Risk of subsequent basal cell carcinoma and squamous cell carcinoma of the skin among patients with prior skin cancer. Skin Cancer Prevention Study Group.

OBJECTIVE--The primary aims of this study were to assess risk of subsequent basal and squamous cell skin cancer among patients with a prior history of these tumors and to examine these risks in relation to patient characteristics and life-style factors. DESIGN--Follow-up of participants in a randomized trial of betacarotene as a possible skin cancer preventive agent. SETTING--Clinical centers in Los Angeles, Calif, San Francisco, Calif, Minneapolis, Minn, and Hanover, NH. PARTICIPANTS--Patients (n = 1805) who were diagnosed as having a basal or squamous cell skin cancer between January 1980 and February 1986 and were free of skin cancer at study entry. MAIN OUTCOME MEASURE--Time from study entry to first new occurrence of basal and squamous cell skin cancer. RESULTS--The estimated risk of developing one or more new skin cancers was 35% at 3 years and 50% at 5 years. New skin cancers tended to be of the same cell type as the previous skin cancers. For both basal and squamous cell skin cancer, risk was higher among patients who were male, were over the age of 60 years, had more prior skin cancers, had severe actinic skin damage, or who burned easily with sun exposure. Compared with those who had never smoked, the rate of subsequent squamous cell skin cancer was higher among current smokers (rate ratio, 2.01; 95% confidence interval, 1.21 to 3.34) and former smokers (rate ratio, 1.62; 95% confidence interval, 1.07 to 2.47) and increased with both duration and amount smoked. There was no clear relationship between smoking and basal cell skin cancer; the rate appeared lower among heavy smokers but was unrelated to duration of smoking. CONCLUSIONS--Persons with a prior nonmelanoma skin cancer had a substantial 5-year risk of developing another tumor of the same histologic type. Number of previous skin cancers, solar damage, and skin sensitivity to sun exposure were particularly related to this risk. The increased risk of squamous cell skin cancer associated with cigarette smoking merits further study.     

蒙药消肿散涂膜剂皮肤刺激和皮肤过敏实验研究

目的对消肿散涂膜剂皮肤的刺激性和致敏性进行了动物实验观察。方法以家兔为模型进行一次给药皮肤刺激和多次给药皮肤刺激实验，以豚鼠为模型观察涂膜剂的皮肤致敏作用。结果消肿散涂膜剂对家兔皮肤未见任何刺激作用，也不引起豚鼠出现过敏反应。结论消肿散涂膜剂是一种安全性很高的外用新剂型。     

Merkel-cell tumour of the skin

The case histories of four patients with a Merkel-cell tumour of the skin are presented and the findings are compared with other reports in the literature. An association with other skin tumours is noted and ultraviolet light may be implicated in the causation of Merkel-cell tumours. The Merkel-cell tumours in this series occurred initially on the face. The difficulty of diagnosis is stressed. It is recommended that wide excision of the tumour be followed by radiotherapy to the excision site plus a large margin, in an attempt to prevent local recurrences that are brought about by lymphatic permeation.     

反鼓取皮移植治疗大面积皮肤撕脱伤的护理

目的:通过13例反鼓取皮移植治疗大面积皮肤撕脱伤,讨反鼓取皮移植治疗大面积皮肤撕脱伤术后患者的护理.方法:对反鼓取皮移植治疗大面积皮肤撕脱伤术后患者在全身和局部的观察,位摆放,复指导及心理疏导等诸方面进行护理.结果:反鼓取皮成中厚自体皮移植的13例患者中,1例一期愈合,例有少量点状皮肤坏死.换药2周后愈合.结论:反鼓取皮移植治疗大面积皮肤撕脱伤是一种有效的方法,需要诸多护理工作的密切配合.     

保存刃厚头皮片分期植皮治疗创伤感染性四肢大面积皮肤缺损

目的 探讨临床治疗创伤感染性四肢大面积皮肤缺损简便易行的植皮新方法。方法 2000年8月-2004年8月对60例患者均取厚度为0．25—0．3mm刃厚头皮,剪成30mm-30mm大小,在四肢感染性大面积皮肤缺损创面清创后邮票状植皮,余留皮片置入平衡液作为保存液的培养瓶中放置在4℃普通冰箱中,术后1周-1月内根据受皮区植皮的存活情况,伤口换药时将余留皮片分期植皮。结果 一个月内经分期植皮所有患者创面均愈合。结论 保存刃厚头皮片分期植皮的方法仅需取皮一次,皮源充分,保存方法简便．植皮存活率高,是一种治疗创伤感染性四肢大面积皮肤缺损的植皮新方法。     

Facial skin flaps and skin grafts for skin cancers

The commonly used skin flaps and skin grafts for plastic surgical reconstruction of facial wounds created by skin cancer extirpation are reviewed.