Stages of skin cancer. TNM

Skin cancer is one of the most common types of dermal cancer. What is skin basal cell carcinoma and why did experts give this pathology this name? In this article, we will consider what basal cell carcinoma looks like, its classification, the main causes of development, and also describe how to treat this disease and the prognosis after the therapeutic course.

Most often, this pathology manifests itself in older people, or more precisely in representatives of the stronger sex. The skin disease in question received such an interesting name because it occurs inside the basal layer of the skin. Basal cell carcinoma is diagnosed in 30% of cases of dermal cancer. In order not to trigger pathologies, you need to know what basal cell carcinoma is and how it manifests itself.

Let's look at the ICD code for basal cell carcinoma of the face and other parts of the body. It is classified as a neoplasm class C00 – D48. The subclass of the pathology under consideration is C44 (malignant skin tumors).

Depending on the location of the cancer lesion, the disease received the following codes:

• C44.0 (lip lesion).
• C1 (eyelid damage).
• C44.2 (basal cell carcinoma of the auricle, auditory canal).
• C3 (different areas of the face: forehead, nose, cheeks).
• C44.4 (basal cell carcinoma of the scalp).
• C44.5 (damage to the skin of the trunk).
• C44.6 (oncology of the dermis of the shoulders, upper extremities).
• C44.7 (damage to the skin of the pelvis, lower extremities).
• C44.8 (oncology of skin beyond the specified localizations).
• C44.9 (unspecified localization).
• C43 (damage to the skin of the genital organs).
• C46 (melanoma).

Basal cell carcinoma of the face

Facial basal cell carcinoma is considered a popular pathology of malignant skin lesions. Often appears in men. You can even recognize the disease yourself. Initially, formations in the form of a small nodule may be disturbing. Its color is flesh-colored and red. Its growth is gradually noted without any discomfort or pain. Then brown crusts appear.

The appearance of suspicious formations on the skin of the face should serve as a signal to visit a doctor. The specialist will prescribe tests that will need to be completed to make an accurate diagnosis.

Basalioma of the scalp

This pathology is considered an intermediate link between benign and malignant formations. More often, pathology is observed in open areas of the skin. However, its localization in the scalp area is possible. It is difficult to detect this pathology due to its location under the hair. The danger of oncology lies in germination into bone and muscle tissue, followed by destruction.

Basalioma of the lower eyelid

Basalioma of the eyelid is a malignant formation of cells of the lower layer of skin. The prognosis for this pathology is quite favorable if quality treatment is provided. Eye cancer is practically not prone to metastasis. Experts also call it corroding ulcer, basal cell carcinoma, or carcinoid.

Basalioma of the lower eyelid often develops in old age. It affects only the skin. There is a gradual growth of malignant formation. Education is growing quite slowly. Gradually it can reach a size of 10 cm. In the first stages of development, basalioma of the eye is like a bubble (translucent, with a dense structure). Then an ulcer appears, a crust forms on it, the removal of which is accompanied by bleeding.

Basalioma of the eye is localized in different areas of the organ of vision:

• lower eyelid;
• external commissure of the eyelid;
• medial commissure of the eyelid;
• upper eyelid.

If any disturbance occurs in the corner of the eye, on any of the eyelids, you should immediately contact a specialist. He will prescribe adequate treatment. In the eye area, basalioma is quite difficult to treat. Microsurgery, radiation therapy, microsurgery with freezing are used. To restore the damaged eyelid and return it to normal mobility, its reconstruction will be required.

Basalioma of the skin of the back

Basalioma on the back is not considered malignant by some experts due to the absence of metastases and its slow growth. If the pathology is advanced and recurs, the prognosis will be unfavorable. Cancer cells arise due to the uncontrolled process of cell transformation. Provoking factors are internal and external environmental factors.

In most cases, the tumor grows slowly. It may increase over several years. At the first stages of development, oncology does not provoke the manifestation of pain. In some cases, burning and itching may occur.

Oncology classification

Superficial basalioma has the following main types:

1. Nodal. This type of pathology is the most common. Basalioma of the face and body looks like a tubercle, whose size reaches 1 cm. Its edges are flat. It is characterized by the formation of a shiny surface, pearlescent color (sometimes a redder color is observed). The tumor is covered with single telangiectasias. The pathology is characterized by slow growth. Moreover, any painful sensations are missing.

Over time, the tumor disintegrates at its apex, and an ulcer appears. A flesh-colored crust forms on the wound, the removal of which is accompanied by the opening of the bottom of the wound. A shaft is formed around the tumor (it is closed, ring-shaped).

This type of facial basal cell carcinoma is most often observed.

It is located in the center, at the top of the face.

Surgical treatment of this pathology brings good results.

1. Superficial. Superficial basalioma is represented by a plaque, the size of which reaches 40 mm. It protrudes above the dermis and is characterized by an ulcerated surface. The wounds are healing, the pathological skin is thinned, has a red-pink color, and is atrophic. Sometimes vermiform edges are observed, as in the nodular form of the disease. Facial basal cell carcinoma of this form occurs, as well as cancer of open areas of the body (most often on the chest). Three quarters of the tumors of this form, located on the lower leg, were recorded in women.
2. Scar. This form has certain distinctive features. Its surface is usually located below healthy dermal tissue. The tumor is characterized by high density, similar to a keloid scar. Her color is gray-pink. The edges of the tumor are slightly raised, shiny, and resemble a worm-shaped cushion, as in the nodular form. Ulcers in the scar form of oncology occur at the border with healthy skin tissue. This makes it difficult to determine the boundaries of oncology necessary for surgical removal of the pathology.

The form in question is observed in primary cancer and its relapse. The recurrence rate reaches 40%. Oncology is most often localized in the chest, face, and neck areas.

1. Ulcerative. Experts consider it the most dangerous. Under its influence, serious defects in the affected tissues occur. This form of oncology is characterized by an ulcerative surface; it is located below the skin level. Sometimes the wound is covered with dark crusts. Their removal visualizes the bottom covered with tubercles. Its color can be different (red, gray, black). The edges of the wound rise above the surrounding skin.

Typically the lesion in question is located on the head. Facial basal cell carcinoma appears in different areas:

• ear basal cell carcinoma;
• upper lip;
• eyelid damage;
• oncology of the skin of the nose, nasolabial folds;
• cheek skin lesions;
• skin pathology on the forehead;
• basal cell carcinoma of the scalp.

