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一项多中心调查:移植皮肤科医生如何监测患有痣的器官移植受者?

A Multicenter Survey: How Do Transplant Dermatologists Monitor Organ Transplant Recipients With Nevi?

作者信息

Özcan Deren, Seçkin Deniz, Haberal Mehmet

机构信息

Department of Dermatology, Baskent University Faculty of Medicine, Ankara, Turkey.

出版信息

Exp Clin Transplant. 2018 Mar;16 Suppl 1(Suppl 1):198-202. doi: 10.6002/ect.TOND-TDTD2017.P64.

Abstract

OBJECTIVES

The incidence and mortality of melanoma are increased in organ transplant recipients. Multiple acquired common and dysplastic nevi are risk factors for melanoma. A new or changing nevus may suggest melanoma. Strategies used by transplant dermatologists to monitor nevi are unknown. Herein, we aimed to assess the methods used by transplant dermatologists for monitoring multiple acquired common nevi, dysplastic nevi, and new or changing nevi.

MATERIALS AND METHODS

A questionnaire was e-mailed to 63 members of the Skin Care in Organ Transplant Patients, Europe.

RESULTS

Thirty-eight (92.7%) of 41 responders reported that they instruct their patients to perform regular self-skin examinations. Of 41 responders, 41.5% prescribed screening every 6 months, 36.6% prescribed it every 12 months, 12.2% prescribed it every 3 months, and 9.7% performed screening without regular intervals. Regarding type of examination, 80.5% performed full-body skin examinations with the naked eye, 70.7% performed dermoscopy of clinically suspicious nevi, 53.6% offered dermoscopic photography of dermoscopically suspicious nevi, 36.6% provided close-up photography of clinically suspicious nevi, 34.1% performed baseline total body photography, and 24.4% conducted dermoscopy of all nevi. We also found that 7.3%, 4.9%, and 4.9% performed only full-body skin examination with the naked eye, only dermoscopy of clinically suspicious nevi, and only dermoscopy of all nevi, respectively.

CONCLUSIONS

Dedicated transplant dermatologists perform a wide variety of nevi screening procedures in organ transplant recipients. Transplant dermatologists should include sequential digital dermoscopic imaging in their armamentarium to follow organ transplant recipients with melanocytic lesions. A combination of techniques is advisable for detecting early posttransplant melanomas.

摘要

目的

器官移植受者中黑色素瘤的发病率和死亡率有所上升。多发性后天性普通痣和发育异常痣是黑色素瘤的危险因素。新出现的或变化的痣可能提示黑色素瘤。移植皮肤科医生用于监测痣的策略尚不清楚。在此,我们旨在评估移植皮肤科医生用于监测多发性后天性普通痣、发育异常痣以及新出现的或变化的痣的方法。

材料与方法

通过电子邮件向欧洲器官移植患者皮肤护理组织的63名成员发送了一份调查问卷。

结果

41名回复者中有38名(92.7%)报告称,他们指导患者定期进行自我皮肤检查。在41名回复者中,41.5%规定每6个月进行一次筛查,36.6%规定每12个月进行一次,12.2%规定每3个月进行一次,9.7%进行不定期筛查。关于检查类型,80.5%用肉眼进行全身皮肤检查,70.7%对临床可疑痣进行皮肤镜检查,53.6%对皮肤镜检查可疑的痣进行皮肤镜摄影,36.6%对临床可疑痣进行特写摄影,34.1%进行基线全身摄影,24.4%对所有痣进行皮肤镜检查。我们还发现,分别仅有7.3%、4.9%和4.9%的人仅用肉眼进行全身皮肤检查、仅对临床可疑痣进行皮肤镜检查以及仅对所有痣进行皮肤镜检查。

结论

专业的移植皮肤科医生对器官移植受者进行多种痣筛查程序。移植皮肤科医生应将连续数字皮肤镜成像纳入其检查手段,以跟踪有黑素细胞病变的器官移植受者。建议采用多种技术组合来检测移植后早期黑色素瘤。

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