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Die Kopfhaut im Alter

Ein dermatoonkologischer Schwerpunktbereich

The aged scalp

A dermato-oncological focus point

  • Leitthema
  • Published:
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Zusammenfassung

Nichtmelanozytärer Hautkrebs und seine Frühformen sind aufgrund von steigender Inzidenz und Prävalenz häufige Diagnosen im dermatologischen Alltag. Die Diagnostik erfolgt zumeist klinisch mit konsekutiver histologischer Sicherung. Die Therapie der Wahl bei invasiven Tumoren ist die vollständige Exzision, erst bei nicht möglicher Exzision sollten andere Therapieoptionen wie Bestrahlung und Systemtherapien erwogen werden. Häufig an für ältere Menschen schlecht einsehbaren und erreichbaren Bereichen der Kopfhaut lokalisiert, stellen sie im klinischen Alltag eine besondere Herausforderung für Arzt und Patienten dar. Die Therapieoptionen sind insbesondere im Bereich der Vorstufen zahlreich und sollte individuell auf den Patienten abgestimmt werden. Der größte Risikofaktor für die Entstehung von nichtmelanozytärem Hautkrebs und seinen Frühformen ist die chronische UV-Exposition. Ein möglicher beruflicher Zusammenhang sollte immer erwogen werden. Insbesondere die Prävention durch Patientenedukation und ausreichende Sonnenschutzmaßnahmen steht im Vordergrund. Die Prognose des nichtmelanozytären Hautkrebses verbessert sich signifikant bei frühzeitiger Diagnosestellung und leitliniengerechter Therapie und Nachsorge.

Abstract

Non-melanoma skin cancer and its precursor lesions are common diagnoses in dermatological practice, due to rising incidence and prevalence. Diagnosis is often clinical with subsequent histological confirmation. First-choice treatment for invasive carcinomas is complete surgical excision. Other therapeutic options, such as radiation or systemic therapies, should only be considered when excision is impossible. Mostly located on parts of the scalp that are poorly visible and accessible, particularly for elderly patients, these lesions are a challenge for physicians and patients alike. Especially regarding precursor lesions, the therapeutic options are numerous and should be adapted to the individual patient. The main risk factor for development of non-melanoma skin cancer and its precursor lesions is chronic UV exposure. A possible occupational context should always be considered. Preventative methods based on patient education and adequate sun protection behavior are particularly important. The prognosis of non-melanoma skin cancer improves significantly with early diagnosis, as well as with guideline-compatible treatment and follow-up.

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  1. Hauttumorcentrum, Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland

    N. Wroblewski, K. Wylon & C. Ulrich

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  1. N. Wroblewski
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Wroblewski, N., Wylon, K. & Ulrich, C. Die Kopfhaut im Alter. Hautarzt 68, 437–444 (2017). https://doi.org/10.1007/s00105-017-3988-2

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