Wälchli R, Theiler M, Neuhaus K, Weibel L
Abteilung für pädiatrische Dermatologie, Kinderspital Zürich, Zürich, Schweiz.
Hautarzt. 2013 Jan;64(1):32-9. doi: 10.1007/s00105-012-2410-3.
Nevi represent congenital hamartomatous malformations of various components of the skin. The most common forms are congenital melanocytic nevi (CMN) and nevi of epithelial origin (epidermal and organoid nevi). Large CMN in particular can lead to severe complications and the management of those affected represents a challenge from birth. In contrast to previous assumptions, the risk of malignancy from CMN is considered to be relatively low however, this may be relevantly increased in certain situations. Possible extracutaneous symptoms in cases of central nervous system (CNS) involvement should not be underestimated and early imaging investigations are part of the routine diagnostic procedure. Surgical measures are still very important in the treatment of CMN but the indications must be weighed up for each individual case. Patients often experience marked stigmatization due to disfigurement by their birthmark and this needs to be taken into consideration for their treatment. The most common epithelial nevi are sebaceous nevi. In 2-13 % of cases additional tumors occur within this nevus and early surgical excision is indicated in most cases, not least for aesthetic reasons. If generalized spreading of epidermal nevi occurs, additional investigations are necessary to exclude associated ophthalmological, cardiac or neurological malformations.
痣代表皮肤各组成部分的先天性错构瘤畸形。最常见的类型是先天性黑素细胞痣(CMN)和上皮来源的痣(表皮痣和器官样痣)。尤其是大型CMN可导致严重并发症,对这些患者的管理从出生起就是一项挑战。与先前的假设相反,CMN发生恶性肿瘤的风险被认为相对较低,然而,在某些情况下这一风险可能会显著增加。中枢神经系统(CNS)受累病例可能出现的皮肤外症状不应被低估,早期影像学检查是常规诊断程序的一部分。手术措施在CMN的治疗中仍然非常重要,但必须针对每个病例权衡适应症。患者常因胎记造成的容貌毁损而遭受明显的污名化,这在其治疗中需要予以考虑。最常见的上皮痣是皮脂腺痣。在2%至13%的病例中,该痣内会出现其他肿瘤,大多数情况下需要早期手术切除,这尤其是出于美观的原因。如果表皮痣发生广泛扩散,则需要进行额外检查以排除相关的眼科、心脏或神经畸形。