCF‘fŤŠŁ”çÇCánćҏó•\”ç”­ˆçˆŮíÇC‹­”çÇ‚đ‚Í‚ś‚ß‚Ć‚ˇ‚éäPŒ´•aC“Ż•”ˆĘ‚ÉĆŽË‚ĚŠů‰‚Ş‚ ‚éÇ—á‚Č‚Ç‚Ş‹“‚°‚ç‚ęC•úŽËü—Ă–@‚É‚ć‚é“ńŽŸ”­‚Ş‚ń‚âd“Ä‚Č—LŠQŽ–Ű‚ސś‚ś‚é‰Â”\Ť‚ލ‚‚˘iNCCNjB

–’jNCCNFNational Comprehensive Cancer NetworkiVersion 2. 2013j

•śŒŁ

1j Bath-Hextall FJ, Perkins W, Bong J, et al: Interventions for basal cell carcinoma of the skin, Cochrane Database Syst Rev, 2007; CD003412.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

2j Rowe DE, Carroll RJ, Day CL Jr: Long-term recurrence rates in previously untreatediprimaryjbasal cell carcinoma: implications for patient follow-up, J Dermatol Surg Oncol, 1989; 15: 315-328.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

3j Fleming ID, Amonette R, Monaghan T, et al: Principles of management of basal and squamous cell carcinoma of the skin, Cancer, 1995; 75: 699-704.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

4j Thissen MR, Neumann MH, Schouten LJ: A systematic review of treatment modalities for primary basal cell carcinomas, Arch Dermatol, 1999; 135: 1177-1183.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

5j Locke J, Karimpour S, Young G, et al: Radiotherapy for epithelial skin cancer, Int J Radiat Oncol Biol Phys, 2001; 51: 748-755.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

6j Lovett RD, Perez CA, Shapiro SJ, et al: External irradiation of epithelial skin cancer, Int J Radiat Oncol Biol Phys, 1990; 19: 235-242.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

7j Neville JA, Welch E, Leffell DJ: Management of nonmelanoma skin cancer in 2007, Nat Clin Pract Oncol, 2007; 4: 462-469.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

8j Robin M, Bruce B, Richard B: Clinical Practice Guide Basal cell carcinoma, squamous cell carcinomaiand related lesionsj-a guide to clinical management in Australia. 2008.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

9j Smeets NW, Krekels GA, Ostertag JU, et al: Surgical excision vs Mohsf micrographic surgery for basal-cell carcinoma of the face: randomised controlled trial, Lancet, 2004; 364: 1766-1772.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

10j Avril MF, Auperin A, Margulis A, et al: Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study, Br J Cancer, 1997; 76: 100-106.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

11j Hall VL, Leppard BJ, McGill J, et al: Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy, Clin Radiol, 1986; 37: 33-34.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

12j Kwan W, Wilson D, Moravan V: Radiotherapy for locally advanced basal cell and squamous cell carcinomas of the skin, Int J Radiat Oncol Biol Phys, 2004; 60: 406-411.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj


CQ12

Šî’ę×–EŠŕ‚Ě‹ÇŠ‰ťŠw—Ă–@‚Ć‚ľ‚Ä5-FU “îp‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

C1

’჊ƒXƒN•”ˆĘ‚Ě•\ÝŒ^Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä‚Í5-FU “îp‚ލ‚‚˘‘tŒř—Ś‚đŽŚ‚ˇB“K‰žÇ—á‚đŒľ‘I‚ˇ‚ę‚΁CŽĄ—Ă–@‚Ć‚ľ‚čl—ś‚ľ‚Ä‚ŕ‚悢B

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Šî’ę×–EŠŕiBCCj‚ɑ΂ˇ‚é‹ÇŠ‰ťŠw—Ă–@Ü‚Ć‚ľ‚āCƒAƒƒŠƒJH•iˆă–ň‹ÇiFDAj‚̓`ƒ~ƒWƒ“‡Ź‘jŠQ–ň‚Ĺ‚ ‚é5-FU “îp‚Ě‚Ý‚đł”F‚ľ‚Ä‚˘‚éB‰ß‹Ž40 ”N‚É‚í‚˝‚éŽg—pŒoŒą‚Š‚çC5-FU ‹ÇŠŽĄ—Ă‚Í’áƒŠƒXƒN•”ˆĘ‚Ě•\ÝŒ^‚ÉŒŔ‚Á‚Ä“K‰ž‚Ş‚ ‚é‚ƍl‚Ś‚ç‚ę‚éB‚ą‚Ěę‡‚Í5“ 5-FU “îp‚É‚Ä95“ˆČă‚ĚŽĄ–ü—Ś‚Ş“ž‚ç‚ę‚é1`5jB•\ÝŒ^ˆČŠO‚Ě‘gDŒ^CÄ”­—áC‚ƒŠƒXƒN•”ˆĘ‚ɂ‚˘‚Ä‚Í5-FU “îp‚É‚ć‚鎥–ü—Ś‚Ş’á‚­CŠO—pŽĄ—Ă‚đs‚Á‚Ä‚ŕ[•”‚ÉŽîá‡‚ŞŽc‘ś‚ˇ‚é‰Â”\Ť‚ލ‚‚˘1`4, 6`8jBŒo•\”ç‹zŽű‚đ‚‚ß‚é‚˝‚ß‚Éphosphatidyl choline ‚đŠîÜ‚Ć‚ľ‚˝5-FU ƒNƒŠ[ƒ€‚ĚŽg—pŒoŒą‚âCƒGƒsƒlƒtƒŠƒ““Y‰ÁƒQƒ‹‚É‚ć‚éŽîá‡“ŕ’“ü‚ம‚Ý‚ç‚ę‚Ä‚˘‚é‚ŞC\•Ş‚ČƒGƒrƒfƒ“ƒX‚Í‚Č‚˘4, 9, 10jB

ˆę”Ę‚É‚Í5-FU ‹ÇŠ“Š—^‚́C5“ťÜ‚đ1 “ú2 ‰ńC­‚Č‚­‚Ć‚ŕ3`6 TŠÔi—Տ°“I”˝‰ž‚É‚ć‚Á‚Ä‚Í10 TŠÔˆČăjŒp‘ą‚ˇ‚éB\•Ş‚ČŽĄ—ĂŒř‰Ę‚đ“ž‚é‚˝‚߂ɂ́C5-FU ‚Ě”Z“xi1“‚ĚƒNƒŠ[ƒ€‚Č‚˘‚ľ—n‰tC2 ‚Č‚˘‚ľ5“‚ĚƒNƒŠ[ƒ€C5“‚Ě—n‰tjCŽg—p•p“xCƒhƒŒƒbƒVƒ“ƒO–@C—Տ°‘gDŠw“I•aŒ^CŠłŽŇ‚ĚƒXƒLƒ“ƒ^ƒCƒvCŽĄ—Ă‘OŒă‚Ě“úŒőĆŽË‚Ě’ö“x‚Č‚Ç‚Ě—vˆö‚đl—ś‚É“ü‚ę‚é•K—v‚Ş‚ ‚éB

–{Ü‚Ě—LŠQŽ–Ű‚Í‘ć1 ‚É“Š—^•”ˆĘ‚É‚¨‚Ż‚é‹}Ť‰ŠÇ”˝‰ž‚Ĺ‚ ‚éB‹ÇŠ‚Ěáu’É‚â”MŠ´Cg”ÁE•‚ŽîCZo‰t‚𔺂¤‚Ń‚ç‚ńE’×ᇁC“ńŽŸŠ´ő‚Ş‹“‚°‚ç‚ę‚éB“Á‚É”S–Œ‚Ě‹ß–T‚É“h•z‚ľ‚˝ę‡‚́C‚ą‚ę‚ç‚Ě•”ˆĘ‚ĚŠ´Šo‚މs•q‚Ć‚Č‚é‚˝‚ß’ˆÓ‚Ş•K—v‚Ĺ‚ ‚éB‰ŠÇ”˝‰žŽŠ‘Ě‚Í5-FU ŠO—p‚ĚŒř‰Ę‚đŽŚ‚ˇ‚ŕ‚Ě‚Ĺ‚ ‚čC‚Ţ‚ľ‚ë‚ť‚ę‚Ş‚Ý‚ç‚ę‚Č‚˘‚Ć‚Ť‚ÍŽĄ—Ă“ŕ—e‚đ•ĎX‚ľ‚Č‚Ż‚ę‚΂Ȃç‚Č‚˘B‘ć2 ‚ɉŠÇ”˝‰ž‚ĚŽĄ–üŒă‚É‹­‚˘F‘f’ž’…‚ŞŒť‚ęC’ˇŠúŠÔ‚É‚í‚˝‚Á‚Ä”ü—e“I–â‘č‚𐜂¸‚é‚ą‚Ć‚Ş‚ ‚éB‚Ü‚˝‚ƒŠƒXƒN•”ˆĘ‚ÉŽĄ—Ă‚đŽ{‚ľ‚˝ę‡‚́C”ěŒúŤá­‚ŕ–â‘č‚É‚Č‚éB‚ť‚Ě‘ź‚É‹H‚Ĺ‚Í‚ ‚é‚ŞC5-FU ‚Č‚˘‚ľ‚ť‚Ě—n‰t‚ɑ΂ˇ‚éƒAƒŒƒ‹ƒM[Ť‚̐ڐG”畆‰ŠCŽĄ—Ă‚É”ş‚¤Œőü‰ß•qÇCˆęŽž“I‚Č’Üb”—Ł‚Ć’ÜbˆŢkCŽ‘ą‚ˇ‚錌ŠÇŠg’ŁC–ňÜŤ‚Ě—Ţ“VávጁC‹•ŒŒŤSŽžŠłC‘ăŽÓy‘f‚ĚƒWƒqƒhƒƒsƒŠƒ~ƒWƒ“’E…‘fy‘fŒ‡‘šÇŠłŽŇ‚É‚¨‚Ż‚é‘Sg“ŐŤ‚Č‚Ç‚Ş•ń‚ł‚ę‚Ä‚˘‚é11jB

