Botella-Estrada R, Nagore E, Sopena J, Cremades A, Alfaro A, Sanmartín O, Requena C, Serra-Guillén C, Guillén C
Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain.
Br J Dermatol. 2006 Mar;154(3):478-84. doi: 10.1111/j.1365-2133.2005.07105.x.
Melanotic pigmentations in scars consecutive to the excision of melanocytic tumours can be secondary to a reactive phenomenon related to the scar tissue or to a recurrence of the melanocytic lesion excised in the first case. Recurrent naevi may sometimes adopt unusual features that make them difficult to differentiate from a melanoma.
To describe the clinical, dermoscopic and histological features of melanotic pigmentations in scars consecutive to the excision of melanocytic tumours, and to correlate the histological diagnosis with the dermoscopic features.
This was a prospective cohort study using macrophotography, dermoscopy and histopathological study. Ninety-five melanotic pigmentations (77 patients) in scars secondary to the excision of melanocytic tumours were prospectively collected in the Department of Dermatology at the Instituto Valenciano de Oncología in Valencia, Spain. Histopathological study was performed in 57 scars.
Thirteen dermoscopic structures were identified. Four criteria allowed a differentiation between reactive and specific melanocytic pigmentations. Presence of globules and presence of heterogeneous pigmentation were features associated with specific melanocytic pigmentations (P < 0.0001). Presence of a regular network and presence of streaks were more frequently found in reactive pigmentations (P = 0.023 and 0.026, respectively).
Dermoscopic examination of melanotic pigmentations in excision scars of melanocytic tumours provides useful information about the origin of that pigmentation. Based on such information, recurrent naevi can be differentiated from reactive pigmentations in most cases. Excision and histopathological diagnosis continue to be imperative in some cases of recurrent naevi with atypical clinical features.
黑色素细胞肿瘤切除术后瘢痕中的黑色素沉着可能继发于与瘢痕组织相关的反应性现象，或首例切除的黑色素细胞病变的复发。复发性痣有时可能呈现出不寻常的特征，使其难以与黑色素瘤区分开来。
描述黑色素细胞肿瘤切除术后瘢痕中黑色素沉着的临床、皮肤镜和组织学特征，并将组织学诊断与皮肤镜特征相关联。
这是一项使用宏观摄影、皮肤镜检查和组织病理学研究的前瞻性队列研究。西班牙巴伦西亚肿瘤研究所皮肤科前瞻性收集了95例黑色素细胞肿瘤切除术后瘢痕中的黑色素沉着（77例患者）。对57个瘢痕进行了组织病理学研究。
识别出13种皮肤镜结构。有四项标准可区分反应性和特异性黑色素细胞色素沉着。小球的存在和色素沉着不均一性的存在是与特异性黑色素细胞色素沉着相关的特征（P < 0.0001）。规则网络的存在和条纹的存在在反应性色素沉着中更常见（分别为P = 0.023和0.026）。
对黑色素细胞肿瘤切除瘢痕中的黑色素沉着进行皮肤镜检查可提供有关该色素沉着起源的有用信息。基于这些信息，在大多数情况下复发性痣可与反应性色素沉着区分开来。对于一些具有非典型临床特征的复发性痣病例，切除和组织病理学诊断仍然必不可少。
