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皮肤镜检查——黑色素瘤诊断的终极工具。

Dermoscopy--the ultimate tool for melanoma diagnosis.

作者信息

Argenziano Giuseppe, Ferrara Gerardo, Francione Sabrina, Di Nola Karin, Martino Antonia, Zalaudek Iris

机构信息

Department of Dermatology, Second University of Naples, Naples, Italy.

出版信息

Semin Cutan Med Surg. 2009 Sep;28(3):142-8. doi: 10.1016/j.sder.2009.06.001.

Abstract

"We are beginning to move away from clinicopathologic diagnosis into an era of clinicoimaging diagnosis." This vision became a fact, as the dermatoscope represents nowadays the dermatologist stethoscope. This is not only because dermoscopy reveals a new and fascinating morphologic dimension of pigmented and nonpigmented skin tumors, but also because it improves the recognition of a growing number of skin symptoms in general dermatology. Melanoma detection remains the most important indication of dermoscopy and in melanoma screening the aim of dermoscopy is to maximize early detection while minimizing the unnecessary excision of benign skin tumors. In the last few years, 3 meta-analyses and 2 randomized studies have definitely proven that dermoscopy allows improving sensitivity for melanoma as compared to the naked eye examination alone. This is the consequence of at least 3 issues: first, the presence of early dermoscopy signs that are visible in melanoma much before the appearance of the classical clinical features; second, an increased attitude of clinicians to check more closely clinically banal-looking lesions; third, an improved attitude of clinicians to monitor their patients.

摘要

“我们正开始从临床病理诊断迈向临床影像诊断时代。”这一愿景已成为现实,如今皮肤镜就如同皮肤科医生的听诊器。这不仅是因为皮肤镜揭示了色素性和非色素性皮肤肿瘤新的、引人入胜的形态学层面,还因为它提高了对普通皮肤科中越来越多皮肤症状的识别能力。黑色素瘤检测仍是皮肤镜最重要的应用指征,在黑色素瘤筛查中,皮肤镜的目的是在将良性皮肤肿瘤不必要切除减到最少的同时,最大限度地实现早期检测。在过去几年中,3项荟萃分析和2项随机研究已明确证明,与单纯肉眼检查相比,皮肤镜可提高黑色素瘤检测的敏感性。这至少是3个因素导致的结果:其一,黑色素瘤在出现典型临床特征之前很久就会出现早期皮肤镜征象;其二,临床医生更加密切检查外观看似平常的病变;其三,临床医生对患者进行监测的态度有所改善。

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