Castro Luiz Guilherme Martins, Messina Maria Cristina, Loureiro Walter, Macarenco Ricardo Silvestre, Duprat Neto João Pedreira, Di Giacomo Thais Helena Bello, Bittencourt Flávia Vasques, Bakos Renato Marchiori, Serpa Sérgio Schrader, Stolf Hamilton Ometto, Gontijo Gabriel
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Universidade Estadual do Pará, Belém, SP, Brazil.
An Bras Dermatol. 2015 Nov-Dec;90(6):851-61. doi: 10.1590/abd1806-4841.20154707.
The last Brazilian guidelines on melanoma were published in 2002. Development in diagnosis and treatment made updating necessary. The coordinators elaborated ten clinical questions, based on PICO system. A Medline search, according to specific MeSH terms for each of the 10 questions was performed and articles selected were classified from A to D according to level of scientific evidence. Based on the results, recommendations were defined and classified according to scientific strength. The present Guidelines were divided in two parts for editorial and publication reasons. In the first part, the following clinical questions were answered: 1) The use of dermoscopy for diagnosis of primary cutaneous melanoma brings benefits for patients when compared with clinical examination? 2) Does dermoscopy favor diagnosis of nail apparatus melanoma? 3) Is there a prognostic difference when incisional or excisional biopsies are used? 4) Does revision by a pathologist trained in melanoma contribute to diagnosis and treatment of primary cutaneous melanoma? What margins should be used to treat lentigo maligna melanoma and melanoma in situ?
巴西上一版黑色素瘤指南于2002年发布。诊断和治疗方面的进展使得更新指南成为必要。协调员基于PICO系统拟定了十个临床问题。针对这10个问题中的每一个，根据特定的医学主题词（MeSH）进行了Medline检索，并根据科学证据水平将所选文章从A到D进行分类。基于这些结果，根据科学强度定义并分类了推荐意见。出于编辑和出版原因，本指南分为两部分。在第一部分中，回答了以下临床问题：1）与临床检查相比，使用皮肤镜诊断原发性皮肤黑色素瘤对患者是否有益？2）皮肤镜是否有助于甲襞黑色素瘤的诊断？3）使用切开活检或切除活检时预后是否存在差异？4）由接受过黑色素瘤培训的病理学家进行复查是否有助于原发性皮肤黑色素瘤的诊断和治疗？治疗恶性雀斑样痣黑色素瘤和原位黑色素瘤应采用何种切缘？
