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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.

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。

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