Roma Paolo, Savarese Imma, Martino Antonia, Martino Domenico, Annese Pietro, Capoluongo Patrizio, Mordente Ines, Nicolino Rachele, Zalaudek Iris, Argenziano Giuseppe
Department of Dermatology, Second University of Naples, Naples, Italy.
J Dermatol Case Rep. 2007 Dec 29;1(1):1-3. doi: 10.3315/jdcr.2007.1.1001.
Epidemiologic data on melanoma reveal a considerable increase in incidence, especially of the early forms (melanoma in situ and early invasive melanoma), but the mortality rates are relatively stable. These data suggest the hypothesis of the existence of a melanoma with less aggressive biological behaviour. This hypothesis is, however, hard to be proven if the assumption is true that more and less aggressive melanomas very often exhibit overlapping clinical and histopathologic features. Digital dermoscopic imaging techniques permit today a detailed documentation of lesions over time and, therefore, represent an optimal tool to disclose the natural evolution of a given lesion. We present five case of slow-growing melanomas observed during a long-term period of follow-up.
Five pigmented skin lesions from five patients with multiple atypical melanocytic nevi were examined at the baseline consultation and digital pictures were taken for monitoring purposes. The lesions have been followed-up for a long time because of the absence of significant changes over time. After a variable period of follow-up (1 to 10 years) all lesions were finally removed and subsequent histopathologic examination revealed early stage melanoma in all cases.
Dermoscopy and digital follow up might be the key factors to improve the knowledge about the natural evolution of nevi and melanoma and the spectrum of undefined melanocytic proliferations.
黑色素瘤的流行病学数据显示其发病率显著上升，尤其是早期类型（原位黑色素瘤和早期侵袭性黑色素瘤），但其死亡率相对稳定。这些数据提示存在生物学行为侵袭性较低的黑色素瘤这一假说。然而，如果越来越侵袭性和侵袭性较低的黑色素瘤常常表现出重叠的临床和组织病理学特征这一假设成立，那么这一假说很难得到证实。如今，数字皮肤镜成像技术能够对病变进行长期详细记录，因此是揭示特定病变自然演变的理想工具。我们报告了5例在长期随访期间观察到的生长缓慢的黑色素瘤病例。
对5例患有多个非典型黑素细胞痣患者的5个色素沉着性皮肤病变在基线会诊时进行了检查，并拍摄了数字图像用于监测。由于病变随时间无显著变化，因此对其进行了长期随访。经过不同时间段（1至10年）的随访后，所有病变最终均被切除，随后的组织病理学检查显示所有病例均为早期黑色素瘤。
皮肤镜检查和数字随访可能是提高对痣和黑色素瘤自然演变以及未明确的黑素细胞增殖谱认识的关键因素。
