先天性黑素细胞痣的临床和皮肤镜特征。

Clinical and dermoscopic characteristics of congenital melanocytic naevi.

机构信息

1st Department of Dermatology - Venereology, 'Andreas Sygros' University Hospital, Athens, Greece.

State Clinic of Dermatology - Venereology, 'Andreas Sygros' University Hospital, Athens, Greece.

出版信息

J Eur Acad Dermatol Venereol. 2018 Oct;32(10):1674-1680. doi: 10.1111/jdv.14988. Epub 2018 May 18.

DOI:10.1111/jdv.14988

PMID:29633355

Abstract

BACKGROUND

Prompted by the limited data, we conducted this study to gather more information on dermoscopic features of CN in children, in order to optimize clinical care and management.

MATERIALS AND METHODS

All children with congenital nevi (CN) attending our Pediatric Pigmented Skin Lesion Unit during a 2-year period were included in the study. Clinical data were collected, and all children underwent clinical and dermoscopic examination. Dermoscopic patterns and specific features were recorded.

RESULTS

Three hundred and thirty CN were examined in a population of 276 children, aged from 6 months to 14 years. The majority (85.14%) had only one congenital naevus, and 43.12% had a family history of congenital nevi. Children with multiple congenital nevi were more likely to have a positive family history of a CN (P = 0.012). Only, in 23 children, neurological/developmental abnormalities were reported. Small CN were the commonest in our cohort (167) followed by the medium-sized (160), whereas large CN (>20 cm) were only three. Thirty-eight CN were located on the volar skin. The globular was the commonest dermoscopic pattern, followed by the reticular, whereas the parallel furrow pattern was the commonest pattern on palms and soles. CN on the trunk were more likely to be globular on the limbs, and reticular and homogeneous on the head and neck (P < 0.001). The commonest dermoscopic findings were haloed and target globules, blotches and perifollicular hypopigmentation, whereas globules and dots around cristae on volar skin. CN located on the limbs were more likely to demonstrate an atypical network (P = 0.001) and a target network with globules (P = 0.020), whereas haloed and target globules (P < 0.001), blotches (P = 0.023) and dots (P = 0.004) were found with an increased frequency in CN on the trunk.

CONCLUSIONS

Given that there is much controversy on the management and accurate classification of CN, our findings may provide useful information.

摘要

背景

由于数据有限，我们进行了这项研究，以收集更多关于儿童先天性痣的临床特征信息，从而优化临床护理和管理。

材料和方法

在两年期间，所有在我们儿科色素性皮肤病变科就诊的患有先天性痣（CN）的儿童均被纳入研究。收集临床资料，所有儿童均接受临床和皮肤镜检查。记录皮肤镜模式和具体特征。

结果

在 276 名儿童中，共检查了 333 个 CN，年龄从 6 个月至 14 岁。大多数（85.14%）只有一个先天性痣，43.12%有先天性痣的家族史。多发性先天性痣的儿童更有可能有先天性痣的阳性家族史（P=0.012）。仅在 23 例儿童中报告有神经/发育异常。在我们的队列中，小 CN（167 个）最常见，其次是中 CN（160 个），而大 CN（>20cm）只有 3 个。38 个 CN 位于掌侧皮肤。球形是最常见的皮肤镜模式，其次是网状，而平行沟纹模式在手掌和足底最常见。躯干上的 CN 在四肢上更可能呈球形，在头颈部呈网状和均匀性（P<0.001）。最常见的皮肤镜表现为晕环和靶状球、斑片和滤泡周围色素减退，而掌侧皮肤上的球和点。位于四肢的 CN 更可能表现为不典型网络（P=0.001）和带球的靶网络（P=0.020），而晕环和靶状球（P<0.001）、斑片（P=0.023）和点（P=0.004）在躯干上的 CN 中更常见。