•śŒŁ

1j Reymann F: Treatment of basal cell carcinoma of the skin with 5-fluorouracili5-FUjointment. A 10-year follow- up study, Dermatologica, 1979; 158: 368-372.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

2j Klein E, Stoll HL Jr, Milgrom H, et al: Tumors of the skin. XII. Topical 5-fluorouracil for epidermal neoplasms, J Sug Oncol, 1971; 3: 331-349.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

3j Ebner H: Treatment of skin epitheliomas with 5-fluorouracili5-FUjointment. Influence of therapeutic design on recurrence of lesions, Dermatologica, 1970; 140iSuppl 1j: 42-46.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j Romagosa R, Saap L, Givens M, et al: A pilot study to evaluate the treatment of basal cell carcinoma with 5-fluorouracil using phosphatidyl choline as a transepidermal carrier, Dermatol Surg, 2000; 26: 338-340.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

5j Gross K, Kircik L, Kricorian G: 5“ 5-Fluorouracil cream for the treatment of small superficial basal cell carcinoma: efficacy, tolerability, cosmetic outcome, and patient satisfaction, Dermatol Surg, 2007; 33: 433-440. iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

6j Klostermann GF: Effects of 5-fluorouracili5-FUjointment on normal and diseased skin. Histological findings and deep action, Dermatologica, 1970; 140iSuppl 1j: 47-54.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj

7j Mohs FE, Jones DL, Bloom RF: Tendency of fluorouracil to conceal deep foci of invasive basal cell carcinoma, Arch Dermatol, 1978; 114: 1021-1022.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

8j Epstein E: Fluorouracil paste treatment of thin basal cell carcinoma, Arch Dermatol, 1985; 121: 207-213.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅲj

9j Bath FJ, Bong J, Perkins W, et al: Interventions for basal cell carcinoma of the skin, Cochrane Database Syst Rev, 2003; CD003413.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

10j Miller BH, Shavin JS, Cognetta A, et al: Nonsurgical treatment of basal cell carcinoma with intralesional 5-fluorouracil/ epinephrine injectable gel, J Am Acad Dermatol, 1997; 36: 72-77.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

11j Rozenman Y, Gurewich J, Gotsman MS: Myocardial ischemia induced by topical use of 5-fluorouracil, Int J Cardiol, 1995; 49: 282-283.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj


CQ13

Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä“€Œ‹—Ă–@‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

C1

Œ‹ßŒ^‚â•\ÝŒ^Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä‚Í“€Œ‹—Ă–@‚ލĔ­—Ś‚Í‚â‚⍂‚˘‚ŕ‚̂́C‚‚˘‘tŒř—Ś‚đŽŚ‚ˇB“K‰žÇ—á‚đŒľ‘I‚ˇ‚ę‚΁CŽĄ—Ă–@‚Ć‚ľ‚čl—ś‚ľ‚Ä‚ŕ‚悢B

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“€Œ‹—Ă–@‚͊ȕցCˆŔ‰ż‚Ŕ畆‰ČŽ{Ý‚Ĺ‚Í‚Ç‚ą‚Ĺ‚ŕs‚Ś‚é‚Ć‚˘‚¤—˜“_‚Ş‚ ‚éˆę•űCˆŤŤŽîᇂ̍Ĕ­—Ś‚͍‚‚˘‚ƍl‚Ś‚ç‚ę‚Ä‚˘‚é1jB

Šî’ę×–EŠŕiBCCj‚ɑ΂ˇ‚é“€Œ‹—Ă–@‚Ć•úŽËü—Ă–@‚đ”äŠr‚ľ‚˝ƒ‰ƒ“ƒ_ƒ€‰ťŽŽŒą‚Ĺ‚Í1 ”NŒăÄ”­—Ś‚Ş“€Œ‹—Ă–@ŒQ39“C•úŽËü—Ă–@ŒQ4“‚Ć•ń‚ł‚ę‚Ä‚˘‚é2j`4jBŒú‚˘•a•Ď‚Ĺ‚ÍÄ”­—Ś‚Şă‚Ş‚é‚ą‚Ć‚Şl‚Ś‚ç‚ę‚˝‚˝‚߁Cˆę’U•a•Ď‚đ‘~ংľ‚Ä”–‚­‚ľ‚˝ŒăC“€Œ‹—Ă–@‚ˇ‚é•ű–@‚ŞŽŽ‚Ý‚ç‚ę‚Ä‚˘‚éBŠO‰Č“IŘœ‚Ć‘~ঌă‚Ě“€Œ‹—Ă–@i“€Œ‹ƒXƒvƒŒ[‚Ĺ2 ƒTƒCƒNƒ‹j‚đ”äŠr‚ľ‚˝ŽŽŒą‚Ĺ‚Í1 ”NŒăÄ”­—ŚiŽčp0 “C “€Œ‹6.25 “ji“Şčň•”C •\ÝŒ^‚ĆŒ‹ßŒ^C Œa2 cm ˆČ‰şj5j ‚ƁC5 ”NŒăÄ”­—ŚiŽčp8.4“C“€Œ‹19.6“ji•\ÝŒ^‚ĆŒ‹ßŒ^CŒa2 cm ˆČ‰şj6j‚đ”äŠr‚ľ‚˝•ń‚Ş‚ ‚čC‚Ć‚ŕ‚É—LˆÓˇ‚Í‚Č‚Š‚Á‚˝‚Ć‚ľ‚Ä‚˘‚é‚ŞCŽ—e“IŒ‹‰Ę‚đŠÜ‚ߊO‰Č“IŘœ‚Ş—L‰v‚Ĺ‚ ‚é‚ĆŒ‹˜_‚ľ‚Ä‚˘‚éB

•\ÝŒ^‚ĆŒ‹ßŒ^‚Ě—źŽŇ‚đ‘ÎŰ‚Ć‚ľ‚˝Œőü—ÍŠw“I—Ă–@photodynamic therapyiPDTj‚Ć‚Ě”äŠrŽŽŒą‚ŁC1 ”NŒă‚Ě‘gDŠw“I‚ČÄ”­—Ś‚Í“€Œ‹—Ă–@ŒQ15“CPDT ŒQ25“‚ŁC10“‚̍ˇ‚Í‚ ‚é‚Ş—LˆÓ…€‚É‚ÍŽŠ‚炸C•aŒ^•Ę‚É‚Ý‚Ä‚ŕˇ‚Í”F‚ß‚ç‚ę‚Č‚Š‚Á‚˝7jB‚ľ‚Š‚ľ“€Œ‹—Ă–@‚ÍPDT ‚ć‚č‚஡—ĂŒă‚̐Ž—e–Ę‚Ĺ‚Í—LˆÓ‚É—ň‚Á‚Ä‚˘‚˝B

•ńŽŇ‚Ě‘˝‚­‚ށC“€Œ‹—Ă–@‚Ě‘ÎŰ‚đŒ‹ßŒ^‚¨‚ć‚Ń•\ÝŒ^‚ĚBCC ‚Ć‚ľ‚Ä‚¨‚čC‚ą‚ę‚ç’჊ƒXƒNÇ—á‚ÉŒŔ‚ę‚ÎŽčp•s”\—á‚Ĺ‚ÍŒŸ“˘‚ľ‚Ä‚ŕ‚悢‚ށCÄ”­—ŚCŽ—e–Ę‚đl—ś‚ˇ‚é‚Ć‹­‚­„§‚ˇ‚é‚ą‚Ć‚Í‚Ĺ‚Ť‚Č‚˘BˆŔ‰ż‚ĹŠČ•Ö‚ČŽĄ—Ă–@‚Ĺ‚ ‚čC‹ď‘Ě“I‚ɂ́C‰t‘Ě’‚‘fƒXƒvƒŒ[‚ĹĹ’á2 ‰ń‚Ě“€Œ‹ƒTƒCƒNƒ‹‚Č‚Ç‚Ş„§‚ł‚ę‚Ä‚˘‚é8jB‚ľ‚Š‚ľC‹ŤŠE•s–ž—Ä‚Č”Áó‹­”çÇŒ^CZŒ^‚âÄ”­—á‚Č‚Ç‚ƒŠƒXƒNŽîᇂɑ΂ľ‚Ä‚ĚƒGƒrƒfƒ“ƒX‚Í‚Č‚­C„§‚Ĺ‚Ť‚Č‚˘B

•śŒŁ

1j Thissen MR, Neumann MH, Schouten LJ: A systematic review of treatment modalities for primary basal cell carcinomas, Arch Dermatol, 1999; 135: 1177-1183.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

2j Hall VL, Leppard BJ, McGill J, et al: Treatment of basal-cell carcinoma: comparison of radiotherapy and cryotherapy, Clin Radiol, 1986; 37: 33-34.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

