Polubothu S, Kinsler V A
Genetics and Genomic Medicine, University College London Great Ormond Street Institute of Child Health, London, WC1N 1EH, U.K.
Paediatric Dermatology, Great Ormond St Hospital for Children NHS Foundation Trust, London, WC1N 3JH, U.K.
Br J Dermatol. 2020 Mar;182(3):721-728. doi: 10.1111/bjd.18149. Epub 2019 Aug 7.
Spontaneous lightening of congenital melanocytic naevi (CMN) has not been studied systematically. Final colour is considered an important outcome after superficial removal techniques such as curettage, dermabrasion or laser ablation, and is often compared with colour at birth.
To quantify the natural history of CMN lightening over time, and explore phenotypic and genotypic predictors of colour change.
A longitudinal cohort study was undertaken of 110 patients with CMN (mean follow-up 5·3 years). Accurate colour-space measurements were taken from professional serial photographs of CMN and normal skin. Changes in colour over time were modelled using multiple logistic regression, against phenotypic and genotypic variables.
Lightening of CMN was significantly associated with lighter normal skin colour (P < 0·001) and with MC1R variant alleles (red/blonde hair gene) (P < 0·001), but not with CMN colour in the first 3 months of life, NRAS genotype or projected adult size of CMN. Importantly, the final colours of adjacent treated and untreated areas of CMN were indistinguishable.
Final CMN colour in childhood is related to the genetically determined skin colour of the individual, is unrelated to the colour of CMN at birth, and is unaffected by superficial removal. What's already known about this topic? Final colour of congenital melanocytic naevi (CMN) is considered an important outcome after superficial removal techniques such as curettage, dermabrasion or laser ablation, and is often compared with colour at birth. The phenomenon of spontaneous lightening in CMN, in which naevi lighten gradually and sometimes dramatically during childhood, has been described but not systematically studied. What does this study add? Final CMN colour in childhood is significantly associated with the individual's normal skin colour, and with MC1R genotype, and is therefore genetically determined. Final CMN colour is not predictable from CMN colour in the first 3 months of life. Superficial removal techniques do not alter the final colour of CMN.
先天性黑素细胞痣（CMN）的自然褪色尚未得到系统研究。在刮除术、磨皮术或激光消融等浅表去除技术之后，最终颜色被视为一项重要的结果指标，并且常与出生时的颜色进行比较。
量化CMN随时间推移的自然褪色过程，并探究颜色变化的表型和基因型预测因素。
对110例CMN患者进行了一项纵向队列研究（平均随访5.3年）。从CMN和正常皮肤的专业系列照片中进行精确的颜色空间测量。使用多元逻辑回归模型，针对表型和基因型变量，对随时间的颜色变化进行建模。
CMN的褪色与较浅的正常皮肤颜色显著相关（P < 0.001），与MC1R变异等位基因（红/金色头发基因）显著相关（P < 0.001），但与出生后前3个月的CMN颜色、NRAS基因型或CMN预计的成人大小无关。重要的是，CMN相邻的治疗区和未治疗区的最终颜色无法区分。
儿童期CMN的最终颜色与个体的遗传决定的皮肤颜色有关，与出生时CMN的颜色无关，且不受浅表去除的影响。关于该主题已知的信息有哪些？在刮除术、磨皮术或激光消融等浅表去除技术之后，先天性黑素细胞痣（CMN）的最终颜色被视为一项重要的结果指标，并且常与出生时的颜色进行比较。CMN存在自然褪色现象，即痣在儿童期会逐渐变淡，有时变化显著，但尚未得到系统研究。本研究补充了哪些内容？儿童期CMN的最终颜色与个体的正常皮肤颜色以及MC1R基因型显著相关，因此是由基因决定的。无法根据出生后前3个月的CMN颜色预测其最终颜色。浅表去除技术不会改变CMN的最终颜色。
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