Experts also use the classification of oncology with the following types:

• perforating;
• adenoid basal cell carcinoma;
• nodular;
• pigmentary;
• cicatricial-atrophic;
• warty;
• pagetoid superficial;
• Spiegler's tumor;
• nodular large nodular (solid basalioma of the skin);
• sclerodermiformis.

Stages of development

Basalioma skin cancer has stages, like any other form of oncology. Let's introduce them:

1. Zero stage. During this period, cancer cells form inside the dermis, but the tumor itself is still absent. The initial stage of pathology can only be detected by an experienced specialist. Symptoms may not appear at all or may be very minor.
2. First stage. Basal cell carcinoma is just developing. This stage is considered the most favorable for treatment. The tumor is within 2 cm.
3. Second stage. At this time, a flat basal cell carcinoma forms. The tumor grows and can reach 5 cm.
4. Third stage. It is fixed for deep basal cell carcinoma. It is characterized by ulcers on the surface, oncological growth into the skin, fatty tissue, muscle fibers, tendons, and bone tissue. The patient is concerned about skin pain.
5. Fourth stage. It records the destruction of bone tissue located under the affected skin.

Risk factors

A type of skin cancer, basalioma, can occur for various reasons, which experts have combined into special groups:

• mandatory reasons;
• relative reasons;
• risk factors.

Let us consider in more detail all the reasons that provoke the development of such skin pathology as basal cell carcinoma of the face or other area of ​​the epidermis.

Mandatory reasons for the development of skin cancer include:

• Bowen's disease;
• xeroderma pigmentosum;
• Keir's erythroplasia;
• Paget's syndrome.

Basalioma on the face and other parts of the body can form for the following relative reasons:

• solar keratosis;
• cutaneous horn;
• trophic ulcers;
• keratoacanthoma;
• syphilitic gummas, granulomas;
• keloid scars;
• radiation ulcers;
• seborrheic acanthoma;
• cold abscess (with tuberculosis).

Basalioma of the face and body can develop under the influence of the following factors:

• immunosuppression;
• numerous moles;
• excessive tanning on the skin;
• long-term exposure to oil products and tar on the epidermis;
• freckles;
• age;
• thermal injuries;
• long-term exposure of the epithelium to arsenic, derivatives of this substance.

Symptoms

If basalioma appears on the face, it is easier to detect it than in other areas. Doctors can achieve rapid remission of the pathology if skin cancer is detected at an early stage. Therefore, it is very important to know the signs of basal cell carcinoma. You can notice the formation of squamous cell carcinoma yourself. The main thing is to pay attention to any neoplasms on the skin of the face and open areas of the dermis. Doctors recommend monitoring any changes in the condition of moles (their color, size, consistency).

The following main signs indicate the development of skin cancer:

• the presence of fuzzy, uneven edges on the mole;
• asymmetry of moles;
• rapid growth of a mole;
• change in mole color;
• large size mole (size greater than 6 mm).

The appearance of one or more of the listed signs requires consultation with an oncologist. It's better to play it safe. These symptoms do not necessarily indicate the development of skin cancer.

Diagnostics

The patient himself can suspect that this disease is developing if he knows what it looks like. Diagnosis is represented by examination of moles. You need to contact a specialist if the color, size, or structure of the mole has changed.

If this dangerous diagnosis is suspected, the doctor will refer the patient for the following studies:

• biopsy;
• Ultrasound;
• MRI;
• tests for tumor markers;
• histological, cytological examination, radiography.

The listed diagnostic methods can confirm/refute a dangerous diagnosis. If the patient has had superficial basal cell carcinoma in the past, he needs to undergo these examinations regularly. This will help prevent recurrence of skin basal cell carcinoma or detect the appearance of new tumors in time.

Treatment

Treatment of skin basal cell carcinoma is most often carried out using the following methods:

• radiation therapy;
• taking medications;
• surgical removal.

The doctor selects treatment for skin basalioma taking into account individual indicators(stage of disease, patient’s condition).

Radiation is given to patients diagnosed with advanced stages of skin cancer. This method of therapy is quite easy to tolerate. The probability of developing complications is 20% (trophic ulcers, headaches, cataracts). I use radiation for patients over 65 years of age. The following methods are popular:

• beta rays;
• close focus radiation therapy.

For chemotherapy I use the following drugs:

• "Doxorubicin".
• "Cisplatin".
• "Methotrexate."

Surgery

If the size of the formation is more than 7 mm, surgical treatment is required. The use of laser therapy for large skin basal cell carcinoma guarantees long-term remission. Most often, the skin pathology disappears forever, and there is no need for repeated laser treatment.

It is important to remember that cancer has fuzzy, jagged edges. Complete elimination tumor requires careful determination of its boundaries. Treatment of basal cell carcinoma on the face and other areas of the skin aimed at removing the tumor is performed using the following methods:

• curettage, fulguration. Used on many areas of the body except the face (nose, eyelids, ears, lips, temples). Initially, curettage is performed, then current is applied to stop the bleeding. Often used to remove formations with smooth edges;
• excision. The formation is removed during a biopsy. Used for small formations under local anesthesia;
• MOS operation. It is a layer-by-layer removal of tissue until all pathologically altered skin cells are eliminated. Use on the entire surface of the skin.

Cryodestruction of basalioma

This treatment method has been used since 1960. Cryodestruction of basalioma is carried out in 2 ways:

1. Aerosol. The effect on cancer cells is at a depth of up to 10 mm.
2. Application. Features deep penetration.

Cryodestruction of basal cell carcinoma involves the formation of ice crystals, which provoke tissue necrosis. Liquid nitrogen is used to freeze multiple skin lesions. The advantages of the procedure are:

• painlessness;
• destruction of oncology;
• satisfactory appearance areas of nitrogen exposure;
• duration (literally 5 minutes);
• relapse prevention;
• immediate activation of protection in the area of ​​injured tissue;
• application for removal of benign and malignant tumors.

Wounds on the skin after cryodestruction heal in about 3 weeks, so not everyone chooses this method of removing formations.

Drug therapy

You can use ointment to treat basal cell carcinoma. In this case, the therapeutic course is 2–3 weeks.

This product is applied under an occlusive dressing. The following ointments are recommended for topical application:

• "Curaderm".
• "Omainovaya."
• "Metvix."
• "Podophylline".
• "Solcoseryl".
• "Fluorouracil".
• "Glyciphone".
• "Ftorafurovaya".
• "Prospidinovaya".

Interferons are used to treat formations in the corners of the eyes, inside the ear, and on the eyelids. In these areas it is impossible to apply surgical excision, chemotherapy, or laser. Also, cryodestruction of basal cell carcinoma is not used in these areas.

