Durnick Anke, Stolz Wilhelm, Landthaler Michael, Vogt Thomas
Department of Dermatology, University of Regensburg, Regensburg, Germany.
Dermatol Surg. 2004 May;30(5):813-6. doi: 10.1111/j.1524-4725.2004.30222.x.
We observed two young women with skin types II to III according to Fitzpatrick's classification who developed pigmented macules in the face that were histologically diagnosed as lentigo maligna melanomas.
The objective of this study was to examine lentigo maligna melanoma in young adults.
According to private photographs of one of those patients a precursor lesion was clinically apparent as early as in her 26th year. Ten years later, the diagnosis of a lentigo maligna melanoma was made. The other patient was diagnosed with lentigo maligna at the age of 37. After excision, a relapse occurred in her 39th year. At this time histopathology revealed an early invasive lentigo maligna melanoma.
These case reports demonstrate that the diagnosis of both lentigo maligna and lentigo maligna melanoma cannot be dismissed because of young age or well-tanning skin types.
We conclude that owing to changes in social behavior and sporting activities with high short-term ultraviolet exposures, one must be aware of the possibility of an unusual early onset of lentigo maligna and lentigo maligna melanoma already in the third and fourth decade of life. Furthermore, our observations support the effectiveness of dermatoscopy in diagnosing ambiguous pigmented skin lesions in sun-exposed skin.
我们观察到两名根据菲茨帕特里克分类法属于II至III型皮肤的年轻女性,她们面部出现色素沉着斑,经组织学诊断为恶性雀斑样痣黑色素瘤。
本研究的目的是研究年轻成年人中的恶性雀斑样痣黑色素瘤。
根据其中一名患者的个人照片,早在其26岁时临床就可明显看出前驱病变。十年后,确诊为恶性雀斑样痣黑色素瘤。另一名患者37岁时被诊断为恶性雀斑样痣。切除后,在她39岁时复发。此时组织病理学显示为早期浸润性恶性雀斑样痣黑色素瘤。
这些病例报告表明,不能因为患者年轻或皮肤晒黑良好就排除恶性雀斑样痣和恶性雀斑样痣黑色素瘤的诊断。
我们得出结论,由于社会行为和体育活动的变化,短期紫外线暴露量高,人们必须意识到在生命的第三和第四个十年就有可能出现不寻常的早期恶性雀斑样痣和恶性雀斑样痣黑色素瘤。此外,我们的观察结果支持皮肤镜在诊断暴露于阳光下皮肤中色素沉着不明确的皮肤病变方面的有效性。