Conforti Claudio, Giuffrida Roberta, Vezzoni Roberta, Resende Fernanda S S, di Meo Nicola, Zalaudek Iris
Dermatology Clinic, Ospedale Maggiore, University of Trieste, Trieste, Italy.
Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy.
Int J Dermatol. 2020 Jan;59(1):16-22. doi: 10.1111/ijd.14512. Epub 2019 Jun 20.
For several decades, melanoma diagnosis was based on symptoms rather than clinical features. In fact, until the 1970s melanoma was widely not recognized and only diagnosed when presenting as a large, ulcerated, and bleeding nodule. Today it is well known that ulceration and bleeding are symptoms of an advanced stage; thus, it comes not as a surprise that the prognosis of melanoma at that time was very poor. This paper was developed to recognize dermoscopy as an integrative part of the clinical examination, bearing in mind that naked eye diagnosis can change after dermoscopy outcomes, and to help clinicians avoid the concept: "If in doubt, cut it out".
几十年来,黑色素瘤的诊断是基于症状而非临床特征。事实上,直到20世纪70年代,黑色素瘤仍未被广泛认识,只有在表现为大的、溃疡的和出血的结节时才会被诊断出来。如今,众所周知溃疡和出血是晚期的症状;因此,当时黑色素瘤的预后非常差也就不足为奇了。撰写本文的目的是将皮肤镜检查视为临床检查的一个组成部分,同时要记住,在皮肤镜检查结果出来后,肉眼诊断可能会改变,并帮助临床医生避免“存疑就切除”的观念。