3j Kokoszka A, Scheinfeld N: Evidence-based review of the use of cryosurgery in treatment of basal cell carcinoma, Dermatol Surg, 2003; 29: 566-571.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

4j Bath FJ, Perkins W, Bong J, et al: Interventions for basal cell carcinoma of the skin, Cochrane Database Syst Rev, 2007; CD003412.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

5j Thissen MR, Nieman FH, Ideler AH, et al: Cosmetic results of cryosurgery versus surgical excision for primary uncomplicated basal cell carcinomas of the head and neck, Dermatol Surg, 2000; 26: 759-764.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

6j Kuijpers DI, Thissen MR, Berretty PJ, et al: Surgical excision versus curettage plus cryosurgery in the treatment of basal cell carcinoma, Dermatol Surg, 2007; 33: 579-587.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

7j Wang I, Bendsoe N, Klinteberg CA, et al: Photodynamic therapy vs. cryosurgery of basal cell carcinomas: results of a phase Ⅲ clinical trial, Br J Dermatol, 2001; 144: 832-840.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

8j Mallon E, Dawber R: Cryosurgery in the treatment of basal cell carcinoma. Assessment of one and two freezethaw cycle schedules, Dermatol Surg, 1996; 22: 854-858.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj


CQ14

Šî’ę×–EŠŕ‚ɑ΂ľ‚ÄŒőü—ÍŠw“I—Ă–@iphotodynamic therapyG PDTj‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

 

•\ÝŒ^‚¨‚ć‚ŃŒ‹ßŒ^Šî’ę×–EŠŕ

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C1

•\ÝŒ^‚¨‚ć‚ŃŒ‹ßŒ^Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä‚ÍPDT ‚ލĔ­—Ś‚Í‚â‚⍂‚˘‚ŕ‚̂́C‚‚˘‘tŒř—Ś‚đŽŚ‚ˇB“K‰žÇ—á‚đŒľ‘I‚ˇ‚ę‚΁CŽĄ—Ă–@‚Ć‚ľ‚čl—ś‚ľ‚Ä‚ŕ‚悢i2013 ”N12 ŒŽŒťÝ•ŰŒŻ“K—pŠOjB

 

‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ

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C2

‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ‚ɑ΂ľ‚ÄPDT ‚ÍŠŠ‚ß‚ç‚ę‚Č‚˘i2013 ”N12 ŒŽŒťÝ•ŰŒŻ“K—pŠOjB

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Šî’ę×–EŠŕiBCCj‚Ě•W€ŽĄ—Ă‚ÍŠO‰Č“IŘœ‚Ĺ‚ ‚é‚ŞC”ńŠO‰Č“IŽĄ—Ă‚Ć‚ľ‚ÄŒőü—ÍŠw“I—Ă–@iphotodynamic therapyGPDTj‚މ˘•Ä‚𒆐S‚É“ą“ü‚ł‚ęC–{–M‚É‚¨‚˘‚Ä‚ŕˆę•”Ž{Ý‚É‚¨‚˘‚čs‚í‚ę‚Ä‚˘‚éBŒőüŠ´ŽóŤ•¨Žż‚Ć‚ľ‚ăAƒƒŠƒJCƒJƒiƒ_C“ú–{‚Ĺ‚Í5-aminolevulinic acidiALAj‚ށCƒˆ[ƒƒbƒpCƒI[ƒXƒgƒ‰ƒŠƒA‚Ĺ‚Ímethyl aminolevulinateiMALj‚ŞŒťÝ—p‚˘‚ç‚ę‚Ä‚˘‚éB

BCC ‚ɑ΂ˇ‚éALA-PDT ‚̏‰Šú‚Ě—Ő°ŽŽŒą‚É‚¨‚Ż‚銎‘S‘tŒř—Ś‚́C•\ÝŒ^‚Ĺ80`100“1`4jCŒ‹ßŒ^‚Ĺ10`50“‚Ć•ń‚ł‚ę‚Ä‚˘‚é1, 4jB‘ĺŒ^—á‚â‘˝”­—á‚đ‘ÎŰ‚Ć‚ľ‚˝•\ÝŒ^BCC ‚Ě’ˇŠúŠŽ‘S‘tŒř—Ś‚Í‚ť‚ę‚ź‚ę78“C86“‚Ĺ‚ ‚Á‚˝3jB

‹ß”NC‘ź‚ĚŽĄ—Ă–@‚đ‘ÎĆ‚Ć‚ľ‚˝ƒ‰ƒ“ƒ_ƒ€‰ť”äŠrŽŽŒą‚Ş•ń‚ł‚ę‚é‚悤‚É‚Č‚Á‚˝5jBŠO‰Č“IŘœ‚đ‘ÎĆ‚Ć‚ľ‚˝4 •ń‚Ě‚¤‚żC•\ÝŒ^BCC ‚ɑ΂ˇ‚éMAL-PDT ‚ĆŠO‰Č“IŘœ‚Ě”äŠrŽŽŒą‚Ĺ‚Ě3 ƒJŒŽŠŽ‘S‘tŒř—Ś‚ÍPDT ŒQ92“‚ɑ΂ľ‚ÄŠO‰Č“IŘœŒQ99“C‘tŒř—á‚Ě1 ”NŒăÄ”­—Ś‚ÍPDT ŒQ9“CŠO‰Č“IŘœŒQ0“‚Ĺ‚ ‚Á‚˝6jBŒ‹ßŒ^BCC ‚ɑ΂ˇ‚éALA-PDT ‚ĆŠO‰Č“IŘœ‚Ě”äŠr‚Í2 •Ń•ń‚ł‚ęC1 •Ň‚Í1 ”NŠŽ‘S‘tŒř—Ś‚Ş62“ vs 79“‚Ĺ—LˆÓˇ‚ÉŽŠ‚炸7jC‚ŕ‚¤1 •Ň‚Í3 ”NÄ”­Žc‘ś—Ś‚Ĺ30“ vs 2“‚ĹPDT ‚Ĺ‚Í—LˆÓ‚ÉŽĄ—ĂŒř‰Ę‚Ş—ň‚Á‚Ä‚˘‚˝8jBŒ‹ßŒ^BCC ‚ɑ΂ˇ‚éMAL-PDT ‚ĆŠO‰Č“IŘœ‚Ć‚Ě”äŠrŽŽŒą‚ł́C5 ”N‘tŒřˆŰŽ—Ś‚Ć‚ľ‚Ä76“ vs 96“‚Ĺ‚â‚Í‚čŠO‰Č“IŘœ‚Ě—DˆĘŤ‚ŞŽŚ‚ł‚ę‚Ä‚˘‚é9jB‚ą‚ę‚ç4 ŽŽŒą‚Ě“ŕ‚Ě2 ‚‚ĹPDT ŒQ‚Ě•ű‚ސŽ—e–Ę‚Ĺ—D‚ę‚Ä‚˘‚˝BPDT ‚Ć“€Œ‹—Ă–@‚Ě”äŠrŽŽŒą‚Í2 •Ň•ń‚ł‚ę‚Ä‚¨‚čC‚˘‚¸‚ę‚ŕÄ”­—Ś‚É—LˆÓˇ‚Í‚Ý‚ç‚ę‚Č‚Š‚Á‚˝‚ށCŽ—eŒř‰Ę‚Ĺ‚ÍPDT ‚Ş—D‚ę‚Ä‚˘‚˝10, 11jB‚ą‚ę‚ç‚Ě—Ő°ŽŽŒą‚ĚŒ‹‰Ę‚đ‘Š‡‚ˇ‚é‚ƁCPDT ‚ÍŠO‰Č“IŘœ‚É”ä‚ׂĒZŠú“I‚Č‘tŒř‚Í‚Ů‚Ú“Ż“™‚É“ž‚ç‚ę‚é‚ŞC’ˇŠú“I‚ČŠ°‰đˆŰŽŒř‰Ę‚Í–ž‚ç‚Š‚É—ň‚éBPDT ‚Ć“€Œ‹—Ă–@‚Ć‚ÍŽĄ—ĂŒř‰Ę‚Í‚Ů‚Ú“Ż“™‚Ĺ‚ ‚éBŽ—eŒř‰Ę‚Ě“_‚Ĺ‚Í‚˘‚¸‚ę‚ĚŽĄ—Ă‚Ć”äŠr‚ľ‚Ä‚ŕPDT ‚Ş—D‚ę‚é‚ą‚Ć‚ŞŽŚ‚ł‚ę‚˝B

