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良性黑素细胞世界的丰富性:痣的皮肤镜-组织病理学相关性

Abundance of the benign melanocytic universe: Dermoscopic-histopathological correlation in nevi.

作者信息

Woltsche Nora, Schmid-Zalaudek Karin, Deinlein Teresa, Rammel Katrin, Hofmann-Wellenhof Rainer, Zalaudek Iris

机构信息

Department of Ophthalmology, Medical University of Graz, Graz, Austria.

Department of Physiology, Medical University of Graz, Graz, Austria.

出版信息

J Dermatol. 2017 May;44(5):499-506. doi: 10.1111/1346-8138.13808.

Abstract

The broad universe of "melanocytic nevi" includes a variety of different subtypes, which can be classified either due to their morphology, epidemiology, genetic alterations or risk for developing melanoma. Regarding morphology, on the one hand macroscopic/clinical and on the other hand histopathological appearance were used to subdivide in the past, often resulting in confusion and poor interobserver agreement, while nowadays dermoscopy presents the clinician's precious bridge between naked-eye examination and histopathological diagnostics, allowing prediction of the lesions' histopathology, follow up and monitoring over time without need of excision. The non-invasive dermoscopic examination relies on the assessment of colors, patterns and the distribution of both within a cutaneous lesion. Until today, the correspondence of certain dermoscopic colors and patterns to certain histopathological correlates has been reported for a huge amount of different cutaneous lesions. Moreover, the correspondence of certain dermoscopic features to certain body sites, age groups and pigmentary traits, but also to specific genetic alterations in lesions, has been broadly investigated. Dermoscopy has led us to a new understanding of melanocytic nevi's biology and evolution and, last but not least, to a new classification system, which we want to present herein.

摘要

“黑素细胞痣”这一广泛范畴包含多种不同亚型,其分类依据可以是形态学、流行病学、基因改变或发生黑色素瘤的风险。就形态学而言,过去一方面依据宏观/临床特征,另一方面依据组织病理学表现进行细分,这常常导致混淆且观察者间一致性较差。而如今,皮肤镜为临床医生提供了肉眼检查与组织病理学诊断之间的宝贵桥梁,能够在无需切除的情况下预测病变的组织病理学特征、进行随访及长期监测。非侵入性皮肤镜检查依赖于对皮肤病变内颜色、模式及其分布的评估。直至今日,大量不同皮肤病变的某些皮肤镜颜色和模式与特定组织病理学关联的对应关系已有报道。此外,某些皮肤镜特征与特定身体部位、年龄组、色素沉着特征以及病变中特定基因改变之间的对应关系也已得到广泛研究。皮肤镜使我们对黑素细胞痣的生物学特性和演变有了新的认识,最后但同样重要的是,它带来了一种新的分类系统,我们将在此呈现。

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