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[日本足底色素性黄斑病变的临床与组织病理学分析——足底早期恶性黑色素瘤检测临床指南的建议]

[Clinical and histopathologic analyses of pigmented macular lesions on the soles of Japanese--proposal of a clinical guideline for detection of early malignant melanoma on the sole].

作者信息

Saida T, Yoshida N

出版信息

Nihon Hifuka Gakkai Zasshi. 1989 Feb;99(2):117-28.

PMID:2746966
Abstract

Of 92 pigmented macular lesions on the soles of Japanese, 88 lesions were histologically confirmed to be melanocytic: 65 ordinary acquired melanocytic nevi, 9 congenital melanocytic nevi, 5 dysplastic nevi, and 5 possible and 4 definite lesions of early malignant melanomas. None of the ordinary acquired melanocytic nevi were more than 7 mm in maximum diameter. Excluding congenital melanocytic nevi, there were 8 lesions whose greatest diameters were more than 7 mm: 2 dysplastic nevi, and 2 possible and 4 definite lesions of early malignant melanoma. Judging from the data obtained in this study, we propose the following clinical guideline for the detection of early lesions of malignant melanoma on the sole. If the pigmented lesions have no possibility of being congenital melanocytic nevus, black heel, lesions of Peutz-Jeghers syndrome, or 5-FU induced lesions, measure the maximum diameters. 1) Lesions with a diameter of more than 7 mm should be excised for histological evaluation. 2) Lesions with a diameter between 6 and 7 mm should be examined histologically when they show conspicuous irregularity in shape, color and/or border or are observed on the soles of a patient older than 50.

摘要

在对日本人脚底的92处色素沉着性黄斑病变进行检查时,经组织学确诊,其中88处病变为黑素细胞性病变:65处为普通获得性黑素细胞痣,9处为先天性黑素细胞痣,5处为发育异常痣,5处可能为早期恶性黑色素瘤病变,4处确诊为早期恶性黑色素瘤病变。所有普通获得性黑素细胞痣的最大直径均不超过7毫米。排除先天性黑素细胞痣后,有8处病变的最大直径超过7毫米:2处发育异常痣,2处可能为早期恶性黑色素瘤病变,4处确诊为早期恶性黑色素瘤病变。根据本研究获得的数据,我们提出以下关于检测脚底早期恶性黑色素瘤病变的临床指南。如果色素沉着性病变不可能是先天性黑素细胞痣、黑踵、黑斑息肉综合征病变或5-氟尿嘧啶诱导的病变,则测量其最大直径。1)直径超过7毫米的病变应切除进行组织学评估。2)直径在6至7毫米之间的病变,当其形状、颜色和/或边界显示明显不规则时,或在50岁以上患者的脚底发现时,应进行组织学检查。

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