“ú–{l‚ő唟‚đč‚ß‚éF‘fŤBCC ‚ł́Cƒƒ‰ƒjƒ“‚Ě‘śÝ‚É‚ć‚čŒőü‚Ş‹zŽű‚ł‚ę‚é‚˝‚ß‚É—LŒřŤ‚Ş—ň‚é4jB‚ť‚Ě——R‚Š‚çC‘Oq‚Ě6 ‚Â‚Ěƒ‰ƒ“ƒ_ƒ€‰ť”äŠrŽŽŒą‚Ě‚¤‚ż4 ‚‚ɂ¨‚˘‚ĐF‘fŤBCC ‚Í‘ÎŰ‚Š‚珜ŠO‚ł‚ę‚Ä‚˘‚éBItoh ‚ç‚Í‚ť‚Ě“_‚đl—ś‚ľCŒ‹ßŒ^BCC 16 •a‘ƒ‚ɑ΂ľ‚Ä‘~ঁ{“d‹CŠŁŒĹ—Ă–@‚ĆALA-PDT ‚Ě•š—p—Ă–@‚đs‚˘C14 •a‘ƒ‚Ĺ—Ő°“I‚ČŠŽ‘S‘tŒř‚đŠĎŽ@‚ľ‚˝12jB‚Ü‚˝C‰˝ě‚ç‚Í”w•”‚Ě•\ÝŒ^BCC 3 —á‚ĆŒ‹ßŒ^BCC 2 —á‚đ‘ÎŰ‚Ć‚ľ‚˝ALA-PDT Œă‚Ě‘gDŠw“I•]‰ż‚ŁC4 —á‚ĚŠŽ‘S‘tŒř‚Ć1 —á‚Ě•”•Ş‘tŒř‚đŠĎŽ@‚ľ‚˝13jB‚˘‚¸‚ę‚ĚŒ¤‹†‚ŕ’ˇŠúŠĎŽ@‚Í‚Č‚ł‚ę‚Ä‚˘‚Č‚˘‚ށC“ú–{l‚Ĺ‚ľ‚Š‚ŕF‘fŤBCC ‚đ‘ÎŰ‚Ć‚ľ‚˝“_‚Ĺ‚Í‹Md‚Č•ń‚Ĺ‚ ‚éB

ˆČă‚ć‚čCBCC ‚ɑ΂ˇ‚éPDT ‚Í’ˇŠú“I‚ČŞŽĄŤ‚Ě“_‚ĹŠO‰Č“IŘœ‚đă‰ń‚é‚ŕ‚Ě‚Ĺ‚Í‚Č‚˘‚ށC‘ĺŒ^—á‚â‘˝”­—á‚ɑ΂ľ‚Ä‚Ě“K‰ž‚Í‚ ‚éB‚ľ‚Š‚ľC“ú–{l‚É‘˝‚˘F‘fŤBCC ‚đ‘ÎŰ‚Ć‚ľ‚˝ƒGƒrƒfƒ“ƒX‚Ş–R‚ľ‚˘‚˝‚߁C–{–MƒKƒCƒhƒ‰ƒCƒ“‚Ć‚ľ‚ÄŒťŽž“_‚ō‚‚˘ƒOƒŒ[ƒh‚Ő„§‚Ĺ‚Ť‚é’iŠK‚É‚Í‚Č‚˘B

•śŒŁ

1j Wolf P, Rieger E, Kerl H: Topical photodynamic therapy with endogenous porphyrins after application of 5-aminolevulinic acid. An alternative treatment modality for solar keratoses, superficial squamous cell carcinomas, and basal cell carcinomas? J Am Acad Dermatol, 1993; 28: 17-21.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

2j Soler AM, Angell-Petersen E, Warloe T, et al: Photodynamic therapy of superficial basal cell carcinoma with 5-aminolevulinic acid with dimethylsulfoxide and ethylendiaminetetraacetic acid: a comparison of two light sources, Photochem Photobiol, 2000; 71: 724-729.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

3j Morton CA, Whitehurst C, McColl JH, et al: Photodynamic therapy for large or multiple patches of Bowen disease and basal cell carcinoma, Arch Dermatol, 2001; 137: 319-324.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j Calzavara-Pinton PG: Repetitive photodynamic therapy with topical delta-aminolaevulinic acid as an appropriate approach to the routine treatment of superficial nonmelanoma skin tumours, J Photochem Photobiol B, 1995; 29: 53-57.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Bath FJ, Perkins W, Bong J, et al: Interventions for basal cell carcinoma of the skin, Cochrane Database Syst Rev, 2007; CD003412.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

6j Szeimies R, Ibbotson S, Murrell D, et al: A clinical study comparing methyl aminolevulinate photodynamic therapy and surgery in small superficial basal cell carcinoma i8-20 mmj, with a 12-month follow-up, J Eur Acad Dermatol Venereol, 2008; 22: 1302-1311.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

7j Berroeta L, Clark C, Dawe R, et al: A randomized study of minimal curettage followed by topical photodynamic therapy compared with surgical excision for low-risk nodular basal cell carcinoma, Br J Dermatol, 2007; 157: 401-403.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

8j Mosterd K, Thissen M, Nelemans P, et al: Fractionated 5-aminolaevulinic acid-photodynamic therapy vs. surgical excision in the treatment of nodular basal cell carcinoma: results of a randomized controlled trial, Br J Dermatol, 2008; 159: 864-870.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

9j Rhodes L, de Lie M, Leifsdottir R, et al: Five-year followup of a randomized, prospective trial of topical methyl aminolevulinate photodynamic therapy vs surgery for nodular basal cell carcinoma, Arch Dermatol, 2007; 143: 1131-1136.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

10j Wang I, Bendsoe N, Klinteberg CA, et al: Photodynamic therapy vs. cryosurgery of basal cell carcinomas: results of a phase Ⅲ clinical trial, Br J Dermatol, 2001; 144: 832-840.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

11j Basset-Seguin N, Ibbotson S, Emtestam L, et al: Topical methyl aminolaevulinate photodynamic therapy versus cryotherapy for superficial basal cell carcinoma: a 5 year randomized trial, Eur J Dermatol, 2008; 18: 547-553.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

12j Itoh Y, Henta T, Ninomiya Y, et al: Repeated 5-aminolevulinic acid-based photodynamic therapy following electro-curettage for pigmented basal cell carcinoma, J Dermatol, 2000; 27: 10-15.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

13j ‰˝ě‰FŒ[C•Ÿ“c’m—YFLED ŒőŒš‚đ—p‚˘‚˝BCC ‚ɑ΂ˇ‚éPDT‚ĚŒŸ“˘, Skin Cancer, 2009; 24: 442-449.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅴj


CQ15

Šî’ę×–EŠŕ‚ɑ΂ľ‚ăCƒ~ƒLƒ‚ƒhŠO—p‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

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C1

•\ÝŒ^Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä‚Í5“ƒCƒ~ƒLƒ‚ƒhƒNƒŠ[ƒ€‚ލĔ­—Ś‚Í‚â‚⍂‚˘‚ŕ‚̂́C‚‚˘‘tŒř—Ś‚đŽŚ‚ˇB“K‰žÇ—á‚đŒľ‘I‚ˇ‚ę‚΁CŽĄ—Ă–@‚Ć‚ľ‚čl—ś‚ľ‚Ä‚ŕ‚悢i2013 ”N12 ŒŽŒťÝ•ŰŒŻ“K—pŠOjB

ƒAƒ‹ƒSƒŠƒYƒ€‚Ö


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ƒCƒ~ƒLƒ‚ƒh‚ÍŽ÷ó×–E‚âƒ}ƒNƒƒtƒ@[ƒW‚Č‚Ç‚É”­Œť‚ľ‚Ä‚˘‚étoll-like receptor 7 ‚É’źÚŒ‹‡‚ľCŽŠ‘R–Ɖu‚đŠˆŤ‰ť‚ˇ‚é“úŒőŠp‰ťÇ‚ƐëŒ\ƒRƒ“ƒWƒ[ƒ}ŽĄ—Ă–ň‚Ĺ‚ ‚éBŠî’ę×–EŠŕiBCCj‚Ĺ‚Íƒvƒ‰ƒZƒ{‚Ć‚Ě”äŠrŽŽŒą‚ޏI—š‚ľ‚Ä‚¨‚čC•Ä‘‚ōs‚í‚ę‚˝ŽŽŒą‚ł́C•\ÝŒ^BCC ‚ɑ΂ľ6 TŠÔ–ˆ“ú‚Ü‚˝‚Í5 ‰ń/ T‚ĚŠO—p‚ŁC‚ť‚ę‚ź‚ę81“C79“‚Ě•a—Šw“IÁŽ¸—Ś‚đŽŚ‚ľ‚Ä‚˘‚é1jB‰˘B‚Ĺ‚ŕ“Ż—l‚ĚŽŽŒą‚ލs‚í‚ęC•\ÝŒ^BCC ‚ɑ΂ľ6 TŠÔ˜A“ú‚ĚŠO—p‚ŁC80“‚Ě•a—Šw“IÁŽ¸—Ś‚đŽŚ‚ľ‚Ä‚˘‚é2jB5 ‰ń/ T‚ĚŠO—pŽĄ—ĂŒă12 TŒă‚Ĺ—Ő°“IÁŽ¸‚đ”F‚ß‚˝163 —ái•a•ĎÁŽ¸89.6“C‘S182 —áj‚Ě‚¤‚żC5 ”NŒă‚Ü‚Ĺ‚É—Ő°“I‚ɍĔ­‚ľ‚˝‚Ě‚Í18 —á‚ŁC‘SÇ—á‚Ě5 ”NŒăŠTŽZ‘tŒř—Ś‚Í77.9“‚ƍ‚‚˘‘tŒř—Ś‚đˆŰŽ‚ľ‚Ä‚˘‚˝3jB“Ż—l‚Ě5 ”NŠÔ‚Ě’ˇŠú‘tŒř—Ś‚đŽŚ‚ľ‚˝•ń‚ŕ‚ ‚é4jB

