Chamlin S L, Williams M L
Department of Pediatrics, University of California, San Francisco 94115, USA.
Adolesc Med. 2001 Jun;12(2):v, 195-212.
Accurate diagnosis of congenital and acquired pigmented lesions accompanied by an understanding of their natural history and disease associations is critical for the appropriate management and counseling of adolescents, as well as timely referral to specialists when indicated. The recognition of atypical nevi and other melanoma risk factors in adolescents should lead to institution of preventive measures, such as routine skin examinations and counseling regarding sun protection. Because the incidence of melanoma is increasing in adolescents as well as adults, prompt identification of suspicious melanocytic lesions may lead to early diagnosis and effective treatment of melanoma. Numerous pigmented lesions can also herald the presence of a multisystem disorder; the recognition of syndromes associated with these lesions should result in appropriate evaluation and genetic counseling of affected individuals. This review distinguishes pigmented lesions that histologically represent a proliferation of melanocytes and that may therefore confer an increased risk for melanoma, from pigmented lesions due to increased melanization alone (i.e., increased melanin content) that are not associated with malignancy.
准确诊断先天性和后天性色素沉着病变，并了解其自然病史和疾病关联，对于青少年的恰当管理和咨询，以及在需要时及时转诊至专科医生处至关重要。识别青少年中的非典型痣和其他黑色素瘤危险因素应促使采取预防措施，如定期皮肤检查和防晒咨询。由于青少年和成年人中黑色素瘤的发病率都在上升，及时识别可疑的黑素细胞病变可能会导致黑色素瘤的早期诊断和有效治疗。许多色素沉着病变也可能预示着多系统疾病的存在；识别与这些病变相关的综合征应促使对受影响个体进行适当评估和遗传咨询。本综述区分了组织学上表现为黑素细胞增殖、因此可能增加黑色素瘤风险的色素沉着病变，与仅因黑素化增加（即黑色素含量增加）而无恶性关联的色素沉着病变。
