Ferrari Angela, Lozzi Gian Piero, Fargnoli Maria Concetta, Peris Ketty
Department of Dermatology, University of L'Aquila, L'Aquila, Italy.
Dermatol Surg. 2005 Nov;31(11 Pt 1):1448-50. doi: 10.2310/6350.2005.31215.
A combined nevus most commonly consists of a blue nevus in combination with a Clark or Spitz nevus. Dermoscopically, combined nevus can mimic melanoma owing to the presence of dermoscopic features common to both types of lesions. Benign clinical and dermoscopic changes can occur in nevi over time, especially in children and young adults.
To describe the dermoscopic evolution of a congenital combined nevus showing unusual dermoscopic features.
Digital dermoscopic analysis was performed at the initial visit and after 8 months. The lesion was surgically excised and histopathologically examined.
An asymptomatic plaque with a central blue area and peripheral brown pigmentation located on the back of a 13-year-old boy was diagnosed dermoscopically as combined nevus. Dermoscopic analysis 8 months later showed color changes from steel blue to gray-blue and black in the central area of the lesion, an increased number of blue-black dots or globules, and peripheral irregular streaks. Histopathology revealed typical features of a congenital combined nevus (blue nevus + compound nevus).
Over time, congenital combined nevus may show clinical and dermoscopic changes in size, color, and structure. Surgical excision is recommended when clinical and dermoscopic features are equivocal and the diagnosis of melanoma cannot be ruled out.
复合痣最常见的是由蓝痣与克拉克痣或斯皮茨痣组合而成。在皮肤镜检查中，由于这两种病变都具有一些共同的皮肤镜特征，复合痣可能会被误诊为黑色素瘤。随着时间的推移，痣可能会出现良性的临床和皮肤镜变化，尤其是在儿童和年轻人中。
描述一例具有不寻常皮肤镜特征的先天性复合痣的皮肤镜演变过程。
在初诊时和8个月后进行数字皮肤镜分析。对病变进行手术切除并进行组织病理学检查。
一名13岁男孩背部有一个无症状的斑块，中央为蓝色区域，周边为褐色色素沉着，皮肤镜检查诊断为复合痣。8个月后的皮肤镜分析显示，病变中央区域的颜色从钢蓝色变为灰蓝色和黑色，蓝黑色小点或小球数量增加，周边出现不规则条纹。组织病理学显示为先天性复合痣（蓝痣+复合痣）的典型特征。
随着时间的推移，先天性复合痣可能会在大小、颜色和结构上出现临床和皮肤镜变化。当临床和皮肤镜特征不明确且不能排除黑色素瘤诊断时，建议手术切除。