Traditional therapy methods

Treatment of basal cell carcinoma on the face can also be carried out using traditional methods. You can use ointment, tincture, mask to treat this pathology. They are prepared from the following plants:

• hemlock;
• carrot;
• roundleaf wintergreen;
• aloe;
• celandine.

Diet

Health directly depends on the products we eat. Experts have identified a number of products containing microelements that suppress the growth of cancer cells. That's why they recommend special food for cancer, which requires inclusion in the diet of the following products:

• greenery;
• garlic;
• carrot;
• cabbage (white, cauliflower, Brussels sprouts), broccoli;
• citrus;
• beet;
• hot pepper (red);
• whole grains.

It is prohibited to consume products containing:

• nitrates, nitrites;
• yeast;
• overheated, stale fats.

Also contraindicated:

• alcohol;
• smoked meats;
• pickles;
• chocolate, cocoa, coffee;
• baking;
• vegetables and fruits from greenhouses (homemade is allowed);
• mushrooms;
• strong broths;
• fatty dairy products.

It is important that the diet is balanced. The food must contain a sufficient amount of minerals, vitamins, and microelements. Such nutrition makes it easier to undergo chemotherapy and improves the quality of life.

Life expectancy, forecasts

When a diagnosis of “basal cell carcinoma of the face or other areas of the dermis” is made, the prognosis for life depends on the form of oncology, its course, stage of development, and correctly selected therapy. If you start treating the tumor in a timely manner, the outcome will be favorable. After tumor removal, patients can live about 10 years, even longer. This skin pathology can be completely cured. Doctors give the best prognosis when the tumor size is no more than 2 cm.

ICD 10 is the international classification of diseases 10th revision. Necessary for easier writing of long illnesses on sick leave certificates. Firstly, it reduces the doctor's time. Secondly, it reduces the size of what is written character by character.

Encoding

Class: neoplasms C00 - D48

Subclass: malignant skin tumors C44

List of oncological diseases on the skin by localization:

• C44.0 — Lips
• C1— Eyelids
• C44.2 — Auditory canal and ear
• C3 - Other areas of the face: nose, forehead, cheeks, etc.
• C44.4 — Scalp skin
• S44.5— Torso
• C44.6 — Upper limbs, shoulders
• S44.7 — Lower limbs and pelvis
• S44.8 — Skin extending beyond the described localizations
• S44.9 — unrefined localization

Diseases excluded from the list:

• C46- melanoma
• C43- skin of the genital organs
• C51-52, C60, C63
• C00 — basal cell carcinoma of the lips

Application

According to the international tumor classification, skin cancer is designated by the coding C44. But the thing is that this is a whole class that is simply pointed to malignant neoplasms on a specific area of ​​the body, but does not indicate the type of neoplasm.

Therefore, there is no exact code according to ICD 10. The only thing that can be specified is the area of ​​the affected body. For example, in the medical history, basal cell skin cancer is indicated once and the localization is specified. For example, C44.3 (on the face) and it seems that you can only use one cipher so as not to constantly write a complex and long name.

Definition

Basalioma or basal cell skin cancer is a malignant neoplasm that develops from the follicles of the upper layer of the skin or epidermis.

Varieties

1. Adenoid
2. Pigmentary
3. Cylinder
4. Ulcerative
5. Scleroderma-like
6. Pagetoid
7. Scleroderma-like
8. Large nodular nodular
9. Exophytic or warty
10. Perforating

• 0 Stage— there is a small neoplasm of atypical cells.
• Stage 1- the tumor is located within the tissues and has a size of up to 20 mm.
• Stage 2- affects nearby tissues, but does not affect the fat layer. Has a size of more than 22mm.
• Stage 3- grows further and affects adipose tissue.
• Stage 4- has a size of more than 5 mm, can affect muscles, bones, cartilage, lymphatic and circulatory systems.

Diagnostics

• Initial examination by a dermatologist and oncologist
• Biopsy of carcinoma.
• Biochemical blood test - the rate of lactate dehydrogenesis increases.
• MRI, CT for large formations.
• Ultrasound of the abdominal cavity to exclude metastases to organs.
• X-ray

Treatment

1. Surgical removal of the tumor— surgeons try to remove both the tumor itself and the nearby affected tissue. If the lymph nodes become infected, they are also removed.
2. Chemotherapy— special chemicals are introduced into the formation or nearby tissues that destroy malignant tissue.
3. Radiation therapy - carried out in combination with chemotherapy and surgery. Before surgery, radiotherapy reduces the tumor and then destroys the remains of the lesion.
4. Photodynamic treatment
5. Cryogenic method- freezing and exposure negative temperatures for malignant formation.

Prevention

• Use sunscreen
• Try not to get sunburned and spend less time in the sun if you have very white skin.
• Quit smoking and alcohol
• Eat right and watch your weight
• Move more and play sports.

C44.3 Malignant neoplasm of the skin of other and unspecified parts of the face

Causes of skin basal cell carcinoma

The issue of histogenesis has not been resolved; most researchers adhere to the dysontogenetic theory of origin, according to which basal cell carcinoma develops from pluripotent epithelial cells. They can differentiate in different directions. In the development of cancer, importance is attached to genetic factors, immune disorders, and adverse external influences (intense insolation, contact with carcinogenic substances). It can develop on clinically unchanged skin, as well as against the background of various skin pathologies (senile keratosis, radiodermatitis, tuberculous lupus, nevi, psoriasis, etc.).

Basal cell carcinoma is a slow-growing and rarely metastasizing basal cell carcinoma that arises in the epidermis or hair follicles, the cells of which are similar to the basal cells of the epidermis. It is considered not as cancer or a benign neoplasm, but as a special kind of tumor with locally destructive growth. Sometimes, under the influence of strong carcinogens, primarily X-rays, basal cell carcinoma develops into basal cell carcinoma. The question of histogenesis has not yet been resolved. Some believe that basaliomas develop from the primary epithelial rudiment, others - from all epithelial structures of the skin, including from embryonic rudiments and malformations.

Risk factors

Provoking factors are insolation, UV, X-rays, burns, and arsenic intake. Therefore, basal cell carcinoma often occurs in people with skin types I and II and albinos who are exposed to intense sun exposure for a long time. It has been established that excessive sun exposure in childhood can lead to the development of a tumor many years later.

