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邹先彪

邹先彪

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皮肤镜

获得性黑色素细胞痣皮肤镜检类型

发表者:邹先彪 4147人已读

摘  要:

背景:获得性黑色素细胞痣的皮肤镜分类中,按形态(球形、球形-网状、球形-均质形、网状形、网状-均质形和均质形)和按色素分布(均匀、中央色素沉着、中央色素减退、外周色素沉着、外周色素减退、多灶性色素沉着或减退)均可分为6种不同类型。大多数患者的痣都有一个显著的皮肤镜表现型。目的:评估多发性获得性黑色素细胞痣患者的年龄是否影响痣的显著皮肤镜表现。方法:自2000年7月至2001年2月,从Graz的色素性皮肤病诊所收集患者。连续选择至少有10个黑色素细胞痣的患者,直至5个年龄组中每组患者的总数达到10人。这5个年龄组为:0~15岁,16~30岁,31~45岁,46~60岁和〉60岁。获得性黑色素细胞痣定义为:良性黑色素细胞增生,表现为直径≥5mm的斑点,出生1年以后发病。采用皮肤镜检查标准对获得性黑色素细胞痣的数字图像进行评估。分析了皮肤镜检特征与患者年龄的关系。作者计算不同年龄组黑色素细胞痣的绝对数和发生频率(后者用百分率表示),以及痣皮肤镜检查的显著型。结果:通过对1268个痣进行分析,发现年龄最小组的皮损以球形为主。相比之下,网状形和(或)均质形在年长的患者(15岁以上)中增多。年龄最小组的黑色素细胞痣常为均匀色素沉着,而16~30岁组常为中央色素沉着。结论:黑色素细胞痣皮肤镜检查的显著型随患者年龄不同而不同。了解黑色素细胞痣年龄相关的显著型,可以更准确地识别与患者年龄关系密切的黑色素细胞皮损的皮肤镜检类型。本观察有助于早期识别一些貌似黑色素瘤的“普通痣”。此外本研究提出了一些与痣发展有关的有意思的问题。北京304医院皮肤科邹先彪

ORIGINAL ARTICLE
Age-related prevalence of dermoscopy patterns in acquired melanocytic naevi
I. Zalaudek*†, S. Grinschgl*, G. Argenziano, A.A. Marghoob, A. Blum§, E. Richtig*, I.H. Wolf*, R. Fink-Puches*, H. Kerl*, H.P. Soyer* and R. Hofmann-Wellenhof*
  *Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036 Graz, Austria

Background Based on the dermoscopic classification of acquired melanocytic naevi, six different dermoscopic types can be distinguished by morphology (globular, globular-reticular, globular-homogeneous, reticular, reticular-homogeneous, homogeneous) and by pigment distribution (uniform, central hyperpigmentation, central hypopigmentation, peripheral hyperpigmentation, peripheral hypopigmentation, multifocal hyper/hypopigmentation). It has been suggested that most individuals harbour one predominant dermoscopic type among their naevi.

Objectives To evaluate whether the age of the patient influences the predominant naevus pattern observed in individuals with multiple acquired melanocytic naevi.

Methods Individuals were recruited from the pigmented skin lesion clinic in Graz between July 2000 and February 2001. Individuals with at least 10 melanocytic naevi were selected consecutively until a total of 10 individuals in each of five age groups was obtained. Age groups were: 0–15 years, 16–30 years, 31–45 years, 46–60 years and > 60 years. Digitized images of acquired melanocytic naevi, defined as benign melanocytic proliferations having a diameter of at least 5 mm with a macular component and which were not apparent within the first year of life, were evaluated by dermoscopic criteria. The associations of dermoscopic features as a function of patient age were analysed. We calculated absolute numbers and frequencies, given as percentages, as well as predominance of the dermoscopic types of naevi in the different age groups.

Results Analysis of 1268 naevi revealed that the globular pattern predominated in the youngest age group. By contrast, the reticular and/or homogeneous patterns were increasingly exhibited in naevi from older individuals (older than 15 years). Uniform pigmentation was most common in melanocytic naevi in the youngest age group, while central hyperpigmentation was predominantly seen in the group of individuals aged 16–30 years.

Conclusions The predominance of dermoscopic types of melanocytic naevi varies according to the individual's age. Awareness of the age-related dermoscopic predominance of melanocytic naevi might allow more accurate recognition of dermoscopic patterns of melanocytic skin lesions that are unusual with respect to the individual's age. This observation may help in the early recognition of some 'banal'-appearing melanomas. Furthermore, the observations made in this study raise interesting questions regarding naevus evolution.

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发表于:2009-01-02 20:21

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