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发育异常痣、黑色素瘤与妊娠——它们之间有什么关系?

Dysplastic nevi, melanoma and pregnancy- where is the relationship?

作者信息

Trayanova E, Chokoeva A A, Tchernev G, Patterson J W, Wollina U, Lotti T

机构信息

“Onkoderma”-Policlinic for Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria.

University of Virginia Health System, Department of Pathology, Charlottesville, VA USA.

出版信息

J Biol Regul Homeost Agents. 2015 Jan-Mar;29(1 Suppl):87-90.

Abstract

Dysplastic nevus is a precursor and a risk factor for the development of malignant melanoma, which explains the scientific interest in this field. Its etiology includes various of endogenous and exogenous factors, as we are considering the influence of hormonal status on the possible malignancy of congenital nevi in particular. The occurrence of some typical melanocytic lesions such as chloasma during pregnancy, where the hormone effect is demonstrated, as well as the more frequent changes of the dysplastic nevi namely within the pregnancy, leads to the idea for the endocrine dependence of the malignant transformation of some melanocytic lesions. We present a case of 37-year-old female patient whom consulted with the dermatologist due to occurrence of pigmented lesions on her left breast. The lesion changed significantly during both her pregnancies with a pause in growth between them and without any signs of regression after the births. During pregnancy, all pigmented skin lesions should be observed with caution because of the increased risk of malignant transformation. Lesions with any suspected changes are required to be immediately removed surgically with appropriate anaesthesia, without waiting to give birth.

摘要

发育异常痣是恶性黑色素瘤发生的前驱病变和危险因素,这解释了该领域的科学研究兴趣。其病因包括多种内源性和外源性因素,尤其是当我们考虑激素状态对先天性痣可能恶变的影响时。一些典型的黑素细胞病变(如孕期出现的黄褐斑,其中可见激素效应)的发生,以及发育异常痣在孕期更频繁的变化,引发了关于某些黑素细胞病变恶变存在内分泌依赖性的观点。我们报告一例37岁女性患者,她因左乳出现色素沉着病变而咨询皮肤科医生。该病变在她的两次孕期中都有显著变化,两次妊娠之间有生长停顿,产后也没有任何消退迹象。孕期应谨慎观察所有色素沉着性皮肤病变,因为恶变风险增加。任何有可疑变化的病变都需要在适当麻醉下立即手术切除,无需等待分娩。

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