6旬農婦長期日曬臉長斑 雷射無效確診皮膚癌
2022-06-26 記者陳宜琳/嘉義報導
60歲農婦臉上出現黑斑，經多次雷射除斑無效，經嘉義長庚皮膚科主任何宜承診斷為皮膚癌。（圖：嘉義長庚醫院提供）
60多歲的陳太太，長年從事農業生產工作，近年來注意到臉上出現黑色斑點，開始以為是痣不以為意，後來痣越變越大，進行多次雷射除斑治療後，黑色斑點仍然很頑強地又長回來，前往嘉義長庚醫院尋求皮膚科何宜承主任的詳細檢查後，診斷是皮膚癌，所幸在病灶早期體積較小時即時進行根除切除手術，術後未再復發，也未留下難看的疤痕。
何宜承主任表示，依據衛福部公布資料，皮膚癌為十大癌症死因之一，且有逐年增加的趨勢，因此國內民眾仍然不可輕忽皮膚癌的發生。從流行病學的觀察，若住在赤道附近比住在高緯度地方其皮膚癌的發生率較高。另外由於上個世紀後期以來，人類開始在日常生活上廣泛大量使用氟氯碳化物產品，結果造成大氣層中臭氧層的嚴重耗損，其結果使得照射到地表的紫外線相對增加，人們極容易曝露在過量的紫外線之下，當然較以往更易得到皮膚癌。
何宜承主任指出，皮膚癌一般的臨床表現為皮膚出現逐漸變大的斑塊、腫瘤或不易癒合的潰瘍，且有疼痛感或癢感等症狀。國人好發的是肢端痣型惡性黑色素細胞瘤，而發生於足底的惡性黑色素細胞瘤則是所有惡性黑色素細胞瘤中預後最差的。在台灣多數惡性黑色素細胞瘤病人被診斷確定時，均屬於疾病晚期，常合併有局部皮膚轉移或淋巴轉移。
台灣每年約有四千多例皮膚癌新增病例，但罹患皮膚癌而死亡的人數卻不超過百人，因此只要定期注意自己與家人身上是否有奇怪、會快速變大或無法癒合皮膚病灶，大多數的皮膚癌是一種易於發現、治癒，較少直接危及生命，無需過度害怕的癌症。
何宜承主任提醒，有關皮膚癌黑色病灶的自我評估方法ABCD四大口訣：A (asymmetry) 形狀不對稱、B (border) 四周不規則、C (color change) 顏色不均勻
、D (diameter) 病灶逐漸變大，以這個基本原則每年或每半年定期在穿衣鏡前，將全身上下皮膚自我詳細瀏覽一番，別忘了也要檢查雙腳底，對國人來說，足底是好發惡性黑色素細胞瘤且又容易被自我檢查忽略的部位，有疑問的部位再請皮膚科醫師複查，是防治惡性黑色素細胞瘤的最佳方法。
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