Zalaudek I, Sgambato A, Ferrara G, Argenziano G
Department of Dermatology, Medical University of Graz, Graz, Austria.
Minerva Pediatr. 2008 Jun;60(3):291-312.
Children may present a variable spectrum of melanocytic skin lesions and the great majority of them is benign. Childhood melanoma is still exceptionally rare, although recent data suggest an increasing incidence even in young age. The optimal management of children presenting with melanocytic skin lesions aims therefore to a twofold goal, that is to reduce unnecessary surgical excisions of benign melanocytic nevi without running the risk to miss melanoma. Dermoscopy is an in vivo, noninvasive optical tool that aids to approaching this goal. It comes therefore not as a surprise that dermoscopy has gained popularity for the diagnosis and management of pigmented and nonpigmented skin lesions in the pediatric praxis. In this article, we provide a review of the current literature on dermoscopy patterns of melanocytic skin lesions and their management with special emphasis to a pediatric population. Moreover, we discuss recent concepts regarding nevogenesis and highlight some controversial aspects regarding childhood melanoma.
儿童可能出现各种不同的黑素细胞性皮肤病变,其中绝大多数是良性的。儿童黑色素瘤仍然极为罕见,尽管最近的数据表明,即使在幼年,其发病率也在上升。因此,对患有黑素细胞性皮肤病变的儿童进行最佳管理的目标有两个,即减少对良性黑素细胞痣的不必要手术切除,同时又不会有漏诊黑色素瘤的风险。皮肤镜检查是一种体内非侵入性光学工具,有助于实现这一目标。因此,皮肤镜检查在儿科实践中用于色素性和非色素性皮肤病变的诊断和管理已越来越受欢迎,这并不奇怪。在本文中,我们综述了有关黑素细胞性皮肤病变的皮肤镜检查模式及其管理的当前文献,特别强调了儿科人群。此外,我们讨论了有关痣发生的最新概念,并强调了一些关于儿童黑色素瘤的争议性方面。