Œ‹ßŒ^‚Ĺ‚Í12 TŠÔ˜A“ú1 ‰ńŠO—p‚Ĺ76“i16/21j‚Ě‘tŒř—Ś‚đŽŚ‚ľ‚˝‚Ć‚ˇ‚é•ń‚ŕ‚ ‚é5j‚ށC8 T‚Ü‚˝‚Í12 T‚Ě˜A“úŠO—p‚Ĺ•a—Šw“IÁŽ¸—Ś‚Í2/3 ˆČ‰ş‚Ĺ‚ ‚Á‚˝‚ą‚Ć‚Š‚玥—ĂŒă‚Ě‘SŘœśŒŸ‚Ş•K—v‚ĆŒ‹˜_‚ľ‚˝•ń6jCMohs Žčp‘O‚̏p‘OŽĄ—Ă‚Ć‚ľ‚ÄŽ{s‚ľ‚˝ę‡‚੮‘SÁŽ¸—Ś‚Í42“‚Ĺ‚ ‚Á‚˝•ń7j‚Č‚Ç’P“ĆŽĄ—Ă‚ĚŒŔŠE‚đŽŚ‚ˇ‚ŕ‚Ě‚Ş‘˝‚­CŒ‹ßŒ^‚Ö‚Ě“K—p‚ÍŒťŽž“_‚ł͐„§‚Ĺ‚Ť‚Č‚˘B‚â‚Í‚čŽîᇂ̌ú‚Ý‚Ş‘‚ˇ‚ɂ‚ę‘tŒř—Ś‚Ş’á‰ş‚ˇ‚é‚悤‚Ĺ‚ ‚é8jBˆę•űC‘~ঁE“d‹C‹ĂŒĹŒă‚ÉŽg—p‚ˇ‚ę‚ΗL—p‚Ĺ‚ ‚Á‚˝‚Ć‚˘‚¤•ń‚â9jCƒCƒ~ƒLƒ‚ƒhŠO—p”TŠÔŒă‚É“€Œ‹—Ă–@‚đŽ{s‚ľC‚ł‚ç‚ɐ”TŠÔŠO—p‚đ‘ą‚Ż‚é‚Ć‚˘‚¤•ű–@‚ŁCÄ”­—áŠÜ‚Ţ21 —á‘S—á‚Ĺ—Ő°“IÁŽ¸C18 ƒJŒŽŒă‚Ü‚Ĺ‚ĚŠĎŽ@‚Ĺ1 —á‚Ě‚Ý‚ÉÄ”­‚đ”F‚ß‚˝‚Ć‚Ě•ń‚ŕ‚ ‚é10jB

—LŠQŽ–Ű‚Ć‚ľ‚Ă͍g”ÁC‚Ń‚ç‚ńC’×ᇁC‹ÇŠŽhŒƒŠ´‚Č‚Ç‚Ě‹ÇŠ”˝‰ž‚ŞŽĺ‘Ě‚Ĺ‚ ‚čCˆŔ‘S‚ÉŽg—p‚Ĺ‚Ť‚é‚ŞC“h•z•”ˆĘ‚̐F‘f’Eo‚Ě•ń‚Ş‘˝‚­8jC–{–M‚Ĺ‚Í–â‘č‚É‚Č‚é‰Â”\Ť‚Ş‚ ‚éB

ˆČă‚ć‚čC•\ÝŒ^BCC ‚ÉŒŔ’股‚ę‚΁C5“ƒCƒ~ƒLƒ‚ƒhƒNƒŠ[ƒ€‚Ě6 TŠÔC5`7 ‰ń/ T‚ĚŠO—p‚Í—L—p‚Š‚ˆŔ‘S‚Ĺ‚ ‚čCŽčp‚ލ˘“ď‚ČÇ—á‚É‚¨‚˘‚Ă͍l—ś‚ł‚ę‚Ă悢B

•śŒŁ

1j Geisse J, Caro I, Lindholm J, et al: Imiquimod 5“ cream for the treatment of superficial basal cell carcinoma: results from two phase Ⅲ, randomized, vehicle-controlled studies, J Am Acad Dermatol, 2004; 50: 722-733.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

2j Schulze HJ, Cribier B, Requena L, et al: Imiquimod 5“ cream for the treatment of superficial basal cell carcinoma: results from a randomized vehicle-controlled phase Ⅲ study in Europe, Br J Dermatol, 2005; 152: 939-947.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

3j Gollnick H, Barona CG, Frank RG, et al: Recurrence rate of superficial basal cell carcinoma following treatment with imiquimod 5“ cream: conclusion of a 5-year longterm follow-up study in Europe, Eur J Dermatol, 2008; 18: 677-682.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j Quirk C, Gebauer K, DefAmbrosis B, et al: Sustained clearance of superficial basal cell carcinomas treated with imiquimod cream 5“Fresults of a prospective 5-year study, Cutis, 2010; 85: 318-324.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Shumack S, Robinson J, Kossard S, et al: Efficacy of topical 5“ imiquimod cream for the treatment of nodular basal cell carcinoma: comparison of dosing regimens, Arch Dermatol, 2002; 138: 1165-1171.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

6j Eigentler TK, Kamin A, Weide BM, et al: A phase Ⅲ, randomized, open label study to evaluate the safety and efficacy of imiquimod 5“ cream applied thrice weekly for 8 and 12 weeks in the treatment of low-risk nodular basal cell carcinoma, J Am Acad Dermatol, 2007; 57: 616-621.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

7j Butler DF, Parekh PK, Lenis A: Imiquimod 5“ cream as adjunctive therapy for primary, solitary, nodular nasal basal cell carcinomas before Mohs micrographic surgery: a randomized, double blind, vehicle-controlled study, Dermatol Surg, 2009; 35: 24-29.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

8j Bath-Hextall FJ, Perkins W, Bong J, et al: Interventions for basal cell carcinoma of the skin, Cochrane Database Syst Rev, 2007; CD003412.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

9j Spencer JM: Pilot study of imiquimod 5“ cream as adjunctive therapy to curettage and electrodesiccation for nodular basal cell carcinoma, Dermatol Surg, 2006; 32: 63-69.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

10j Gaitanis G, Nomikos K, Vava E, et al: Immunocryosurgery for basal cell carcinoma: results of a pilot, prospective, open-label study of cryosurgery during continued imiquimod application, J Eur Acad Dermatol Venereol, 2009; 23: 1427-1431.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj


CQ16

Ä”­‚ľ‚˝Šî’ę×–EŠŕ‚É‚Í‚Ç‚ĚŽĄ—Ă‚ŞŠŠ‚ß‚ç‚ę‚é‚Š

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A

Ä”­‚ľ‚˝Šî’ę×–EŠŕ‚ɑ΂ľ‚ẮCŠO‰Č“IŘœ‚Ş‹­‚­„§‚ł‚ę‚éB

ƒAƒ‹ƒSƒŠƒYƒ€‚Ö


Ą‰đŕ

ˆę“xÄ”­‚ľ‚˝Šî’ę×–EŠŕiBCCj‚́C‰‰ńŽĄ—Ă—á‚ć‚č‚ŕ50“ˆČă‚‚˘Ä”­ƒŠƒXƒN‚đ—L‚ˇ‚é‚Ć‚ł‚ę‚é1jBÄ”­‚đ‚Ť‚˝‚ľ‚₡‚˘ˆöŽq‚́C•a•Ď‚̐i“W‚Ş—Ő°“I‚É•s–ž—āCŠˆ“ŽŤ‚̍‚‚˘‘gDŒ^Cፍ­‘gD‚Ĺ‚Ě•s‹K‘ĽE‘˝”­Ť‚̐ZC‚Č‚Ç‚Ĺ‚ ‚éB

Ä”­ŤBCC ‚đ‘ÎŰ‚Ć‚ľ‚˝—Տ°Œ¤‹†‚Ć‚ľ‚ẮCŠO‰Č“IŘœ102 —á‚ĆMohs Žčp100 —á‚Ć‚Ěƒ‰ƒ“ƒ_ƒ€‰ť”äŠrŽŽŒą‚ލs‚í‚ę‚Ä‚˘‚é2jB5 ”NÄ”­—Ś‚ÍŠO‰Č“IŘœŒQ‚Ĺ12.1“CMohs ŽčpŒQ2.4“‚ŁCMohs ŒQ‚Ş—LˆÓ‚É—D‚ę‚Ä‚˘‚˝ip  0.015jB‚Ü‚˝C”ńƒ‰ƒ“ƒ_ƒ€‰ť”äŠrŽŽŒą‚Ĺ‚Í‚ ‚é‚ŞCÄ”­ŤBCC 97 —á‚đ‘ÎŰ‚Ć‚ľ‚ÄŠO‰Č“IŘœCMohs ŽčpiŒĹ’č–@jC•úŽËü—Ă–@‚Ě”äŠr‚đs‚Á‚˝ŽŽŒą‚ł́C5 ”NˆČă‚ĚŠĎŽ@ŠúŠÔ‚É‚¨‚Ż‚é‚ť‚ę‚ź‚ę‚ĚÄ”­—Ś‚Í5C12C11“‚Ć•ń‚ł‚ę‚Ä‚˘‚é3jBƒI[ƒXƒgƒ‰ƒŠƒA‚É‚¨‚Ż‚鐔ç—á‹K–Í‚ĚMohs Žčpƒf[ƒ^ƒx[ƒX‚É‚ć‚ę‚΁CÄ”­ŤBCC ‚ɑ΂ˇ‚éMohs Žčp‚Ě5 ”NÄ”­—Ś‚Í4“‚Ĺ‚ ‚é4jBŠO‰Č“IŘœŒă‚ɁCƒpƒ‰ƒtƒBƒ“•ď–„‰i‹v•W–{‚Ĺ’f’[‰AŤ‚đŠm”F‚ľ‚Ä‚Š‚çÄŒš‚đs‚¤“ńŠú“IŽčp‚ĚÄ”­ŤBCC ‚ɑ΂ˇ‚鎥—ÐŹŃ‚́C5 ”NÄ”­—Ś‚Ĺ2.3“5jC4.7“6j‚Ć•ń‚ł‚ę‚Ä‚˘‚éB

