Gorman Mark, Hart Andrew, Mathew Bipin
Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, UK.
Hull Royal Infirmary, Hull, UK.
Dermatol Res Pract. 2015;2015:310270. doi: 10.1155/2015/310270. Epub 2015 Apr 1.
Skin cancer has been shown to present asymmetrically, prevalent on the left side of the body, more so in subtypes of cutaneous melanoma such as lentigo maligna. Biases have been linked to cumulative UV light exposure and automobile driving patterns. Though left-right ratios have previously correlated with the side men or women tend to position themselves or countries drive on, more recent trends indicate a consistent left-sided bias. To clarify reasons for changing trends, a review of the evidence base and LM's laterality in a UK cohort (99 cases 2000-2011) was conducted for the first time. The strong correlation of left-sided excess, found in both genders (ratios 1.381-1.5, P < 0.05 X (2) 0.841), is congruent with more recent findings. Though evidence indicates that driving position is no longer a risk factor for LM, due most likely to improved car window UV protection, it remains the most commonly attributed cause. Understanding phenomena such as UV lights "scatter effect" or that cumulative exposure may not be a significant risk factor helps rationalize older conclusions that would otherwise appear contradictory. The reasons for left-sided excess remain unclear but may be due to factors requiring further research such as the body's anatomical/embryological asymmetry.
皮肤癌已被证明呈现不对称分布，在身体左侧更为普遍，在诸如恶性雀斑样痣等皮肤黑色素瘤亚型中更是如此。这种偏向与紫外线累积暴露和汽车驾驶模式有关。尽管左右比例以前曾与男性或女性倾向于所处的位置或国家的驾驶方向相关，但最近的趋势表明存在持续的左侧偏向。为了阐明趋势变化的原因，首次对英国一个队列（2000 - 2011年的99例病例）的证据基础和恶性雀斑样痣的偏侧性进行了综述。在两性中均发现左侧过量的强相关性（比例为1.381 - 1.5，P < 0.05，X(2) 0.841），这与最近的研究结果一致。尽管有证据表明驾驶位置不再是恶性雀斑样痣的风险因素，这很可能是由于汽车车窗紫外线防护的改善，但它仍然是最常被提及的原因。理解诸如紫外线“散射效应”或累积暴露可能不是一个重要风险因素等现象，有助于使那些否则可能显得相互矛盾的早期结论合理化。左侧过量的原因尚不清楚，但可能是由于需要进一步研究的因素，如身体的解剖学/胚胎学不对称。