Pathogenesis

The epidermis is slightly atrophic, sometimes ulcerated, and there is a proliferation of tumor basophilic cells similar to the cells of the basal layer. Anaplasia is mild, mitoses are few. Basalioma rarely metastasizes, since tumor cells that enter the bloodstream are not capable of proliferation due to the lack of growth factor produced by the tumor stroma.

Pathomorphology of skin basalioma

Histologically, basal cell carcinoma is divided into undifferentiated and differentiated. The undifferentiated group includes solid, pigmented, morphea-like and superficial basal cell carcinomas, the differentiated group includes keratotic (with piloid differentiation), cystic and adenoid (with glandular differentiation) and with sebaceous differentiation.

The WHO international classification (1996) identifies the following morphological variants of basal cell carcinoma: superficial multicentric, codular (solid, adenoid cystic), infiltrating, non-sclerosing, sclerosing (desmoplastic, morphea-like), fibro-epithelial; with adnexal differentiation - follicular, eccrine, metatypical (basosquamous), keratotic. However, the morphological boundary of all varieties is unclear. Thus, in an immature tumor there may be adenoid structures and, on the contrary, with its organoid structure, foci of immature cells are often found. Also, there is no complete correspondence between the clinical and histological pictures. Usually there is correspondence only for such forms as superficial, fibroepithelial, scleroderma-like and pigmented.

For all types of basal cell carcinomas, the main histological criterion is the presence of typical complexes of epithelial cells with dark-colored oval nuclei in the central part and palisade-like complexes located along the periphery. In appearance, these cells resemble basal epithelial cells, but differ from the latter in the absence of intercellular bridges. Their nuclei are usually monomorphic and not subject to anaplasia. The connective tissue stroma proliferates together with the cellular component of the tumor, located in the form of bundles among cellular strands, dividing them into lobules. The stroma is rich in glycosaminoglycans, staining metachromatically with toluidine blue. It contains many tissue basophils. Retraction gaps are often detected between the parenchyma and stroma, which many authors regard as a fixation artifact, although the possibility of exposure to excessive secretion of hyaluronidase is not denied.

Solid basal cell carcinoma among undifferentiated forms it occurs most often. Histologically, it consists of various shapes and sizes of strands and cells of compactly located basaloid cells with unclear boundaries, resembling a syncytium. Such complexes of basal epithelial cells are surrounded at the periphery by elongated elements, forming a characteristic “picket fence”. Cells in the center of the complexes can undergo dystrophic changes with the formation of cystic cavities. Thus, along with solid structures, cystic ones can exist, forming a solid-cystic variant. Sometimes destructive masses in the form of cellular detritus are encrusted with calcium salts.

Pigmented basal cell carcinoma Histologically it is characterized by diffuse pigmentation and is associated with the presence of melanin in its cells. The tumor stroma contains a large number of melanophages with a high content of melanin granules.

An increased amount of pigment is usually detected in the cystic variant, less often in the solid and superficial multicentric. Basaliomas with pronounced pigmentation contain a lot of melanin in the epithelial cells above the tumor, throughout its entire thickness up to the stratum corneum.

Superficial basal cell carcinoma often multiple. Histologically, it consists of small, multiple solid complexes associated with the epidermis, as if “suspended” from it, occupying only the upper part of the dermis to the reticular layer. Lymphohistiocytic infiltrates are often found in the stroma. The multiplicity of foci indicates the multicentric genesis of this tumor. Superficial basal cell carcinoma often recurs after treatment along the periphery of the scar.

Scleroderma-like basal cell carcinoma, or the “morphea” type, is distinguished by the abundant development of scleroderma-like connective tissue, in which narrow cords of basal epithelial cells are “embedded”, extending deep into the dermis down to the subcutaneous tissue. Polygarden-like structures can be seen only in large cords and cells. Reactive infiltration around tumor complexes located among the massive connective tissue stroma, as a rule, it is scanty and more pronounced in the zone of active growth on the periphery. Further progression of destructive changes leads to the formation of small (cribrosoform) and larger cystic cavities. Sometimes destructive masses in the form of cellular detritus are encrusted with salts calcium.

Basal cell carcinoma with glandular differentiation, or adenoid type, is characterized by the presence, in addition to solid areas, of narrow epithelial strands consisting of several, and sometimes 1-2 rows of cells forming tubular or alveolar structures. The peripheral epithelial cells of the latter have a cubic shape, as a result of which the polysad-like character is absent or less clearly expressed. The internal cells are larger, sometimes with a pronounced cuticle; the cavities of the tubes or alveolar structures are filled with epithelial mucin. The reaction with carcinoembryonic antigen produces positive staining for extracellular mucin on the surface of cells lining the duct-like structures.

Basal cell carcinoma with cyloid differentiation characterized by the presence of keratinization foci in complexes of basal epithelial cells, surrounded by cells similar to spinous ones. In these cases, keratinization occurs bypassing the keratohyaline stage, which resembles the keratogenic zone of the isthmus of normal hair follicles and may have tricho-like differentiation. Sometimes there are immature milked follicles with initial signs of the formation of hair shafts. In some cases, structures are formed that resemble embryonic hair buds, as well as epithelial cells containing glycogen, corresponding to the cells of the outer layer of the hair follicle. Sometimes there may be difficulty in differentiating from follicular basaloid hamartoma.

Basal cell carcinoma with sebaceous differentiation It is rare and is characterized by the appearance of foci or individual cells typical of the sebaceous glands among the basal epithelial cells. Some of them are large, signet-shaped, with light cytoplasm and eccentrically located nuclei. When stained with Sudan III, fat is revealed in them. Lipocytes are much less differentiated than in a normal sebaceous gland; transitional forms are observed between them and the surrounding basal epithelial cells. This indicates that this type of cancer is histogenetically associated with the sebaceous glands.

Fibroepithelial type(syn.: Pincus fibroepithelioma) is a rare type of basal cell carcinoma that occurs mostly in the lumbosacral region and can be combined with seborrheic keratosis and superficial basal cell carcinoma. Clinically it may look like fibropapilloma. Cases of multiple lesions have been described.

Histologically, narrow and long cords of basal epithelial cells are found in the dermis, extending from the epidermis, surrounded by a hyperplastic, often edematous, mucoid-altered stroma with a large number of fibroblasts. The stroma is rich in capillaries and tissue basophils. Epithelial strands anastomose with each other and consist of small dark cells with a small amount of cytoplasm and round or oval, intensely stained nuclei. Sometimes in such cords there are small cysts filled with homogeneous eosinophilic contents or horny masses.

