Tripp Jackie M, Kopf Alfred W, Marghoob Ashfaq A, Bart Robert S
Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York 10016, USA.
J Am Acad Dermatol. 2002 May;46(5):674-82. doi: 10.1067/mjd.2002.121029.
Opinions concerning the significance of dysplastic nevi and their management vary among dermatologists.
The purpose of this study was to assess how fellows of the American Academy of Dermatology (AAD) perceive and manage dysplastic nevi.
Questionnaires were sent to 1216 fellows of the AAD; 456 questionnaires were returned.
Almost all respondents (98%) accept the dysplastic nevus, or atypical mole, as an entity. Seventy-five percent of respondents perform follow-up total cutaneous examinations on all their patients with dysplastic nevi, and another 22% on some of them; 86% usually intend to do total removals when they perform biopsies of dysplastic nevi; 75% use margins of 2 mm or less when removing dysplastic nevi; 49% order baseline total-cutaneous photographs of some or all of their patients with multiple dysplastic nevi, although only 12% do so routinely; 67% prefer to re-excise dysplastic nevi when margins are positive, some using histologic atypia as a criterion; 60% recommend an ophthalmologic examination for at least some of their patients with many dysplastic nevi, although only 3% do so routinely; 12% always recommend cutaneous examinations of blood relatives of their patients with dysplastic nevi and another 81% recommend such examinations for at least some of their patients with dysplastic nevi; 23% use dermoscopy; 99% recommend self-examination; almost 100% recommend sunscreen use and 93%, sun avoidance.
Most respondents, in agreement with the literature, accept the concept that patients with dysplastic nevi are at increased risk for melanoma and that methods for prevention and early detection of melanomas are appropriate for these patients.
皮肤科医生对于发育异常痣的重要性及其处理方法的看法各不相同。
本研究旨在评估美国皮肤科协会（AAD）的成员如何看待和处理发育异常痣。
向1216名AAD成员发送了问卷；共收回456份问卷。
几乎所有受访者（98%）都认可发育异常痣或非典型痣这一概念。75%的受访者会对所有发育异常痣患者进行随访时进行全面皮肤检查，另有22%的受访者会对部分患者进行此类检查；86%的受访者在对发育异常痣进行活检时通常打算将其完全切除；75%的受访者在切除发育异常痣时采用2毫米或更小的切缘；49%的受访者会为部分或所有有多发性发育异常痣的患者拍摄基线全皮肤照片，不过只有12%的受访者会定期这么做；67%的受访者在切缘阳性时更倾向于再次切除发育异常痣，有些人将组织学异型性作为标准；60%的受访者建议至少对部分有多发性发育异常痣的患者进行眼科检查，不过只有3%的受访者会定期这么做；12%的受访者总是建议对发育异常痣患者的血亲进行皮肤检查，另有81%的受访者建议至少对部分发育异常痣患者进行此类检查；23%的受访者使用皮肤镜检查；99%的受访者建议自我检查；几乎100%的受访者建议使用防晒霜，93%的受访者建议避免日晒。
大多数受访者与文献观点一致，认可发育异常痣患者患黑色素瘤的风险增加这一概念，并且认为针对这些患者的黑色素瘤预防和早期检测方法是合适的。
