Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.
Br J Dermatol. 2013 Jun;168(6):1267-72. doi: 10.1111/bjd.12260.
A series of studies has investigated epidemiological, clinical and genetic characteristics of patients with multiple primary melanoma (MPM). However, comparison of the clinical and dermoscopic features of MPM within a given individual has been described only in case reports.
To describe the dermoscopic features of MPM for each given patient, and to evaluate the characteristics eventually associated with similar or dissimilar appearance.
From the databases of three skin-lesion clinics in the U.S.A., Italy and Spain we collected the dermoscopic images of melanomas in patients diagnosed with MPM.
Among 58 patients with MPM, we found that 53% of patients had dermoscopically similar melanomas and 47% of patients had dermoscopically different melanomas. In older patients 59% of melanomas were dermoscopically similar vs. 47% in younger patients (P=0·377). Similar thickness was associated with the occurrence of dermoscopically similar melanomas (19/30 cases, 63%; P=0·039). Most (65%) of the synchronous lesions were similar, compared with 36% of nonsynchronous lesions (P=0·029), and most (69%) of the melanomas on sun-damaged skin were similar, vs. 37% of melanomas on nonsun-damaged skin (P=0·015; odds ratio 3·88, 95% confidence interval 1·11-13·98). The percentage of dermoscopically different melanomas was higher in patients with a family history of melanoma (67% vs. 48%).
MPMs in a given patient have almost the same chance of looking dermoscopically similar or different. However, a subset of elderly patients with sun-damaged skin may present multiple, similar, thin melanomas characterized by pigment-network and regression structures.
一系列研究调查了多发性原发性黑色素瘤（MPM）患者的流行病学、临床和遗传特征。然而，只有在病例报告中才描述了给定个体中 MPM 的临床和皮肤镜特征。
描述每位患者 MPM 的皮肤镜特征，并评估最终与相似或不同外观相关的特征。
我们从美国、意大利和西班牙的三个皮肤病变诊所的数据库中收集了诊断为 MPM 的患者的黑色素瘤皮肤镜图像。
在 58 名 MPM 患者中，我们发现 53%的患者有皮肤镜下相似的黑色素瘤，47%的患者有皮肤镜下不同的黑色素瘤。在老年患者中，59%的黑色素瘤皮肤镜下相似，而在年轻患者中为 47%（P=0·377）。相似的厚度与皮肤镜下相似的黑色素瘤的发生有关（19/30 例，63%；P=0·039）。与非同步病变的 36%相比，同步病变的 65%更相似（P=0·029），与非日光损伤皮肤的黑色素瘤的 37%相比，日光损伤皮肤的黑色素瘤的 69%更相似（P=0·015；优势比 3·88，95%置信区间 1·11-13·98）。有黑色素瘤家族史的患者皮肤镜下不同黑色素瘤的比例较高（67% vs. 48%）。
给定患者的 MPM 几乎同样有可能具有相似或不同的皮肤镜外观。然而，一组老年、日光损伤皮肤患者可能会出现多个相似、薄的黑色素瘤，其特征为色素网和退行性结构。