Nevobasocellular syndrome(syn. Gordin-Goltz syndrome) is a polyorganotropic, autosomal dominant syndrome related to phakomatoses. It is based on a complex of hyper- or neoplastic changes due to disorders of embryonic development. The cardinal symptom is the appearance in the early period of life of multiple basal cell carcinomas, accompanied by odontoten cysts of the jaws and anomalies of the ribs. There could be cataracts and changes in the central nervous system. It is also characterized by frequent changes in the palms and soles in the form of “indentations”, in which basaloid structures are also found histologically. After the early nevoid-basaliomatous phase, several years later, usually during puberty, ulcerative and locally destructive forms appear in these areas as an indicator of the onset of the oncological phase.

Histological changes in this syndrome are practically no different from the types of basal cell carcinomas listed above. In the area of ​​the palmoplantar “indentations” there are defects in the stratum corneum of the epidermis with thinning of its remaining layers and the appearance of additional epithelial processes from small typical basaloid cells. Large basal cell carcinomas rarely develop in these places. Individual basal cell lesions of a linear nature include all types of organoid basal cell carcinomas.

Histogenesis of skin basalioma

Basalioma can develop both from epithelial cells and from the epithelium of the pilosebaceous complex. Using serial sections, M. Hundeiker and N. Berger (1968) showed that in 90% of cases the tumor develops from the epidermis. Histochemical examination of various types of cancer shows that in most cells glycogen and glycosaminoglycans are found in the tumor stroma, especially in adamantinoid and cylindromatous patterns. Glycoproteins are constantly detected in basement membranes.

Electron microscopy revealed that most cells of tumor complexes contain a standard set of organelles: small mitochondria with a dark matrix and free polyribosomes. There are no intercellular bridges at the contact sites, but finger-like projections and a small number of desmosome-like contacts are found. In areas of keratinization, layers of cells with intact intercellular bridges and a large number of tonofilaments in the cytoplasm are noted. Occasionally, zones of cells containing cellular membrane complexes are found, which can be interpreted as a manifestation of glandular differentiation. The presence of melanosomes in some cells indicates pigment differentiation. In basal epithelial cells, organelles characteristic of mature epithelial cells are absent, which indicates their immaturity.

It is currently believed that this tumor develops from pluripotent germinal epithelial cells under the influence of various types of external stimuli. Histologically and histochemically, the connection of basal cell carcinoma with the anagen stage of hair growth has been proven and the similarity with proliferating embryonic hair buds has been emphasized. R. Holunar (1975) and M. Kumakiri (1978) believe that this tumor develops in the germinal layer of the ectoderm, where immature basal epithelial cells with the potential for differentiation are formed.

Symptoms of skin basal cell carcinoma

Skin basal cell carcinoma has the appearance of a single formation, hemispherical in shape, often round in outline, slightly elevated above the skin level, pink or grayish-red in color with a pearlescent tint, but may not differ from normal skin. The surface of the tumor is smooth; in its center there is usually a small recess, covered with a thin, loosely adjacent squamous crust, upon removal of which erosion is usually detected. The edge of the ulcerated element is thickened like a roller, consists of small whitish nodules, usually designated as “pearls” and having diagnostic value. In this state, the tumor can exist for years, slowly growing.

Basaliomas can be multiple. Primary plural form, according to K.V. Daniel-Beck and A.A. Kolobyakova (1979), occurs in 10% of cases, the number of tumor foci can reach several dozen or more, which may be a manifestation of non-basocellular Gorlin-Goltz syndrome.

Forms

Surface view begins with the appearance of a limited scaly patch of pink color. Then the spot acquires clear contours, oval, round or irregular shape. Dense small shiny nodules appear along the edge of the lesion, which merge with each other and form a roll-like edge raised above the skin level. The center of the hearth sinks slightly. The color of the lesion becomes dark pink, brown. Lesions may be solitary or multiple. Among the superficial forms, self-scarring or pagetoid basalioma is distinguished with a zone of atrophy (or scarring) in the center and a chain of small, dense, opalescent, tumor-like elements along the periphery. The lesions reach a significant size. Usually has a multiple nature and a persistent course. Growth is very slow. Its clinical features may resemble Bowen's disease.

At pigmented form the color of the lesion is bluish, purple or dark brown. This type is very similar to melanoma, especially nodular, but has a denser consistency. Dermoscopic examination can provide significant assistance in such cases.

Tumor type is characterized by the appearance of a nodule, which gradually increases in size, reaching 1.5-3 cm or more in diameter, acquires a rounded appearance, and a stagnant pink color. The surface of the tumor is smooth with pronounced telangiectasias, sometimes covered with grayish scales. Sometimes its central part ulcerates and becomes covered with dense crusts. Rarely, the tumor protrudes above the skin level and has a stalk (fibroepithelial type). Depending on the size they distinguish small and large nodular forms.

Ulcerative appearance occurs as a primary variant or as a result of ulceration of the superficial or tumor form of the neoplasm. A characteristic feature The ulcerative form is a funnel-shaped ulceration, which has a massive infiltrate (tumor infiltration) fused with the underlying tissues with unclear boundaries. The size of the infiltrate is much larger than the ulcer itself (ulcus rodens). There is a tendency to deep ulcerations and destruction of underlying tissues. Sometimes the ulcerative form is accompanied by papillomatous, warty growths.

Scleroderma-like, or scar-atrophic, appearance It is a small, clearly demarcated lesion with a thickening at the base, almost not rising above the level of the skin, yellowish-whitish in color. Atrophic changes and dyschromia may be detected in the center. Periodically, along the periphery of the element, foci of erosion of various sizes may appear, covered with an easily removable crust, which is very important for cytological diagnosis.

Pincus fibroepithelial tumor classified as a type of basal cell carcinoma, although its course is more favorable. Clinically, it manifests itself in the form of a skin-colored nodule or plaque, of dense elastic consistency, and practically does not undergo erosion.

How is diagnosis carried out?

Survival prognosis

Prevention

Publication date: 03-10-2016

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Dear friends, hello. Today we will talk to you about what nasal basal cell carcinoma is and how it is treated. Read the article carefully and remember all the nuances.

Features of nasal basal cell carcinoma

Basalioma, or otherwise basal cell carcinoma, is considered one of the most common types of malignant tumors that develop in the cells of the basal layer of the epidermis.

ICD 10 code – C44 (malignant neoplasms of the skin of other and unspecified parts of the face).

Often people themselves notice any lesions on the face, in particular on the nose, because this is the most protruding part of it.

Due to its location, the nose is constantly exposed to UV rays, which are the main cause of tumor development.

