Hibler Brian P, Connolly Karen L, Lee Erica H, Rossi Anthony M, Nehal Kishwer S
Memorial Sloan Kettering Cancer Center, Dermatology Service, 16 E. 60th Street, 4th Floor Dermatology, New York, New York, 10022.
Lincoln Hospital, Dermatology Service, 234 E. 149th Street, Bronx, New York, 10451.
Lasers Surg Med. 2017 Nov;49(9):819-826. doi: 10.1002/lsm.22691. Epub 2017 May 29.
Lentigo maligna (LM) is melanoma in situ on sun-damaged skin and presents diagnostic challenges due to overlapping features with benign pigmented lesions. Cosmetic treatments may be inadvertently performed on LM. The aim of this study is to estimate the prevalence of LM with prior cosmetic treatment, and evaluate surgical outcomes.
Retrospective review of biopsy-proven LM presenting over a 10-year-period (2006-2015). Prior cosmetic treatment and biopsies were recorded. Records were reviewed for demographic data, clinical characteristics, and surgical outcomes.
37/503 (7.4%) patients with LM reported prior cosmetic therapy. Most (95%) were on the head and neck; mean size 1.9 cm. Most patients reported cryotherapy (73%), followed by laser (29.7%), topical bleaching agents (18.9%), and electrodessication, and/or curettage (5.3%). Ten patients (27%) received two or more modalities. Eight patients (21.6%) reported prior benign biopsies. Six patients (16%) had invasive disease, two on initial biopsy and 4/34 (11.7%) upstaged upon excision. Average margin for clearance was 9.1 mm.
Prior cosmetic treatment of LM is not uncommon, and may delay diagnosis and obscure borders, resulting in wider surgical margins. Clinicians should consider a biopsy confirming the benign nature of equivocal lesions prior to cosmetic treatment. Lasers Surg. Med. 49:819-826, 2017. © 2017 Wiley Periodicals, Inc.
恶性雀斑样痣（LM）是日光损伤皮肤原位黑素瘤，因其与良性色素性病变特征重叠，故诊断存在挑战。可能会无意中对LM进行美容治疗。本研究旨在评估曾接受美容治疗的LM的患病率，并评估手术效果。
回顾性分析2006年至2015年期间经活检证实的LM。记录先前的美容治疗和活检情况。查阅记录以获取人口统计学数据、临床特征和手术效果。
37/503例（7.4%）LM患者报告曾接受美容治疗。大多数（95%）位于头颈部；平均大小为1.9厘米。大多数患者报告接受过冷冻治疗（73%），其次是激光治疗（29.7%）外用漂白剂（18.9%）以及电干燥和/或刮除术（5.3%）。10例患者（27%）接受过两种或更多种治疗方式。8例患者（21.6%）报告曾接受过良性病变活检。6例患者（16%）患有浸润性疾病，2例初次活检时发现，4/34例（11.7%）切除时疾病分期上升。平均切缘为9.1毫米。
先前对LM进行美容治疗并不罕见，可能会延迟诊断并使边界模糊，导致手术切缘更宽。临床医生在进行美容治疗前应考虑对可疑病变进行活检以确认其良性性质。《激光外科与医学》2017年；49：819 - 826。© 2017威利期刊公司