”ńŽčp“I‚ČŽĄ—Ă‚Ě•ń‚Ć‚ľ‚ẮC‚˘‚¸‚ę‚ŕ”äŠrŽŽŒą‚Ĺ‚Í‚Č‚˘‚ށC•úŽËü—Ă–@7, 8jC“€Œ‹—Ă–@9jCŒőü—ÍŠw“I—Ă–@10jCƒCƒ~ƒLƒ‚ƒhŠO—p—Ă–@11j‚É‚ć‚é‚ŕ‚Ě‚Ş‚ ‚éB•úŽËü—Ă–@‚Ĺ‚Í’†‰›ŠĎŽ@ŠúŠÔ57 ƒJŒŽ‚Ĺ‚ĚÄ”­—Ś9.8“7jC•˝‹Ď42 ƒJŒŽ‚Ĺ8.8“8j‚Ć•ń‚ł‚ę‚Ä‚˘‚éB“€Œ‹—Ă–@‚Ĺ‚ÍÄ”­—Ś3.6“‚Ć‚Ě•ń‚Ş‚ ‚é‚ŞC‚ť‚Ě–ń”ź”‚ĚÇ—á‚ÍŠĎŽ@ŠúŠÔ‚Ş2 ”NˆČ“ŕ‚Ć’Z‚˘9jB‚Ü‚˝C•úŽËüŽĄ—ĂŒă‚ĚŽc‘śEÄ”­‚ɑ΂ľ‚ÄŒőü—ÍŠw“I—Ă–@‚đŽ{s‚ľ‚˝•ń‚Ĺ‚ĚŠŽ‘S‘tŒř—Ś‚Í80“ˆČă‚ĆŽŚ‚ł‚ę‚Ä‚˘‚é‚ŞCÇ—ᐔ‚Ş‚â‚⏭‚Č‚˘10jB‚ą‚ę‚ç‚Í‚˘‚¸‚ę‚ŕ‰˘•Ä‚Š‚ç‚Ě•ń‚Ĺ‚ ‚čCÄ”­‚ÉŽŠ‚Á‚˝‘OŽĄ—Ă‚Ě“ŕ—e‚Ć‚ľ‚Ä‚Í“d‹C‹ĂŒĹpC•úŽËü—Ă–@C“€Œ‹—Ă–@‚Ş”äŠr“I‘˝‚˘B–{–M‚É‚¨‚˘‚Ä‚ÍBCC ‚̏‰ŠúŽĄ—Ă‚Ć‚ľ‚Ä‚Ů‚ÚŠO‰Č“IŘœ‚Ě‚Ý‚Şs‚í‚ę‚Ä‚˘‚é‚Ě‚ŞŒťó‚Ĺ‚ ‚é‚˝‚߁C‚ą‚ę‚ç‚Ě”wŒiˆöŽq‚Ěˆá‚˘‚đl—ś‚ˇ‚é•K—v‚Ş‚ ‚éBŘœŒăÄ”­BCC 34 —á‚ɑ΂ľ‚Ä5“ƒCƒ~ƒLƒ‚ƒhƒNƒŠ[ƒ€‚đT3 ‰ńC6 TŠÔŠO—p‚ľ‚˝Ĺ‹ß‚Ě•ń‚Ĺ‚Ě3 ”NÄ”­—Ś‚Í29.4“‚Ĺ‚ ‚č11jC„§‚Ĺ‚Ť‚郌ƒxƒ‹‚Ĺ‚Í‚Č‚˘B

ˆČă‚đ‘‡‚ˇ‚é‚ƁCÄ”­ŤBCC ‚ɑ΂ľ‚Ä‚ÍŠO‰Č“IŘœ‚ŠMohs Žčp‚ސ„§‚ł‚ę‚é‚ŞC–{–M‚É‚¨‚˘‚Ä‚ÍŽíX‚Ě——R‚ĹMohs Žčp‚Ě“ą“ü‚͍˘“ď‚Č–Ę‚Ş‚ ‚é‚̂ŁC–{–MƒKƒCƒhƒ‰ƒCƒ“‚Ć‚ľ‚Ä‚ÍŠO‰Č“IŘœi“Á‚É“ńŠú“IŽčpj‚đ‘ćˆę‘I‘đ‚ĚŽĄ—Ă–@‚Ć‚ľ‚Đ„§‚ˇ‚éB‚ľ‚Š‚ľ‚—îC‡•šÇ“™‚Ě——R‚ĹŽčp‚ލ˘“ď‚ČÇ—á‚ɑ΂ľ‚ẮC•úŽËü—Ă–@C“€Œ‹—Ă–@“™‚Ě”ńŽčp“IŽĄ—Ă‚Ě“K‰ž‚ŕl—ś‚ł‚ę‚éB

•śŒŁ

1j Silverman MK, Kopf AW, Bart RS, et al: Recurrence rates of treated basal cell carcinomas. Part 3: Surgical excision, J Dermatol Surg Oncol, 1992; 18: 471-476.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

2j Mosterd K, Krekels GA, Nieman FH, et al: Surgical excision versus Mohsf micrographic surgery for primary and recurrent basal-cell carcinoma of the face: a prospective randomised controlled trial with 5-yearsf follow-up, Lancet Oncol, 2008; 9: 1149-1156.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅱj

3j Sakura CY, Calamel PM: Comparison of treatment modalities for recurrent basal cell carcinoma, Plast Reconstr Surg, 1979; 63: 492-496.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅲj

4j Leibovitch I, Huilgol SC, Selva D, et al: Basal cell carcinoma treated with Mohs surgery in Australia Ⅱ. Outcome at 5-year follow-up, J Am Acad Dermatol, 2005; 53: 452-457.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Niederhagen B, von Lindern JJ, Bergé S, et al: Staged operations for basal cell carcinoma of the face, Br J Oral Maxillofac Surg, 2000; 38: 477-479.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

6j Lawrence CM, Haniffa M, Dahl MG: Formalin-fixed tissue Mohs surgeryislow Mohsjfor basal cell carcinoma: 5-year follow-up data, Br J Dermatol, 2009; 160: 573-580.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

7j Wilder RB, Shimm DS, Kittelson JM, et al: Recurrent basal cell carcinoma treated with radiation therapy, Arch Dermatol, 1991; 127: 1668-1672.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

8j Caccialanza M, Piccinno R, Grammatica A: Radiotherapy of recurrent basal and squamous cell skin carcinomas: a study of 249 re-treated carcinomas in 229 patients, Eur J Dermatol, 2001; 11: 25-28.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

9j Kuflik EG, Gage AA: Recurrent basal cell carcinoma treated with cryosurgery, J Am Acad Dermatol, 1997; 37: 82-84.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

10j Soler AM, Warloe T, Tausjo J, et al: Photodynamic therapy of residual or recurrent basal cell carcinoma after radiotherapy using topical 5-aminolevulinic acid or methylester aminolevulinic acid, Acta Oncol, 2000; 39: 605-609.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹VIj

11j Ruiz-Villaverde R, Sanchez-Cano D, Burkhardt-Perez P, et al: Has imiquimod 5“ cream a role in the management of recurrent basal cell carcinoma? Eur J Dermatol, 2009; 19: 481-483. iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj; 3: 1427-1431.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj


CQ17

Ä”­”­ŒŠ‚đ–Ú“I‚Ć‚ľ‚˝ŽĄ—ĂŒă‚Ě’čŠú“I‚ČŒo‰ßŠĎŽ@‚ÍŠŠ‚ß‚ç‚ę‚é‚Š

„§“x

C1

’čŠú“I‚ČŒo‰ßŠĎŽ@‚đl—ś‚ľ‚Ä‚ŕ‚悢‚ށC‚ť‚Ě•p“x‚âŠúŠÔ‚ɂ‚˘‚Ä‚ĚŠî€‚ÍŽŚ‚ł‚ę‚Ä‚˘‚Č‚˘B

ƒAƒ‹ƒSƒŠƒYƒ€‚Ö


Ą‰đŕ

Šî’ę×–EŠŕiBCCj‚ĚŽĄ—Ă‚đs‚Á‚˝ŠłŽŇ‚ĚŒo‰ßŠĎŽ@–@‚ÉŠÖ‚ľ‚ẮC‚ť‚Ě•p“x‚âŠúŠÔ‚Č‚Ç‚Ě–žŠm‚ČƒRƒ“ƒZƒ“ƒTƒX‚Í‚Č‚˘BĹ‹ß‚Ĺ‚Í’áƒŠƒXƒNÇ—á‚ĹŠĎŽ@ŠúŠÔ‚đ’Zk‚ˇ‚é•ń‚ŕ‚ ‚é‚ŞC‚ƒŠƒXƒNÇ—á‚Ĺ‚Í]—ˆ’Ę‚č5 ”NŠÔ‚ĚŒo‰ßŠĎŽ@‚ŞŠŠ‚ß‚ç‚ę‚Ä‚˘‚é1jB‚ť‚ĚŽĺ‚Č–Ú“I‚ÍŽîᇂ̍Ĕ­‚¨‚ć‚ѐV‹K•a•Ď‚Ě‘Šú”­ŒŠ‚ĆŽĄ—Ă‚É‚ ‚éBˆę”Ę“I‚ɂ́CpŒă‚̏‰”N“x‚Í6 ƒJŒŽ‚˛‚ƂɁC2`3 ”NŠÔ‚Í1 ”N‚˛‚Ć‚ÉŒo‰ß‚đŠĎŽ@‚ˇ‚éB