The skin in the area of ​​the cartilaginous part of the nose (in place of the wings and tip) is very thin. There is practically no fatty tissue underneath, as a result of which the neoplasm quickly penetrates into the cartilage.

It is quite difficult to remove a cancerous tumor from this place. The operation often leaves a scar. Moreover, due to its close location to the organs of vision, nasal basal cell carcinoma can affect the periorbital retina.

If you have previously had basal cell carcinoma, then you should be especially careful about your health and regularly visit a doctor for timely diagnosis of relapses. I will say that they develop in approximately 30-40% of patients.

Main types of nasal skin basal cell carcinoma (with photo)

Tumors in this part of the body grow very quickly. This is due to the structural features of the nose and the anatomical characteristics of the skin. Here is a list of the main types of neoplasms with photos.

• Initial stage of basal cell carcinoma. It looks like a small plaque, most often located on the wing of the nose or in the nasolabial fold. The first symptoms can be mistaken for the formation of a nevus or acne.

• Next, nodular basal cell carcinoma develops. It is characterized by a single shiny node, which contains numerous dilated vessels.

• Over time, the node grows. It becomes large, hard to the touch, and red. It is often affected by small lesions.

• At the fourth stage, the tumor can metastasize to internal organs and the eye area. This is the most dangerous stage of the disease, which is rarely treatable.

These were the main stages of development of basal cell cancer of the skin of the nose. Also often observed:

• pigmented basalioma with an ulcer in its central part. The edges of the tumor can be of different colors (from beige to black).

• ulcerative neoplasm under the scab. Parts of the scab may periodically fall off, causing the tumor to bleed. This type of cancer is often confused with keratoma, especially if the patient has several of them on his face.

• fibrosing basal cell carcinoma. It looks like scar plaques.

How is diagnosis carried out?

If you notice the first symptoms of a tumor, you should consult an oncologist. The examination is carried out using a dermatoscope - a special device that allows you to examine the tumor as accurately as possible.

A biopsy may be required to confirm the diagnosis. A small section of the pathological tissue is removed by puncture or surgical scraping. The material is sent to the laboratory for research.

Treatment options for basal cell tumor of the face

Treatment methods are chosen by the doctor depending on the severity of the disease and the depth of the lesion. The main task is to completely eliminate the tumor and prevent relapse.

If you consult a specialist at the initial stage, such a tumor will be subject to surgical excision.

In addition to the affected tissue, healthy tissue must also be removed to avoid relapses. The operation is performed on an outpatient basis under local anesthesia.

Radiation therapy is also used to remove the tumor. This method is based on remote exposure of the tumor through highly active x-ray radiation, leading to the death of pathological cells.

This method of removing basal cell carcinoma has one drawback - you need to undergo approximately 25 sessions of gamma therapy (radioactive irradiation).

Treatment after radiation is based on the use of chemotherapy. If you treat a tumor comprehensively, this will lead to the destruction of mutated tissues.

There are cases when, due to surgical excision of the tumor, a large area of ​​tissue may be damaged. In this case, you can resort to the services of a plastic surgeon.

• Fulguration and curettage. This procedure is performed under local anesthesia. The affected area is cauterized with electric current.
• Moss micrographic surgery. This type of basal cell carcinoma removal is less traumatic and can therefore be used on the face. It is based on layer-by-layer removal of affected tissue under a microscope.

Survival prognosis

With nasal basal cell carcinoma, the main thing is to detect it in time. If this is done at the initial stage, then the prognosis after surgery is favorable - up to 95%.

With later diagnosis, a positive outcome is observed in only 60% of patients. The good news is that this type of cancer rarely metastasizes.

Prevention

• Avoid direct sunlight on the face area. Try to hide from the sun after 11 a.m. and before 4 p.m.
• Use sunscreen and hats during spring and summer.
• Conduct self-examination regularly to detect the disease early.

Well, dear readers, you understand that basal cell carcinoma of the skin of the nose can be very dangerous. Do not delay visiting a specialist if you notice any suspicious formations on your face.

The appearance of polyps in the gallbladder - is it dangerous? Benign formations of various etiologies in this organ of the digestive system are found in every sixth inhabitant of the planet. In people of the fairer sex after 35 years of age, this pathology is diagnosed in 80% of cases. In ICD-10, this disease is coded K82. What are gall bladder polyps? Are these benign tumors dangerous?

Etiology and pathogenesis of the disease

To date, the true reason for which the disease develops has not been clarified.

The appearance of gall bladder polyps is provoked by such disorders as:

The asymptomatic form of chronic cholecystitis leads to excessive growth of the walls of the organ - hyperplasia. Hyperplastic growths have drop-shaped, irregular or rounded outlines. These polypous formations are located on the thickened wall of the vesica fellea. Benign polypous neoplasms grow into the lumen of the digestive organ. Sometimes they are located on a thin long stalk.

Typical pathology clinic

A patient has symptoms of gallbladder polyps - what does this mean? Usually, in the initial stage of vesica fellea lesions, objective and subjective symptoms are not detected. Specific signs of pathology may appear when a large tumor-like neoplasm begins to impede the functionality of other organs.

The digestion process is disrupted because the flow of bile necessary for digesting fatty foods is hampered. The ducts of the organ expand, since large polyps significantly disrupt the normal outflow of bile. Gradually, pathological changes appear in the thickened wall of the affected organ.

An excessive amount of bilirubin is formed in the blood, since there is a mechanical obstacle to the excretion of this substance. Pain is periodically felt in the area of ​​the right hypochondrium. If hyperplastic growths are located in the neck of the bladder, unpleasant symptoms appear. After eating, a cramping or dull pain occurs on the right side, since the normal outflow of biological fluid from the bladder into the duodenum is disrupted due to a mechanical obstruction. The photo will help you find out what benign gall bladder polyps look like.

Painful disorders such as:

• bitter taste in the mouth;
• yellow white of eyes;
• the skin is yellow;
• sour belching after eating;
• causeless weight loss;
• constant insufficient bowel movements, flatulence;
• feeling of discomfort in the epigastrium, eruption of stomach contents.

In medical practice there are the following types gall bladder polyps:

Why are gallbladder polyps dangerous?

A person has no idea about anything for a long time after the formation of polyps, so there is no doubt about their cunning. Often only in the office ultrasound examination Quite by accident, a specialist identifies gall bladder polyps in a patient if their length has reached 10 mm. However, smaller structures are not hypoechoic. They are not determined during instrumental diagnostics.

