Wolf Omer, Shalom Avshalom
Department of Plastic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.
Harefuah. 2010 Aug;149(8):519-23, 550.
The acronym ABCDE, which was originally described to help with clinically discriminating between benign and malignant pigmented skin lesions, represents the key clinical criteria for diagnosing cutaneous malignant melanoma (CMM). The early stage in CMM is sometimes hard to identify for it frequently mimics the characteristics of atypical nevus. It is estimated that clinical diagnosis accuracy in CMM lies somewhere between 50-75%. This warrants the search for better diagnostic tools. During the last decade, and specifically with the advances in dermoscopy, also known as dermatoscopy or epiluminescence microscopy (ELM), there is literally a new depth and dimension to the clinical diagnosis of pigmented skin lesions. What strikes out as its distinct clinical advantage is its ability to differentiate between an atypical nevus--for which follow-up is the preferred clinical choice, and CMM--which warrants surgical treatment at an early stage. This edge dermoscopy process, put together with a digital interface applied in total-body mapping--as practiced in directed centers, may help decrease the number of false positive excisions without an increase in morbidity from CMM.
首字母缩写词ABCDE最初用于帮助临床鉴别良性和恶性色素沉着性皮肤病变，它代表了诊断皮肤恶性黑色素瘤（CMM）的关键临床标准。CMM的早期阶段有时难以识别，因为它常常模仿非典型痣的特征。据估计，CMM的临床诊断准确率在50%至75%之间。这就需要寻找更好的诊断工具。在过去十年中，特别是随着皮肤镜检查（也称为皮肤显微镜检查或透照荧光显微镜检查（ELM））的进展，色素沉着性皮肤病变的临床诊断确实有了新的深度和维度。其显著的临床优势在于能够区分非典型痣（临床首选随访观察）和CMM（需要早期手术治疗）。这种先进的皮肤镜检查方法，结合在定向中心实施的全身映射应用数字接口，可能有助于减少假阳性切除的数量，同时不会增加CMM的发病率。
