Kassi Komenan, Vanwijck Romain, Kanga Jean-Marie
Department of Dermatology and Infectious Disease, School of Medicine, University of Cocody-Abidjan, Abidjan, Ivory Coast; Dermatology Center, Treichville University Hospital, Abidjan, Ivory Coast.
Int J Dermatol. 2014 Jul;53(7):899-903. doi: 10.1111/ijd.12430. Epub 2013 Dec 30.
Melanoma is responsible for 75% of all skin cancer-related deaths. Lentigo maligna (LM), the most prevalent melanoma in situ (MIS), accounts for 79-83% of all MIS. Its location in the head and neck area requires that tissue be spared in the course of clearing the tumor.
We conducted a therapeutic study based on our practice experience with the so-called "collarette" skin biopsy technique used in the management of LM.
Thirty-one patients were diagnosed with LM in the head and neck area. These included 16 women and 15 men with a mean ± standard deviation (SD) age of 64.4 ± 13.6 years (range: 33-88 years). The majority (36%) of lesions were located on the cheek. To clear the tumor, surgery was performed using margins of >10 mm in 71% of cases. The average surface area of the surgical defect was 5.8 cm(2) (range: 1.1-15.5 cm(2) ). Reconstructive skin grafts were performed in the majority (68%) of cases. After the removal of the central tumor, 16 cases of MIS and 15 cases of invasive melanoma were identified. Only one patient experienced recurrence over a mean ± SD follow-up of 31 ± 16 months.
The so-called "collarette" or "spaghetti" skin excision and biopsy technique is an advantageous and efficient way to achieve tumor clearance and represents an equally effective alternative to Mohs micrographic surgery in the treatment of LM in the head and neck area.
黑色素瘤导致了75%的皮肤癌相关死亡。恶性雀斑样痣（LM）是最常见的原位黑色素瘤（MIS），占所有MIS的79 - 83%。其位于头颈部区域，这要求在清除肿瘤的过程中尽量保留组织。
我们基于在LM治疗中使用所谓“项圈式”皮肤活检技术的实践经验进行了一项治疗研究。
31例患者被诊断为头颈部区域的LM。其中包括16名女性和15名男性，平均年龄±标准差为64.4±13.6岁（范围：33 - 88岁）。大多数（36%）病变位于脸颊。为清除肿瘤，71%的病例手术切缘>10 mm。手术缺损的平均表面积为5.8 cm²（范围：1.1 - 15.5 cm²）。大多数（68%）病例进行了皮肤移植重建。切除中央肿瘤后，确诊16例MIS和15例浸润性黑色素瘤。在平均±标准差为31±16个月的随访期内，仅1例患者出现复发。
所谓的“项圈式”或“意大利面条式”皮肤切除活检技术是实现肿瘤清除的一种有利且有效的方法，在头颈部区域LM的治疗中是与莫氏显微外科手术同样有效的替代方法。