If the size of the polyp exceeds 10 mm, the hyperplastic growth can move within the neck of the bladder and block its lumen. This disrupts the flow of bile. Bile obstruction, inflammation, and infection of the organ quickly develop. Even in asymptomatic cases, hyperplastic growths of gallbladder tissue very often degenerate into malignant neoplasms. The incidence of cancerous degeneration is up to 30%.

Excess bilirubin in the circulatory system is extremely dangerous, since such pigmented toxic Chemical substance harms brain cells. The patient's health deteriorates significantly. The danger increases when polyps grow. A big problem is the possibility of torsion of their legs, pinching of hyperplastic outgrowths. Necrosis develops due to disruption of the blood supply to the organ. The development of purulent cholecystitis is often a consequence of polyposis.

The growth of polyps can accelerate in a woman’s body while she is expecting a baby. During pregnancy, all these complications are extremely dangerous for the fetus and mother. Assimilation nutrients is violated. The fetal brain cells are poisoned by increased bilirubin. There is a risk of fetal death due to metabolic disorders.

Diagnostic tests

It is very difficult to identify this complex disease. Ultrasound is the cheapest and most accessible diagnostic method. Using an ultrasound examination, thickening of the organ lining can be detected. A hyperacoustic shadow is visible along the wall of the bubble. However, the nature of the neoplasm tissue is not always determined reliably using ultrasound diagnostics. The location and structure of the tumor-like neoplasm should be studied in detail if, after ultrasound, this polyp raises doubts in the doctor.

Endoscopic ultrasonography is the most interesting and promising highly informative diagnostic method. On the monitor screen, a benign formation appears as a light structure with an acoustic shadow. Using an ultrasonic sensor, a specialist can detect multiple or single formations.

Accurate diagnosis is carried out using MRI. During the study, the gallbladder with tumor-like formations is clearly visible. Using a multi-planar imaging method using radiofrequency pulses, continuous magnetic field allows you to get a clear image of them. The condition of the soft tissues of the bladder can be assessed.

Gallbladder polyposis is reliably diagnosed by performing fine-needle aspiration biopsy. To thoroughly examine the bladder and ensure the absence of other pathologies, MR cholangiography is used. Contrasting the gallbladder is performed to study the digestive organ during oral cholecystography. After administration of the contrast agent, radiography is performed. In the presence of polyps, organ defects are clearly visible.

Treatment tactics for polyps

Is it possible to do without surgery? Not all formations can be treated conservatively. Treatment with traditional methods is ineffective. Only medical technology will help solve the problem. Watchful waiting is used if a small single polyp is detected. In this situation, it is important to perform an abdominal ultrasound every 2 months.

Surgical treatment requires pathological proliferation of the epithelium. Tumor-like neoplasms that become malignant, are resistant to therapy, or recur must be removed. Hereditary predisposition and suspicion of a malignant process are indications for surgery.

If benign growths are detected, experts usually recommend immediately performing cholecystectomy - removal of the gallbladder, since the high risk of malignancy of the tumor-like neoplasm should be taken into account. Laparoscopic cholecystectomy is a gentle treatment method.

There is no need to waste time. You can significantly reduce the likelihood of serious complications if you undergo periodic preventive medical examinations. At the first suspicion of trouble, you should go to a specialist for medical help.

Basalioma of the skin of the nose (basal cell carcinoma, basal cell carcinoma) is a malignant pathology growing from the basal cells or structures of the hair follicle. But not all oncologists think so. Many people believe that basal cell carcinoma is an intermediate link between nevi and carcinomas. The pathology extremely rarely metastasizes and is the most common among all skin cancers. In the advanced stage of the disease, the neoplasm can melt the underlying skin layers, muscles, even cartilage and bones.

The pathology develops extremely rarely in children and is practically not registered in newborns. Both men and women get sick equally age group from 50 years old. The disease, according to ICD 10, is coded C 44 (other malignant neoplasms of the skin). So how to treat basalioma and how to quickly identify it?

Classification and causes of neoplasm: briefly

Correct classification for basal cell carcinoma of the face and nose is very important. Further treatment depends on the type of tumor. right choice method of specific therapy. There are 4 stages of neglected pathology, where the first stage is the beginning of the disease, and stage 4 is the final stage of the disease, often leading to irreversible consequences for the whole organism (cachexia, melting of bone tissue, etc.). Features of the classification of the disease include the identification of several forms of basal cell carcinoma. These include: nodular, superficial, cicatricial, ulcerative.

The causes of the disease remain unclear, since all the triggers for the onset of the disease have not been identified. For decades now, such a topic has been a subject of dispute among world-famous aesculapians. There are certain predisposing factors that increase the risk of pathology. Let's list some of them:

• prolonged exposure to aggressive UV radiation, including in a solarium;
• radiation;
• burdened heredity;
• persistent decrease in immunity;
• age;
• albinism;
• obligatory precancerous conditions (Bowen's disease, Paget's disease, Queyra's erythroplasia)
• relative precancerous pathologies (keloid scars, cutaneous horn, syphilitic gummas or granulomas, tuberculosis, etc.);
• contact with petroleum derivatives or tar;
• exposure to strong chemical irritants, especially arsenic;
• occupational hazards (high temperatures, finely dispersed pollution, constant injury to the skin area).

Symptoms of the disease

Symptoms of basalioma of the facial skin are similar to the manifestations of a neoplasm on the wings of the nose. The symptoms depend on the type of disease and quite clearly characterize the form of the disease. To identify it, you should carefully examine the appearance, quantity, size and shape of the tumor. An experienced oncologist will be able to make the correct diagnosis.

Nodular (nodular) basalioma, located on the skin of the face, is characterized by a rounded shape. The knot is pink in color and has a small pit (notch) in the center. Even the slightest trauma to the tumor is the beginning of bleeding, which is difficult to stop. It is often complicated by the formation of erosive and ulcerative surfaces, which complicates treatment.

The ulcerative form of basal cell carcinoma is the most dangerous. It melts the surrounding tissue, the ulcerative bottom is localized below the level of the epidermis. The ulcerative edges do not have a clear shape and rise above the epidermal layer of the skin. Sometimes the ulcer can “heal”, becoming covered with a dense, hard, almost black crust. If this cover is disturbed, a greyish, blackish or scarlet bottom will be exposed. The following symptoms are also typical:

• color grayish-pinkish;
• dense consistency;
• tendency to re-grow after treatment;
• slow, almost imperceptible growth;
• in advanced cases, ulcerative surfaces form along the edges of the tumor.

