Tchernev Georgi, Lozev Ilia, Temelkova Ivanka, Chernin Svetoslav, Yungareva Irina
Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, General Skobelev Nr 79, Sofia 1606, Bulgaria.
Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, General Skobelev 26, Sofia 1407, Bulgaria.
Open Access Maced J Med Sci. 2018 Aug 16;6(8):1442-1445. doi: 10.3889/oamjms.2018.276. eCollection 2018 Aug 20.
Skin, nervous tissue, dopamine and melanoma share a common neuroectodermal origin. Hence, processes that modulate nervous tissue formation, patient mental status, motor regulation of individuals, and skin cancerogenesis are inextricably linked. Psycho-neuro-endocrine oncology (or dermato-oncology), i.e. P.N.E.O., is a new model or trend in medicine and science presented for the first time in the world literature by us, that aims to examine the relationship between the mental state, the hormones and the malignant transformation. Schizophrenia and Parkinson's disease are the two main patterns of disease where the main symptoms are related to dopamine levels in the human body. According to our analyses of the available literature, the amount of dopamine is related to the incidence of melanocytic or non-melanocytic cutaneous tumours in patients with central nervous system diseases and those affecting the motor function and coordination. Such patterns of interaction are extremely indicative of the elucidation of the ubiquitous hypothesis or statement: "My illness is on a mental basis, caused by stress …".
We present a 44-year-old patient with untreated schizophrenia for approximately 25 years, associated with advanced acral localised melanoma. Schizophrenia is generally associated with a higher level of dopamine, which is also a key precursor to melanin synthesis. After a careful analysis of all literature on melanoma in patients with 1) treated and untreated schizophrenia, 2) those with untreated and untreated forms of Parkinson's disease, it would be logical to conclude that the high level of dopamine in the described patient groups is a risk factor for the development of melanoma.
The possible mechanisms for the occurrence of malignant melanoma within the so-called psycho/neuro/endocrine oncology (P.N.E.O.), as well as the effective methods of prevention, are under discussion.
皮肤、神经组织、多巴胺和黑色素瘤有着共同的神经外胚层起源。因此，调节神经组织形成、患者精神状态、个体运动调节以及皮肤癌发生的过程紧密相连。心理神经内分泌肿瘤学（或皮肤肿瘤学），即P.N.E.O.，是我们在世界文献中首次提出的医学和科学新模型或新趋势，旨在研究精神状态、激素与恶性转化之间的关系。精神分裂症和帕金森病是两种主要疾病类型，其主要症状与人体内多巴胺水平有关。根据我们对现有文献的分析，多巴胺的量与中枢神经系统疾病患者以及影响运动功能和协调能力的患者中黑素细胞性或非黑素细胞性皮肤肿瘤的发病率有关。这种相互作用模式对于阐明普遍存在的假设或说法极具指示性：“我的病是精神性的，由压力引起……”。
我们报告一名44岁患者，患有未治疗的精神分裂症约25年，同时伴有晚期肢端局限性黑色素瘤。精神分裂症通常与较高水平的多巴胺有关，而多巴胺也是黑色素合成的关键前体。在仔细分析了所有关于1）已治疗和未治疗的精神分裂症患者、2）未治疗的帕金森病患者和已治疗的帕金森病患者的黑色素瘤文献后，可以合理地得出结论，所述患者群体中高水平的多巴胺是黑色素瘤发生的危险因素。
所谓心理/神经/内分泌肿瘤学（P.N.E.O.）中恶性黑色素瘤发生的可能机制以及有效的预防方法正在讨论中。
