Vezzoni Roberta, Conforti Claudio, Vichi Silvia, Giuffrida Roberta, Retrosi Chiara, Magaton-Rizzi Giovanni, Di Meo Nicola, Pizzichetta Maria Antonietta, Zalaudek Iris
Dermatology Clinic, Hospital Maggiore, University of Trieste, Italy.
Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy.
Dermatol Pract Concept. 2020 Apr 3;10(2):e2020028. doi: 10.5826/dpc.1002a28. eCollection 2020.
The association of melanoma with a preexisting nevus is still a debated subject. Histopathological data support an associated nevus in approximately 30% of all excised melanomas. The annual risk of an individual melanocytic nevus becoming malignant is extremely low and has been estimated to be approximately 0.0005% (or less than 1 in 200,000) before the age of 40 years, to 0.003% (1 in 33,000) in patients older than 60 years. Current understanding, based on the noticeable, small, truly congenital nevi and nevi acquired early in life, is that the first develops before puberty, presents with a dermoscopic globular pattern, and persists for the lifetime, becoming later a dermal nevus in the adult. In contrast, acquired melanocytic nevi develop mostly at puberty and usually undergo spontaneous involution after the fifth decade of life. The purpose of this review is to analyze the data of the literature and to propose, on the basis of epidemiological and clinical-dermoscopic characteristics, a new model of melanogenesis of nevus-associated melanoma.
黑色素瘤与先前存在的痣之间的关联仍是一个有争议的话题。组织病理学数据表明，在所有切除的黑色素瘤中，约30%存在相关的痣。单个黑素细胞痣恶变的年风险极低，据估计，40岁之前约为0.0005%（或低于二十万分之一），60岁以上患者为0.003%（三万三千分之一）。基于明显的、小的、真正的先天性痣以及生命早期获得的痣，目前的认识是，前者在青春期前形成，呈现皮肤镜下的球状模式，并终生存在，后来在成人期成为真皮内痣。相比之下，后天性黑素细胞痣大多在青春期形成，通常在生命的第五个十年后自发消退。本综述的目的是分析文献数据，并基于流行病学和临床皮肤镜特征，提出一种与痣相关的黑色素瘤发生的新模型。