Superficial basal cell carcinoma is a borderline condition between a benign and a malignant process. As a pathology, it develops in people after 50 years of age, damaging exposed areas of the epidermis. On the face, the most dangerous tumor formation is considered to be the area affected by the inner and outer corners of the eye. It grows “inside out”, rising as a pink spot above the surrounding tissues. The skin over the tumor is thin, has an atrophic appearance, and often ulcerates.

All types of basal cell carcinoma, especially the solid form, are absolutely painless. A lot of time passes from the first manifestation to contacting a specialist; the neoplasm manages to grow many times over, which worsens the prognosis of the disease. With multiple lesions, the tumor leads to cachexia, severe, frequent bleeding, and destruction of bone tissue. All types of neoplasms and outcomes from lack of treatment can be seen in the photo.

Diagnostics

Diagnostic methods are aimed at verifying the diagnosis and preventing medical errors. Nasal basalioma requires histological examination. A small section of skin is sent to a histologist. After the study, the type of cancer, the degree of development and the type of cancer cells are determined. Histology is prescribed in all doubtful cases, to exclude other skin diseases that have similar symptoms.

Live healthy! Basalioma

Basalioma. What is this?

Basalioma of the Skin of the Nose, Removal, Plastic [Basalioma of the Skin of the Face Photo]

Basalioma of the skin of the nose, removal, plastic surgery

Biopsy and CO2 laser removal of basal cell carcinoma of the skin of the dorsum of the nose.

Collecting a detailed life history is another surefire method of making an accurate diagnosis. Be sure to take into account information about bad habits, lifestyle, the presence of frequent injuries, occupational hazards. In rare cases, an ultrasound examination is prescribed, computer diagnostics. Be sure to examine regional and nearby lymph nodes, which will not allow you to miss cancer of the skin of the face, wings and back of the nose. General and biochemical blood tests and a general urinalysis are prescribed.

Traditional treatment methods

Treatment of basal cell carcinoma on the face is a scrupulous process that requires deep knowledge and the availability of precise medical equipment. Most often, combination therapy is used, using several therapeutic techniques. This way you can achieve stable remission, prevent the development of metastases, and prolong the patient’s life. Do not be afraid of being referred to an oncology clinic; modern science can help even in advanced cases.

Surgery

Small basaliomas of the facial skin are usually not removed using a scalpel method (curettage and subsequent fulguration), for fear of leaving a significant defect after surgery. It is no longer possible to do without surgical treatment in the last, fourth stage of the disease, when the subcutaneous tissue, muscles, and facial bones are affected. The cost of the procedure, given the complexity of the manipulation, is quite high. The procedure involves the presence of bleeding, the administration of painkillers, and suturing.

Radiation therapy

Radiation therapy is ideal for treating basal cell carcinomas that are difficult to reach. The method has been known for a long time, has been well studied, and all contraindications to therapy have been clarified. The procedure is carried out only in a hospital setting, under the supervision of a radiation oncologist - a specialist who can correctly select the dose and other parameters of the supplied radiation. The manipulation is quite easily tolerated by patients.

As complications, you can notice changes in blood tests, such as a drop in hemoglobin, and extremely rarely, radiation burns. Radiation therapy is affordable. But the duration of the course can be more than one month, which reduces the attractiveness of this type of treatment. With timely access to specialists, the technique significantly improves the prognosis of the disease.

Drug therapy (chemotherapy)

Chemotherapy is used less and less in the treatment of basal cell carcinomas. Today there is no reliable, categorical data confirming the positive dynamics of the development of the disease. Treatment with medications is prescribed after removal of the cancer lesion. The oncologist-chemotherapist selects a therapeutic regimen after carefully reviewing the patient’s data. Typically, cytostatics (Imiquimod or 5-fluorouracil) are prescribed, which are harmful to the affected tissues.

Modern therapeutic techniques (laser therapy, cryotherapy)

Modern methods of treating neoplasms safely include cryogenic and laser destruction. Cryotherapy is the effect of liquid nitrogen on a pathological process. Evaporating from the surface of the skin, it causes a critical decrease in temperature in a separate area of ​​the skin, which leads to freezing of the pathological growth. The manipulation is carried out on an outpatient basis, using special sprayers and a thermos to store the substance.

Laser treatment can work wonders, because now we can treat pathology with high temperatures. I am pleased with the high precision of the manipulation, the complete absence or very slight scar, even when treating large neoplasms.

Mixed treatment

This treatment regimen is distinguished by maximum therapeutic indicators. As a rule, several sessions of radiation therapy are prescribed before surgery, then the tumor itself is removed, choosing the most gentle method. According to indications, specialists may prescribe postoperative radiation or chemotherapy. To reduce the risk of formation of a disfiguring scar, regenerating and anti-inflammatory ointments are actively used. Such complex therapy is carried out only in an oncology clinic under inpatient hospitalization conditions.

Traditional treatment

According to “grandmother’s” advice, treatment is carried out when radiotherapy has been performed and the disease is in remission, which will allow achieving a lasting therapeutic effect. Such recipes will be beneficial in the early stages of the disease, in the absence of germination into the underlying tissues, in the absence of metastatic lesions. Cannot be used traditional medicine as a substitute for traditional treatment. Here are several recipes suitable for curing the diagnosis of “Basal cell carcinoma of the face.”

Tobacco tincture

Tobacco tincture has a suppressive effect that prevents the growth of cancer cells. To prepare the tincture, you will have to remove pure tobacco from a whole pack of unfiltered cigarettes. Such tobacco products do not contain unnecessary flavorings or additional substances. Mix the resulting raw material with two hundred grams of vodka, leave for 14 days, then, after straining, apply a moistened swab as a lotion. During the first 10 days of use, improvements will become noticeable - scarring of the frame, cell regeneration, reduction in the area of ​​skin damage. This treatment is useful for severe symptoms of skin disease.

Camphor tincture

Pharmaceutical camphor crystals (10 grams) are mixed with a bottle of high-quality 40% vodka. Shake the container daily and leave until solids are completely dissolved. Apply a rag soaked in the resulting solution. Alternate ten-day use with a five-day break.

carrot juice

Carrots are an inexhaustible storehouse of vitamins and mineral complexes. It is useful to pour freshly squeezed juice over the newly formed skin and apply compresses for a short time. It can also be taken orally, half a glass a day, having a beneficial effect on all organs and systems of the body. As a method of treatment, carrot juice has earned a lot of positive reviews, which contributes to the popularization of the method.