‘ćˆę‚ĚŽîᇂ̋ǏŠÄ”­‚́C–ń50“‚ŞĹ‰‚Ě2 ”NŠÔ‚ɁC66“‚Ş3 ”NŠÔ‚ɁC80“‚Ş5 ”N‚Ü‚Ĺ‚ÉoŒť‚ˇ‚é2jBÄ”­Žîᇂ̌Ÿo‚ɂ‚˘‚ẮCŽ‹fCGfC‚ł‚ç‚ÉŠłŽŇ‚ĚŠ´Šo•Ď‰ť‚Č‚Ç‚É’ˆÓ‚ľC‹^‚í‚ľ‚˘•”ˆĘ‚͐ϋɓI‚ɐśŒŸ‚ĹŠm”F‚ˇ‚é•K—v‚Ş‚ ‚éB

‘ć“ń‚̐V‹K•a•Ď‚ÉŠÖ‚ľ‚ẮC1 ‚‚ĚBCC ‚Ş”­ś‚ľ‚˝ŠłŽŇ‚Í‘ź‚̔畆Šŕ‚â•Ę‚ĚBCC ‚𐜂ś‚郊ƒXƒN‚ލ‚‚˘3jB‚˘‚¸‚ę‚ŕ”’FlŽí‚Ěƒf[ƒ^‚Ĺ‚ ‚é‚ŞC‰ŠúŽĄ—ĂŒă‚Ɉř‚Ť‘ą‚Ť—Lž™×–EŠŕ‚đ”­Ç‚ˇ‚郊ƒXƒN‚Í5`10“‚Ĺ‚ ‚čCƒƒ‰ƒm[ƒ}‚đ”­Ç‚ˇ‚郊ƒXƒN‚͈ę”ʐl‚É”ä‚ׂĖń2`4 ”{‚ƍl‚Ś‚ç‚ę‚Ä‚˘‚éB‚ł‚ç‚É“Á•M‚ˇ‚ׂŤ“_‚́C1 ‚‚ĚBCC ‚đ”­Ç‚ľ‚˝ŠłŽŇ‚Ě–ń20“‚Ş1 ”NˆČ“ŕ‚ɁC40“‚Ş5 ”NˆČ“ŕ‚É•Ę‚ĚBCC ‚đ”­Ç‚ˇ‚鎖ŽŔ‚Ĺ‚ ‚é4`9jB•Ą”‚ĚBCC ‚đ”­Ç‚ľ‚˝ŠłŽŇ‚Í‚ł‚ç‚ɃŠƒXƒN‚Şă¸‚ľC“Á‚ɐF”’‚Ě”§ifair skin typej‚Ĺ‚Í‚ć‚č‚ť‚ĚŒXŒü‚Ş‹­‚˘BĹ‰‚Ě2 ”NˆČ“ŕ‚ÉĹ‚ŕƒŠƒXƒN‚ލ‚‚˘‚ށC”NŽŸ‚˛‚Ć‚ĚƒŠƒXƒN‚Í5 ”NŠÔ‚đ’Ę‚ľ‚āCˆę”ʐl‚Ě10`12 ”{‚É‚ŕ‚Č‚é7jB‘Šú‚ɐV‹K•a•Ď‚đ”­ŒŠ‚ˇ‚é‚ą‚ƂŁCŠmŽŔ‚ČŽčpŽĄ—Ă‚Ş‰Â”\‚Ć‚Č‚čC‘ă‘Ö—Ă–@‚ŕ‘I‘đ‚Ĺ‚Ť‚éBŽĄ—Ă‚É‚ć‚鐎—e“IE‹@”\“I‘¤–Ę‚ŕl‚Ś‚ę‚΁CŽĄ—Ă‚É”ş‚¤•›ŽŸ“Iě—p‚đŒyŒ¸‚ˇ‚é‚˝‚߁C‘Šú‚Ě‘Îˆ‚Ş–]‚Ü‚ľ‚˘B

•śŒŁ

1j McLoon NM, Tolland J, Walsh M: Follow up basal cell carcinoma: an audit of current practice, J Eur Acad Dermatol Venereol, 2006; 20: 698-701.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

2j Rowe DE, Carroll RJ, Day CL: Long-term recurrence rates in previously untreatediprimaryj basal cell carcinoma: implications for patient follow up, J Dermatol Surg Oncol, 1989; 15: 315-328.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹ Ⅰj

3j •ÎŒb”üŽqC“y‹„ŽmC˛“ĄLˆę‚Ů‚ŠFŠî’ę×–EŠŕpŒăƒtƒHƒ[ƒAƒbƒvŠúŠÔ‚ÉŠÖ‚ˇ‚錟“˘, Skin Cancer, 2005; 20: 291-295.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

4j ‘ş“c—mŽOCŒF–ěŒöŽqFŠî’ę×–EŠŕ‚Ě•Ą””­ś‚ɂ‚˘‚Ä, Visual Dermatology, 2003; 2: 834-837.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

5j Karagas MR, Stukel TA, Greenberg ER, et al: Risk of subsequent basal cell carcinoma and squmous cell carcinoma of the skin among patients with prior skin cancer. Skin Cancer Prevention Study Group, JAMA, 1992; 267: 3305-3310.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

6j Robinson JK: Risk of developing another basal cell carcinoma. A 5-year prospective study, Cancer, 1987; 60: 118-120.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

7j Marghoob A, Kopf AW, Bart RS, et al: Risk of another basal cell carcinoma developing after treatment of a basal cell carcinoma, J Am Acad Dermatol, 1993; 28: 22-28.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

8j Schreiber MM, Moon TE, Fox SH, et al: The risk of developing subsequent nonmelanoma skin cancers, J Am Acad Dermatol, 1990; 23: 114-118.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

9j Schinstine M, Goldnman GD: Risk of synchronous and metachronous second nonmelanoma skin cancer when referred for Mohs micrographic surgery, J Am Acad Dermatol, 2001; 44: 497-499.iƒGƒrƒfƒ“ƒXƒŒƒxƒ‹Ⅳj

