Dediol Iva, Bulat Vedrana, Zivković Maja Vurnek, Marković Bernarda Misanović, Situm Mirna
Department of Dermatovenerology, "Sestre milosrdnice" University Hospital Center, Zagreb, Croatia.
Coll Antropol. 2011 Sep;35 Suppl 2:311-3.
Dysplastic nevus is an acquired or hereditary nevus that clinically seems atypical and pathohistologically dysplastic. The term of dysplastic nevus has changed through history and even until now the dermatologists and pathologists have not found the same conclusion for name and definition of dysplastic nevus. Epidemiology of dysplastic nevus is different depending on geographic lattitude, being three times higher in Australia than in Great Britain. Genetic factors play a role in etiology of dysplastic nevus but are still not well defined. UV radiation is indisputable main etiological factor in developing dysplastic nevus. Many studies confirm that children who have been using sun protection creams with SPF have less dysplastic nevi than those who did not. Nevus with geographic shape and muddy borders, dominately macular, red to brown colored and has 5 mm or more in diameter is clinically dysplastic nevus. ABCDE rules count for dysplastic nevus as well as for melanoma but prefferable diagnostic criteria for dysplastic nevus would be "ugly duckling sign". Pathohistologic analysis is the key in confirming the diagnosis of dysplastic nevus. Great experience and knowledge in dermatopathology field is essential for pathologists to make a distinction between dysplastic nevus and melanoma in situ. Likewise great experience in dermatooncology field is essential in differentiating dysplastic nevus from other nevi. Surgical excision is the only therapy that should be done for dysplastic nevus. Regular follow up is highly recommended for patients with dysplastic nevus and syndroma naevi dysplastic. Education about sun protection measures and self-examination techniques is essential for all patients with dysplastic nevi and their family.
发育异常痣是一种后天性或遗传性痣，临床上看似不典型，病理组织学上表现为发育异常。发育异常痣这一术语在历史上有所变化，直至如今，皮肤科医生和病理学家对于发育异常痣的命名和定义仍未达成相同结论。发育异常痣的流行病学因地理纬度而异，在澳大利亚的发病率比在英国高三倍。遗传因素在发育异常痣的病因中起作用，但仍未明确界定。紫外线辐射无疑是发育异常痣发生的主要病因。许多研究证实，使用防晒系数（SPF）的防晒霜的儿童比未使用的儿童患发育异常痣的情况更少。具有地图状形态和边界模糊、以斑疹为主、呈红棕色且直径5毫米或更大的痣在临床上为发育异常痣。ABCDE规则适用于发育异常痣以及黑色素瘤，但发育异常痣更可取的诊断标准是“丑小鸭征”。病理组织学分析是确诊发育异常痣的关键。病理学家在区分发育异常痣和原位黑色素瘤时，在皮肤病理学领域的丰富经验和知识至关重要。同样，在皮肤肿瘤学领域的丰富经验对于区分发育异常痣与其他痣也至关重要。手术切除是针对发育异常痣应采取的唯一治疗方法。强烈建议对患有发育异常痣和发育异常痣综合征的患者进行定期随访。对所有患有发育异常痣的患者及其家属进行防晒措施和自我检查技术的教育至关重要。
