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解析色素皮损相关误区。

Dispelling myths concerning pigmented skin lesions.

机构信息

Dermatology Unit, Second University of Naples, Naples, Italy.

Skin Spectrum Medical Services, Como, Perth, Australia.

出版信息

J Eur Acad Dermatol Venereol. 2016 Jun;30(6):919-25. doi: 10.1111/jdv.13557. Epub 2016 Feb 3.

DOI:10.1111/jdv.13557
PMID:26840917
Abstract

The history of medicine is replete with examples of debunked myths, and in daily clinical dermatological practice, we must still counter many misconceptions regarding pigmented lesions, both with patients and other medical practitioners. Debunking myths and attempting to explain the reasons for these erroneous beliefs are the purposes of this review. The literature review has been partially guided by the results obtained from an online questionnaire conducted on an Italian website (www.vediamocichiara.it) from February 15, 2015 to March 15, 2015. The remaining discussed were selected on the basis of the existing literature and our personal experience. In order to explore these misconceptions, the following are the seven most salient questions that require investigation: (i) Is it dangerous to excise moles?; (ii) Is it dangerous to traumatize moles?; (iii) Are plantar moles worrisome?; (iv) Is it necessary to selectively apply sunscreen to moles?; (v) Is it inadvisable to partially biopsy a melanoma?; (vi) Do moles turn into melanoma?; and (vii) Is it necessary to perform sentinel lymph node biopsy for thin melanomas and for atypical Spitz naevi? Myths are ubiquitous, being prevalent in dermatological practice, with many of them concerning pigmented skin lesions. By encouraging critical analysis by patients and medical practitioners, the birth and perpetuation of myths can potentially be minimized, for the ultimate benefit of patients. This requires a scientific approach to be rigorously applied to dermatology, with critical questioning of unsubstantiated hypotheses including those emanating from the mass media as well as from respected sources.

摘要

医学史上充斥着被揭穿的谬论的例子,在日常临床皮肤科实践中,我们仍必须反驳许多关于色素病变的误解,无论是与患者还是与其他医疗从业者。揭穿这些谬论并试图解释这些错误信念的原因是本次综述的目的。文献综述部分基于 2015 年 2 月 15 日至 3 月 15 日在意大利网站(www.vediamocichiara.it)上进行的在线问卷调查的结果,其余部分则根据现有文献和我们的个人经验进行选择。为了探讨这些误解,以下是需要调查的七个最突出的问题:(i) 切除痣是否危险?;(ii) 损伤痣是否危险?;(iii) 足底痣是否令人担忧?;(iv) 是否需要有选择性地在痣上涂抹防晒霜?;(v) 部分活检黑色素瘤是否不可取?;(vi) 痣是否会变成黑色素瘤?;以及 (vii) 对于薄型黑色素瘤和非典型 Spitz 痣是否有必要进行前哨淋巴结活检? 皮肤科实践中普遍存在着各种谬论,其中许多涉及色素性皮肤病变。通过鼓励患者和医疗从业者进行批判性分析,可以最大限度地减少谬论的产生和延续,最终使患者受益。这需要在皮肤科领域严格应用科学方法,对未经证实的假设进行批判性质疑,包括来自大众媒体以及受尊敬的来源的假设。

相似文献

1
Dispelling myths concerning pigmented skin lesions.解析色素皮损相关误区。
J Eur Acad Dermatol Venereol. 2016 Jun;30(6):919-25. doi: 10.1111/jdv.13557. Epub 2016 Feb 3.
2
[Evaluation of the diagnosis of pigmented tumors of the skin and factors leading to a decision to excise. Dermatologists of the Postgraduate Association of Haute-Normandie].[皮肤色素性肿瘤的诊断评估及决定切除的相关因素。上诺曼底研究生协会皮肤科医生]
Ann Dermatol Venereol. 1999 Jun-Jul;126(6-7):494-500.
3
Atypical moles.非典型痣
Am Fam Physician. 2008 Sep 15;78(6):735-40.
4
The spectrum of spitzoid tumours: A clinical study.Spitz 样肿瘤的光谱:一项临床研究。
Australas J Dermatol. 2012 Aug;53(3):211-5. doi: 10.1111/j.1440-0960.2012.00902.x. Epub 2012 Jun 4.
5
Diagnostic ability of general practitioners and dermatologists in discriminating pigmented skin lesions.全科医生和皮肤科医生鉴别色素沉着性皮肤病变的诊断能力。
J Am Acad Dermatol. 2001 Jun;44(6):979-86. doi: 10.1067/mjd.2001.113442.
6
Pigmented skin lesions of the upper extremity.上肢色素沉着性皮肤病变。
Hand Clin. 2004 Aug;20(3):283-91, vi. doi: 10.1016/j.hcl.2004.03.011.
7
Accuracy in skin cancer diagnosis: a retrospective study of an Australian public hospital dermatology department.皮肤癌诊断的准确性:澳大利亚公立医院皮肤科的回顾性研究。
Australas J Dermatol. 2012 May;53(2):112-7. doi: 10.1111/j.1440-0960.2011.00855.x. Epub 2012 Jan 19.
8
Analysis of features associated with equivocal diagnosis and diagnostic discordance of Spitz naevi over an 18-year period.18 年期间Spitz痣的可疑诊断及诊断不一致相关特征分析
Eur J Dermatol. 2015 Apr;25(2):162-8. doi: 10.1684/ejd.2014.2497.
9
Accuracy of clinical diagnosis of skin lesions.皮肤病变临床诊断的准确性。
Br J Dermatol. 2008 Sep;159(3):661-8. doi: 10.1111/j.1365-2133.2008.08715.x. Epub 2008 Jul 4.
10
The surgical management of Spitz naevi and atypical spitzoid neoplasms: A review of the literature.Spitz 痣和非典型 Spitz 样肿瘤的外科治疗:文献复习。
Surgeon. 2013 Aug;11(4):205-9. doi: 10.1016/j.surge.2013.01.001. Epub 2013 Mar 7.

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No One Should Die of Melanoma: Time for This Vision to Be Realized?
不应有人死于黑色素瘤:是时候实现这一愿景了吗?
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