The skin cancer prevention is the timely detection of malignant tumors of the skin at a curable stage.
Skin cancer is a disease that is free to proliferate in the malignant cells of the skin and destroy their immediate environment and can also infect the entire body.
The type of cancer can be distinguished mainly by the malignant melanoma, and squamous Basalzellkrebs.
The so-called “Black Skin Cancer” – Malignant melanoma – makes up about three quarters of the cases of skin cancer. The other forms of skin cancer are “White skin cancer” called. The white primary cancer is rarely metastases (secondary tumors) and can be detected in good time he will be treated well and safely.

 

Malignant melanoma
Malignant melanoma is the most dangerous skin cancer, as he often metastases, so-called metastasizes to other organs.
It occurs predominantly on the exposed parts of the body – face, décolleté and hands – but also in other places. Malignant melanomas resemble moles. These moles should be checked regularly and removed when striking change.

 

Actinic keratosis – light keratosis
An actinic keratosis is a skin disorder of keratinization.
It is caused by solar radiation – or tanning beds – and therefore occurs particularly in people who are frequently exposed to this radiation.
In some cases, may develop from an actinic keratosis cancer – the so-called squamous cell carcinoma.
One speaks therefore also of precancerous actinic keratoses (precancerous lesions).

 

Squamous or squamous cell cancer
There are two types of spino:

Keratinized squamous
It is formed preferentially to chronically inflamed and on chemically or by radiation-damaged skin and scar on tight.

Unverhorntes squamous
The unverhornte squamous built on the mucous membranes of the body, ie in the area of the vagina, urethra, anus, tongue, esophagus and conjunctiva. It is caused by radiation in addition to chemical poisons such as arsenic and tobacco smoke, or HPV – Human Papilloma Virus.

De-differentiated squamous (a special form)
This arises from actinic keratosis and is developing very fast.
The squamous is removed surgically. It is always important that the tumor is removed “to healthy”. This means that not only the tumor but also a part of the surrounding tissue is removed to make sure that no residual tumor left behind. To rule out a lymph node involvement, these must also be examined. Sometimes radiation therapy is required.

 

Basal Cell Carcinoma
The Basalzellkrebs – Basal Cell Carcinoma – appeared earlier and in particular on sun-exposed skin areas with more older people. Meanwhile, younger people are affected.
Basal cell carcinomas are removed surgically, as a rule – or removed by laser – in healthy individuals.

Provision
The skin cancer screening is performed at regular intervals.
It includes a detailed examination of the skin, from head to foot – if necessary by means of a supervisory microscopy (dermoscopy) – changes of the skin. Striking and cancer suspicious changes can be detected in time and distance.

Your Benefits
Skin cancer is a steadily growing and dangerous disease, diagnosed each year in many patients. You can protect yourself by regular skin cancer screening from both the cancer and before his serious consequences.

The skin cancer screening is part of your personal pension for a long and healthy life.
Quality assurance in aesthetic dermatology with 20-MHz ultrasound skin on the example of fold augmentation.

 

Dr. Med. N. Brenner
In recent years the media has created an ideal of beauty, in which more and more people want to measure. Beauty inspires self-confidence and makes you successful. The good thing is who has a smooth skin, a slender body, symmetrical facial features.

The desire for “wrinkle free” face, lends to perform more and more patients undergo invasive wrinkle treatment can be. Many disciplines are concerned with fold augmentation, which contributes to the development of new techniques and new substances. The rapid spread of new indications and filler materials requires a critical examination of the available drugs, particularly in relation to the potential quality assurance.

The ever-increasing entitlement attitude of the patient requires a critical approach to the available preparations. Careful diagnosis and experience of the therapist to determine the quality of the method applied to a large extent.

 

Imaging techniques have proven to be a diagnostic tool in many areas of medicine and have now firmly established in routine diagnostics. The non-invasive and reproducible 20MHz ultrasound is used to assess the skin. Using ultrasound images of the skin may take place with various fold augmentation filler substance be documented and ongoing processes, the time lag in the skin, are presented.

The ultrasound shows normal skin, young skin a strong entrance echo caused by impedance mismatch of water to the epidermis as well as by reflection in the epidermis. Below is a clearly demarcated hyper echoic dermis. The high echogenicity is due to the structure, density, spatial arrangement and the voltage of the collagenous connective tissue. The subcutaneous connective tissue is located in the high-frequency sonogram of hypo echoic represents the muscle fascia is hyper echoic.

Figure 1: Ultrasound image normal young skin. epidermis a-, b-dermis, subcutaneous tissue c-, d-muscle fascia.

Skin aging is influenced by two main factors: external factors on the one hand, as the UV exposure and smoking (1), intrinsic constitutional factors on the other hand, a genetic predisposition, the so-called “biological clock” (2).

Both changes are in the intrinsic and extrinsic aging, chronological aging process both individual cell types as well as structural proteins of the dermis. Through the release of reactive oxygen radicals leads to the degradation of the connective tissue of the skin. Thus causing the superoxide anion and the hydroxyl radical destruction of the collagen molecule (3).

Using ultrasound images of the skin, the skin wrinkles and aging processes are well documented. If the skin ultrasound images of the temporal region of a 20 – and compares a 65-year-old patient, the different Koriumstruktur missing immediately apparent: In the upper portion of the dermis arises as a hypoechoic band that is from the remaining dermis well-demarcated, dar. low echogenicity of the dermis caused by the loss of collagen. This corresponds to the diagnosis of actinic elastosis and the loss of connective tissue and degeneration of collagen fibers described.

Figure 2: Skin ultrasound of the temporal region of a 20-year-old patient

Figure 3: Ultrasonic skin of temporal region of a 65-year-old patient

For various injectable fillers are used Faltenaugmentation,
are placed on the certain requirements. A “good” filler should not be toxic and immunologically inactive. The substance should be removed from the body naturally. Long-term results are desirable, but the product should be absorbable.

Polylactic acid (Sculptra ™), a polymer of Alphahydroxysäurefamilie is used as a biodegradable filler biokompartibel since 1999. Polylactic acid is used due to their biological and mechanical properties for over 20 years in medicine. It is used as a dissolvable suture material in prosthetic surgery and sustained drug release.
Since it is a synthetic substance, no allergy testing is required. PLA is biodegradable and bioresorbable: it is quite natural on the lactate to CO2 and Pyruvatzyklus degraded and excreted in the breath.

Sculptra is well suited for the correction of wrinkles and scars and for facial contouring and volume filling. Especially nasolabial folds, mouth wrinkles and volume defects of the cheek (buccal Fettatrophie of age and drug-induced lipodystrophy) can be effectively treated with polylactic acid.

Figure 4: Faltenaugmentation on a 35-year-old patient with polylactic acid

Figure 5: Skin ultrasound in the treatment of nasolabial folds

Figure 6: Skin Ultrasound 8 weeks after infection

 

The quality control of areas treated with 20-MHz ultrasound enables the detection of skin collagen neogenesis after 4 to 6 weeks after injection, this results in thickening of the skin.
By skin ultrasound scans can also skeptics among patients and colleagues will be convinced and temporary increase in the depth of wrinkles after treatment with polylactic acid is more easily tolerated by patients.

The injected volume of polylactic acid causes an immediate filling of wrinkles and volume defects. Within 3-4 days the water in the injected volume is removed from the body. And the depth of wrinkles increases somewhat. After that comes through the formation of collagen to a natural structure of the connective tissue and therefore a balance of wrinkles. After about 6 weeks may be decided whether the treatment can be performed.