Böhm M, Schiller M, Nashan D, Stadler R, Luger T A, Metze D
Department of Dermatology, and the Ludwig Boltzmann Institute for Cell Biology and Immunobiology of the Skin, University of Münster, Germany.
J Am Acad Dermatol. 2001 May;44(5):747-54. doi: 10.1067/mjd.2001.112349.
The origin of diffuse melanosis resulting from metastatic melanoma is unknown. We examined the light microscopic and ultrastructural changes in the skin of an affected 35-year-old woman and determined the peripheral blood levels of melanocyte growth factors. A total of 7 biopsy specimens were examined by light and electron microscopy and immunohistology (S-100, HMB45, MART1, CD68, MAC387). Serum/plasma levels of melanocyte growth factors of the patient were determined by enzyme-linked immunosorbent assays and compared with those of normal volunteers (n = 10) and amelanotic patients with metastatic melanoma (n = 10), matched to the UICC stage of the affected patient. Hyperpigmented but otherwise apparently normal skin of the patient displayed epidermal melanocyte hyperplasia, increased melanogenesis, and dermal pigment stored in histiocytes and other cells along with extracellular deposits. Blood levels of alpha-melanocyte stimulating hormone, hepatocyte growth factor, and endothelin-1 were significantly elevated in the affected patient. Aberrant production of these factors may not only be responsible for activation of the pigment system in diffuse melanosis of metastatic melanoma, but also for increased proliferation, motility, and pigment incontinence of normal and malignant melanocytes.
转移性黑色素瘤所致弥漫性黑变病的起源尚不清楚。我们检查了一名35岁受影响女性皮肤的光镜和超微结构变化，并测定了外周血中黑素细胞生长因子的水平。共对7份活检标本进行了光镜、电镜及免疫组织化学检查（S-100、HMB45、MART1、CD68、MAC387）。通过酶联免疫吸附测定法测定患者黑素细胞生长因子的血清/血浆水平，并与正常志愿者（n = 10）及与受影响患者UICC分期匹配的无色素性转移性黑色素瘤患者（n = 10）进行比较。患者色素沉着过度但外观正常的皮肤表现为表皮黑素细胞增生、黑素生成增加，真皮色素储存在组织细胞和其他细胞中，并伴有细胞外沉积物。受影响患者的α-黑素细胞刺激素、肝细胞生长因子和内皮素-1的血液水平显著升高。这些因子的异常产生可能不仅是转移性黑色素瘤弥漫性黑变病色素系统激活的原因，也是正常和恶性黑素细胞增殖、运动及色素失禁增加的原因。
