Basal cell carcinoma(BCC)is by far the most common human skin cancer.In Caucasians,BCCs account for around 90%of periocular malignancies.However,periocular BCCs are usually neglected due to their slow and painless gro...Basal cell carcinoma(BCC)is by far the most common human skin cancer.In Caucasians,BCCs account for around 90%of periocular malignancies.However,periocular BCCs are usually neglected due to their slow and painless growth,unless presenting complaints,e.g.,large size,bleeding,recurrent infections of the tumor,or secondary symptoms resulting from adjacent structures involvement as epiphora,limited eye globe motility as well as globe displacement.Moreover,although the tumor can usually be cured with local excision,local recurrence can occur in up to 20%of eyelid BCC cases.Recurrent BCCs of the eyelid show a poorer overall prognosis than the primary ones.In addition,the management of advanced diseases,such as orbital or intracranial invasion as well as metastatic lesions,is challenging and often involves a multidisciplinary approach.In this paper,we reviewed the recent research progress of pathogenesis,clinical presentation,and therapeutics of periocular BCCs.We introduced the molecular pathogenesis of BCCs[multi-step ultraviolet(UV)-induced carcinogenesis model,genetic predisposition,and epigenetic changes],clinical classification,and tumor-node-metastasis(TNM)clinically stage of eyelid skin BCCs.We also emphasized the treatment of BCCs,i.e.,surgical resection,oculoplastic reconstruction,and alternative therapies(radiation therapy,systemic therapy,topical therapy,and prophylactic therapy).In the end,we proposed that considering the possible iatrogenic damage to the surface of the eye by surgical excision,the treatment of periocular BCCs is recommended to be performed by or in the presence of an oculoplastic surgeon.展开更多
A smooth and timely fitting of a visually appealing,custom-made eye prosthesis after the loss of an eye is not only essential from a cosmetic point of view but above all facilitates good social and psychological rehab...A smooth and timely fitting of a visually appealing,custom-made eye prosthesis after the loss of an eye is not only essential from a cosmetic point of view but above all facilitates good social and psychological rehabilitation.Cryolite glass prostheses must be replaced at least once a year,PMMA prostheses polished once a year and renewed every five years.In children,especially in growth phases,the fit of the prosthesis should be checked at least every six months and adjusted,if necessary.Ocularists and ophthalmologists should determine an individual cleaning procedure together with the patient,which depends on both the prosthesis material and external factors.Complications such as allergic,giant papillary,viral,and bacterial conjunctivitis or even blepharoconjunctivitis sicca must be detected and treated at an early stage to avoid discomfort and to maintain the ability of prosthesis wear.In the case of inflammation-induced shrinkage of the conjunctival fornices or post-enucleation socket syndrome,surgical interventions are necessary.In summary,an early supply with an eye prosthesis,adequate treatment of complications,and attention to psychological aspects,form the basis for a successful long-term rehabilitation of anophthalmic patients.展开更多
基金This study was supported by the Koeln Fortune Program/Faculty of Medicine,University of Cologne,Germany(No.2680148101)the State Scholarship Fund from China Scholarship Council,China(No.201708080141).
文摘Basal cell carcinoma(BCC)is by far the most common human skin cancer.In Caucasians,BCCs account for around 90%of periocular malignancies.However,periocular BCCs are usually neglected due to their slow and painless growth,unless presenting complaints,e.g.,large size,bleeding,recurrent infections of the tumor,or secondary symptoms resulting from adjacent structures involvement as epiphora,limited eye globe motility as well as globe displacement.Moreover,although the tumor can usually be cured with local excision,local recurrence can occur in up to 20%of eyelid BCC cases.Recurrent BCCs of the eyelid show a poorer overall prognosis than the primary ones.In addition,the management of advanced diseases,such as orbital or intracranial invasion as well as metastatic lesions,is challenging and often involves a multidisciplinary approach.In this paper,we reviewed the recent research progress of pathogenesis,clinical presentation,and therapeutics of periocular BCCs.We introduced the molecular pathogenesis of BCCs[multi-step ultraviolet(UV)-induced carcinogenesis model,genetic predisposition,and epigenetic changes],clinical classification,and tumor-node-metastasis(TNM)clinically stage of eyelid skin BCCs.We also emphasized the treatment of BCCs,i.e.,surgical resection,oculoplastic reconstruction,and alternative therapies(radiation therapy,systemic therapy,topical therapy,and prophylactic therapy).In the end,we proposed that considering the possible iatrogenic damage to the surface of the eye by surgical excision,the treatment of periocular BCCs is recommended to be performed by or in the presence of an oculoplastic surgeon.
文摘A smooth and timely fitting of a visually appealing,custom-made eye prosthesis after the loss of an eye is not only essential from a cosmetic point of view but above all facilitates good social and psychological rehabilitation.Cryolite glass prostheses must be replaced at least once a year,PMMA prostheses polished once a year and renewed every five years.In children,especially in growth phases,the fit of the prosthesis should be checked at least every six months and adjusted,if necessary.Ocularists and ophthalmologists should determine an individual cleaning procedure together with the patient,which depends on both the prosthesis material and external factors.Complications such as allergic,giant papillary,viral,and bacterial conjunctivitis or even blepharoconjunctivitis sicca must be detected and treated at an early stage to avoid discomfort and to maintain the ability of prosthesis wear.In the case of inflammation-induced shrinkage of the conjunctival fornices or post-enucleation socket syndrome,surgical interventions are necessary.In summary,an early supply with an eye prosthesis,adequate treatment of complications,and attention to psychological aspects,form the basis for a successful long-term rehabilitation of anophthalmic patients.