BCC@CQ1`CQ17 ˆę——
CQ   „§“x „§•ś
  1. 1DŠî’ę×–EŠŕ‚Ě”­ś—\–h‚đ–Ú“I‚Ć‚ľ‚˝Ž‡ŠOü–hŒä‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  C1 Šî’ę×–EŠŕ‚Ě”­ś—\–h‚Ě‚˝‚ß‚ĚŽ‡ŠOü–hŒä‚đl—ś‚ľ‚Ä‚ŕ‚悢‚ށC“ú–{l‚ɑ΂ˇ‚é—L‰vŤ‚Í•s–ž‚Ĺ‚ ‚éB
  1. 2DŠî’ę×–EŠŕ‚Ě”­ś—\–h‚đ–Ú“I‚Ć‚ľ‚˝Ž‰‘B•ę”Á‚̐؏œ‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  C1 Šî’ę×–EŠŕiBCCj‚Ě”­ś—\–h‚Ě‚˝‚ß‚ÉŽ‰‘B•ę”Á‚đŘœ‚ľ‚˝•ű‚Ş‚ć‚˘‚Ć‚˘‚¤\•Ş‚ČƒGƒrƒfƒ“ƒX‚Í‘śÝ‚ľ‚Č‚˘B‚˝‚ž‚ľC–{•ę”Á‚́C’†”NˆČ~‚É‚Č‚Á‚Ä2 ŽŸŤ‚ÉŠeŽí‚Ě•t‘ŽŠíŽîᇂ𐶂ś‚é‚ą‚Ć‚Ş‚ ‚é‚̂ŁCŽ—e–Ę‚ŕŠ¨ˆÄ‚ľ‚Ä“K“–‚ČŽžŠú‚ɐ؏œ‚đl—ś‚ľ‚Ä‚ŕ‚悢B
  1. 3DŠî’ę×–EŠŕ‚̐f’f‚Ƀ_[ƒ‚ƒXƒRƒs[‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  A Šî’ę×–EŠŕ‚̓_[ƒ‚ƒXƒRƒs[‚É‚¨‚˘‚Ä“Á’Ľ“IŠŒŠ‚đ’ć‚ľC\•Ş‚Ȑ¸“x‚Ě‰ć‘œŒŸ¸‚Ć‚ľ‚Ä‹­‚­„§‚ł‚ę‚éB
  1. 4D—Տ°“I‚ÉŠî’ę×–EŠŕ‚Ş‹^‚í‚ę‚é•a•Ď‚đCf’fŠm’č‚Ě‚˝‚߂ɐśŒŸ‚ˇ‚é‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚é‚Š
  B Ú×‚Č—Ő°“I•]‰ż‚Ćƒ_[ƒ‚ƒXƒRƒs[‚É‚ć‚Á‚Ä‚ŕŠî’ę×–EŠŕ‚Ɛf’f‚đŠm’č‚Ĺ‚Ť‚Č‚˘•a•Ď‚ɂ‚˘‚ẮCśŒŸ‚đŽŔŽ{‚ľ‚Đf’f‚đŠm’股‚é‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚éB
  1. 5DŠî’ę×–EŠŕ‚ɑ΂ľ‚ÄŠO‰Č“IŘœ‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  A Šî’ę×–EŠŕ‚ĚŽĄ—Ă‚Ě‘ćˆę‘I‘đ‚Ć‚ľ‚Ä‹­‚­ŠŠ‚ß‚ç‚ę‚éB
  1. 6DŠî’ę×–EŠŕ‚ĚŒ´”­‘ƒ‚́C“÷Šá“I•Ó‰‚Š‚牽mm —Ł‚ľ‚Đ؏œ‚ˇ‚ׂŤ‚Š
’჊ƒXƒN‚ĚŠî’ę×–EŠŕ A ’჊ƒXƒN‚ĚŠî’ę×–EŠŕ‚́C4mm ‚̐؏œƒ}[ƒWƒ“‚Ş‹­‚­ŠŠ‚ß‚ç‚ę‚éB
  ‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ B ‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ‚́C5`10mm ‚̐؏œƒ}[ƒWƒ“‚ŞŠŠ‚ß‚ç‚ę‚éB
  1. 7DŠî’ę×–EŠŕ‚͂ǂ̐[‚ł‚Ĺ‚ĚŘœ‚ŞŠŠ‚ß‚ç‚ę‚é‚Š
  B ‘˝‚­‚Ěę‡C”牺Ž‰–bD‚đ\•ŞŠÜ‚ß‚ÄŘœ‚ˇ‚é‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚é‚ŞC‘gDŒ^‚ލ‚ƒŠƒXƒNi”Áó‹­”çÇŒ^CZŒ^C”÷ŹŒ‹ßŒ^j‚ŕ‚ľ‚­‚ÍŽîᇌa‚Ş‘ĺ‚Ť‚˘ę‡‚É‚Í‚ć‚č[•”‚Ü‚Ĺ‚ĚŘœ‚đ—v‚ˇ‚é‚ą‚Ć‚Ş‚ ‚éB
  1. 8DŠî’ę×–EŠŕ‚̐؏œŽž‚ɁCŘœ’f’[‚̐v‘Ź•a—ŒŸ¸‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  B Ä”­Ç—á‚⍂ƒŠƒXƒN‘gDŒ^‚ĚŠî’ę×–EŠŕ‚É‚¨‚˘‚ẮC“€Œ‹Ř•Đ‚É‚ć‚ép’†v‘Ź•a—ŒŸ¸‚É‚ć‚éŘœ’f’[‚ĚŠm”F‚ŞŠŠ‚ß‚ç‚ę‚éB
  1. 9DŠî’ę×–EŠŕ‚ɑ΂ľ‚Ä“ńŠú“IŽčp‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  B ‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ‚ɑ΂ľ‚ẮC‰i‹v•W–{‚É‚ć‚č’f’[‰AŤ‚đŠm”F‚ľ‚˝ă‚ĹÄŒš‚ˇ‚é“ńŠú“IŽčp‚ÍŠŠ‚ß‚ç‚ę‚éB
  1. 10DŽčp‚Ő؏œ’f’[—zŤ‚ĚŠî’ę×–EŠŕ‚ɏpŒă‚̒ljÁŽĄ—Ă‚đs‚¤‚ą‚Ć‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  B ‚ƒŠƒXƒN‚ĚŠî’ę×–EŠŕ‚Í’f’[‰AŤ‚É‚Č‚é‚悤‚ɍĐ؏œ‚đs‚¤‚ą‚Ć‚ŞŠŠ‚ß‚ç‚ę‚éB•sŠŽ‘SŘœ—á‚ĹŽčp‚ލ˘“ď‚Š‚ŕ‚ľ‚­‚ÍŠó–]‚ľ‚Č‚˘ŠłŽŇ‚ɑ΂ľ‚ẮC•úŽËüŽĄ—Ă‚đl—ś‚ľ‚Ä‚ŕ‚悢B
  1. 11DŠî’ę×–EŠŕ‚ɑ΂ˇ‚鍪ŽĄŽĄ—Ă‚Ć‚ľ‚Ä•úŽËü—Ă–@‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  B ‹@”\‚␎—eŤ‚đl—ś‚ľ‚˝ę‡C•úŽËü—Ă–@‚ÍŠî’ę×–EŠŕ‚ĚŞŽĄŽĄ—Ă‚Ěˆę‚‚Ƃľ‚ÄŠŠ‚ß‚ç‚ę‚éB
  1. 12DŠî’ę×–EŠŕ‚Ě‹ÇŠ‰ťŠw—Ă–@‚Ć‚ľ‚Ä5-FU“îp‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  C1 ’჊ƒXƒN•”ˆĘ‚Ě•\ÝŒ^Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä‚Í5-FU“îp‚ލ‚‚˘‘tŒř—Ś‚đŽŚ‚ˇB“K‰žÇ—á‚đŒľ‘I‚ˇ‚ę‚΁CŽĄ—Ă–@‚Ć‚ľ‚čl—ś‚ľ‚Ä‚ŕ‚悢B
  1. 13DŠî’ę×–EŠŕ‚ɑ΂ľ‚Ä“€Œ‹—Ă–@‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  C1 Œ‹ßŒ^‚â•\ÝŒ^Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä‚Í“€Œ‹—Ă–@‚ލĔ­—Ś‚Í‚â‚⍂‚˘‚ŕ‚̂́C‚‚˘‘tŒř—Ś‚đŽŚ‚ˇB“K‰žÇ—á‚đŒľ‘I‚ˇ‚ę‚΁CŽĄ—Ă–@‚Ć‚ľ‚čl—ś‚ľ‚Ä‚ŕ‚悢B
  1. 14DŠî’ę×–EŠŕ‚ɑ΂ľ‚ÄŒőü—ÍŠw“I—Ă–@iphotodynamic therapyGPDTj‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
•\ÝŒ^‚¨‚ć‚ŃŒ‹ßŒ^Šî’ę×–EŠŕ C1 •\ÝŒ^‚¨‚ć‚ŃŒ‹ßŒ^Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä‚ÍPDT ‚ލĔ­—Ś‚Í‚â‚⍂‚˘‚ŕ‚̂́C‚‚˘‘tŒř—Ś‚đŽŚ‚ˇB“K‰žÇ—á‚đŒľ‘I‚ˇ‚ę‚΁CŽĄ—Ă–@‚Ć‚ľ‚čl—ś‚ľ‚Ä‚ŕ‚悢i2013”N12 ŒŽŒťÝ•ŰŒŻ“K—pŠOjB
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  1. 15DŠî’ę×–EŠŕ‚ɑ΂ľ‚ăCƒ~ƒLƒ‚ƒhŠO—p‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  C1 •\ÝŒ^Šî’ę×–EŠŕ‚ɑ΂ľ‚Ä‚Í5“ƒCƒ~ƒLƒ‚ƒhƒNƒŠ[ƒ€‚ލĔ­—Ś‚Í‚â‚⍂‚˘‚ŕ‚̂́C‚‚˘‘tŒř—Ś‚đŽŚ‚ˇB“K‰žÇ—á‚đŒľ‘I‚ˇ‚ę‚΁CŽĄ—Ă–@‚Ć‚ľ‚čl—ś‚ľ‚Ä‚ŕ‚悢i2013 ”N12 ŒŽŒťÝ•ŰŒŻ“K—pŠOjB
  1. 16DÄ”­‚ľ‚˝Šî’ę×–EŠŕ‚É‚Í‚Ç‚ĚŽĄ—Ă‚ŞŠŠ‚ß‚ç‚ę‚é‚Š
  A Ä”­‚ľ‚˝Šî’ę×–EŠŕ‚ɑ΂ľ‚ẮCŠO‰Č“IŘœ‚Ş‹­‚­„§‚ł‚ę‚éB
  1. 17DÄ”­”­ŒŠ‚đ–Ú“I‚Ć‚ľ‚˝ŽĄ—ĂŒă‚Ě’čŠú“I‚ČŒo‰ßŠĎŽ@‚ÍŠŠ‚ß‚ç‚ę‚é‚Š
  C1 ’čŠú“I‚ČŒo‰ßŠĎŽ@‚đl—ś‚ľ‚Ä‚ŕ‚悢‚ށC‚ť‚Ě•p“x‚âŠúŠÔ‚ɂ‚˘‚Ä‚ĚŠî€‚ÍŽŚ‚ł‚ę‚Ä‚˘‚Č‚˘B
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’†ƒŠƒXƒN•”ˆĘi–jC‘OŠzC“ށCčň•”C‘Oăřœ•”j‚Ĺ10 mm ˆČă
’჊ƒXƒN•”ˆĘi‘ĚŠ˛CŽlŽˆj‚Ĺ20 mm ˆČă
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iNCCNFClinical practice guideline in oncology. Basal cell and squamous cell skin cancers. V.2. 2013, BCC-A ‚ć‚čˆę•”‰ü•Ďj