Egberts Friederike, Kaehler Katharina C, Brasch Jochen, Schwarz Thomas, Cerroni Lorenzo, Hauschild Axel
Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany.
J Am Acad Dermatol. 2008 May;58(5):880-4. doi: 10.1016/j.jaad.2007.12.028. Epub 2008 Feb 6.
Immunosuppressive regimens may have significant impact on the number of pigmented lesions and the clinical appearance of nevi. Whether immunosuppression can also influence the clinical and histopathologic appearance of malignant melanocytic lesions is still a matter of debate. A patient was immunosuppressed because of heart and bone marrow transplantation. A clinically inconspicuous mole was removed from the left flank and was considered to be a papillomatous nevus. After 1 year, the patient developed multiple pigmented lesions over the entire body, which presented clinically as benign papillomatous nevi and histologically as atypical Spitz nevi. Three months later melanoma metastases were removed from the patient's left axilla, which finally resulted in the death of the patient. Thus, in retrospect, the eruptive pigmented lesions have to be considered as cutaneous melanoma metastases. The atypical clinical and histopathologic appearance of the melanocytic lesions as well as the course of disease may have been influenced by the immunosuppression.
免疫抑制方案可能对色素沉着性病变的数量和痣的临床表现产生重大影响。免疫抑制是否也会影响恶性黑素细胞性病变的临床和组织病理学表现仍存在争议。一名患者因心脏和骨髓移植而接受免疫抑制治疗。从左下腹切除了一个临床上不显眼的痣，被认为是乳头状痣。1年后，患者全身出现多个色素沉着性病变，临床呈现为良性乳头状痣，组织学表现为非典型斯皮茨痣。3个月后，从患者左腋窝切除黑色素瘤转移灶，最终导致患者死亡。因此，回顾来看，爆发性色素沉着性病变必须被视为皮肤黑色素瘤转移灶。黑素细胞性病变的非典型临床和组织病理学表现以及疾病进程可能受到了免疫抑制的影响。
