High-intensity focused ultrasound (HIFU) has recently emerged as a novel non-invasive treatment modality in dermatology, offering precise ablation of cutaneous lesions with minimal damage to surrounding tissue. Originally developed for deep-seated tumors, dermatological HIFU platforms operating at ~20 MHz enable submillimeter-scale treatment of thermal or mechanical injuries localized to the epidermis and superficial dermis, making them suitable for managing benign, premalignant, and malignant skin conditions. This review outlines the mechanistic basis of HIFU—including thermal coagulation, acoustic cavitation, and immunomodulatory effects—and presents the current evidence for its efficacy in treating actinic keratoses and basal cell carcinomas (BCCs), where early studies report clearance rates of 70–97% and excellent cosmetic outcomes. Compared to conventional therapies such as surgery, photodynamic therapy, or cryotherapy, HIFU offers reduced procedural pain, faster healing, and the ability to treat multiple lesions in a single session. Its role in field cancerization and potential utility in prophylaxis for high-risk skin areas are also explored. While promising, long-term oncologic outcomes and standardized treatment protocols remain under investigation. HIFU represents a significant advancement in non-invasive skin cancer management, aligning oncologic efficacy with patient-centered care.
高强度聚焦超声（HIFU）作为一种新型无创治疗手段，近年来在皮肤科领域崭露头角，能够精准消融皮肤病灶，同时对周围组织损伤极小。该技术最初针对深部肿瘤开发，而皮肤科专用的约20 MHz HIFU平台可实现表皮及真皮浅层亚毫米级别的热损伤或机械损伤治疗，适用于处理良性、癌前及恶性皮肤病变。本文综述了HIFU的作用机制基础——包括热凝固、声空化及免疫调节效应，并系统呈现了该技术在治疗光化性角化病和基底细胞癌方面的现有证据：早期研究显示其清除率达70-97%，且美容效果优异。相较于手术、光动力疗法或冷冻疗法等传统治疗方式，HIFU具有操作疼痛轻、愈合速度快、单次治疗可处理多发病灶的优势。本文同时探讨了该技术在区域癌化治疗中的作用，以及在高风险皮肤区域预防性应用的潜力。尽管前景广阔，其长期肿瘤学疗效及标准化治疗方案仍有待深入研究。HIFU技术标志着无创皮肤癌治疗领域的重大进展，在实现肿瘤学疗效的同时，充分体现了以患者为中心的诊疗理念。
肿瘤(癌症)患者之家