Department of Dermatology, Virgen Macarena University Hospital, Seville, Spain.
J Dermatol. 2011 Jan;38(1):3-9. doi: 10.1111/j.1346-8138.2010.01131.x.
Early diagnosis and prompt surgical excision are the most important aims in the secondary prevention of cutaneous melanoma. Dermoscopy has increased the accuracy in the detection of melanoma because of dermoscopic-specific features that can be easily detected by trained dermoscopists. However, the classical melanoma-specific criteria such as multicomponent pattern, atypical pigmented network, irregular dots/globules, irregular streaks, multiple colors, blue-whitish veil or regression structures may not be present in all of these lesions. For some early melanomas change, as evidenced by sequential dermoscopic monitoring, may be the only feature suggesting malignancy. At present, even with dermoscopy, the diagnosis of these early melanomas remains to be a challenge for dermatologist. Patient education, digital dermoscopic follow up and consensus diagnosis have been proposed to overcome this problem.
早期诊断和及时的外科切除是皮肤黑色素瘤二级预防的最重要目标。由于具有易于被训练有素的皮肤镜医生检测到的皮肤镜特征，皮肤镜检查提高了黑色素瘤检测的准确性。然而，经典的黑色素瘤特异性标准，如多组分模式、非典型色素网、不规则点/小球、不规则条纹、多种颜色、蓝白色面纱或退行性结构，可能并不存在于所有这些病变中。对于某些早期黑色素瘤，如连续皮肤镜监测所证实的那样，可能只有改变这一特征提示恶性肿瘤。目前，即使有皮肤镜检查，这些早期黑色素瘤的诊断仍然是皮肤科医生面临的挑战。为了解决这个问题，已经提出了患者教育、数字皮肤镜随访和共识诊断。
