Sgubbi Paola, Savoia Francesco, Dika Emi, Neri Iria, Fanti Pier A, Patrizi Annalisa
Unit of Dermatology, Department of Specialist, Diagnostic and Experimental Medicine, Sant'Orsola-Malpighi Policlinic, University of Bologna, Bologna, Italy.
Unit of Dermatology, AUSL della Romagna, Umberto I Hospital of Lugo, Ravenna, Italy -
G Ital Dermatol Venereol. 2019 Feb;154(1):14-17. doi: 10.23736/S0392-0488.17.05521-3. Epub 2017 Mar 14.
Melanoma is an infrequent neoplasm in children and adolescents. The number of consultancies for melanocytic nevi control in the pediatric population is increased by the major anxiety of parents and pediatricians.
A retrospective chart review was performed in order to evaluate the incidence rate of melanoma, Spitz nevi, congenital and acquired melanocytic nevi in patients aged 14 years or less and referred to our institution from April 2010 to September 2015.
A total of 32,755 dermatologic pediatric consultancies were performed in the considered 66 months period, including 4260 patients referred for mole control (13%). During the same period, a total of 5193 excisions of melanocytic lesions were performed (adults and pediatric patients), 259 of which were performed in 250 patients aged 14 years or less (4.98%). Only 1 in situ melanoma of the nail matrix was detected in a 12-year-old female patient (0.38% of surgical excisions). The number needed to excise (NNE) in our pediatric population, calculated by comparing the total number of excised lesions and the number of melanomas found, was 259.
Our data leads to 3 major observations: 1) the rarity of melanoma in patients with 14 years of age or less is confirmed; 2) the number of excisions performed in this pediatric population is extremely high; 3) neither the cases of melanoma and atypical Spitz neoplasm (ASN) nor the majority of Spitz nevi were referred to us for a generic mole control. Mole controls in the pediatric population should be properly addressed, incrementing the attention on specific suspicious cutaneous lesions.
黑色素瘤在儿童和青少年中是一种罕见的肿瘤。家长和儿科医生的高度焦虑增加了儿科人群中黑素细胞痣监测的咨询数量。
进行了一项回顾性病历审查，以评估2010年4月至2015年9月期间转诊至本机构的14岁及以下患者中黑色素瘤、斯皮茨痣、先天性和后天性黑素细胞痣的发病率。
在66个月的研究期间，共进行了32755次儿科皮肤科咨询，其中4260名患者因痣监测前来就诊（占13%）。同一时期，共进行了5193例黑素细胞病变切除术（包括成人和儿科患者），其中259例在250名14岁及以下患者中进行（占4.98%）。仅在一名12岁女性患者中检测到1例甲母质原位黑色素瘤（占手术切除病例的0.38%）。通过比较切除病变总数和发现的黑色素瘤数量计算得出，我们儿科人群的切除所需例数（NNE）为259。
我们的数据得出3个主要观察结果：1）证实了14岁及以下患者中黑色素瘤罕见；2）该儿科人群的切除例数极高；3）黑色素瘤和非典型斯皮茨肿瘤（ASN）病例以及大多数斯皮茨痣并非因一般的痣监测转诊至我们这里。儿科人群的痣监测应得到妥善处理，增加对特定可疑皮肤病变的关注。
