Friedman R J, Rigel D S, Heilman E R
Department of Dermatology, New York University School of Medicine, New York.
Dermatol Clin. 1988 Apr;6(2):249-56.
In conclusion, although there are data, some quite convincingly implicating dysplastic nevi and congenital nevi (particularly "giant") as "precursors" of malignant melanomas, our ability to predict the magnitude of these associations is lacking. Thus, until additional basic and clinical research data are forthcoming, any recommendation to prophylactically remove all congenital nevi or all dysplastic nevi in order to decrease the incidence of malignant melanoma is premature. In regard to congenital nevi, evidence exists that giant (larger than 20 cm in diameter) congenital nevi may have a significant risk factor so as to warrant, when feasible, prophylactic excision of such lesions. In our opinion, no uniform recommendation can be made at this time for the management of small and medium-sized congenital nevi. Patients with familial dysplastic nevus syndrome should be followed carefully and educated concerning the early detection of malignant melanoma. Patients with sporadic dysplastic nevus syndrome deserve further study to enable us to accurately determine their risk of developing malignant melanoma.
总之，尽管有数据表明，一些数据颇具说服力地将发育异常痣和先天性痣（尤其是“巨大型”）视为恶性黑色素瘤的“前驱病变”，但我们仍缺乏预测这些关联程度的能力。因此，在获得更多基础和临床研究数据之前，为降低恶性黑色素瘤的发病率而预防性切除所有先天性痣或所有发育异常痣的任何建议都为时过早。关于先天性痣，有证据表明，巨大型（直径大于20厘米）先天性痣可能是一个重要的危险因素，在可行的情况下，应对此类病变进行预防性切除。我们认为，目前对于中小型先天性痣的处理无法给出统一建议。家族性发育异常痣综合征患者应密切随访，并就恶性黑色素瘤的早期检测对其进行教育。散发性发育异常痣综合征患者值得进一步研究，以便我们准确确定他们发生恶性黑色素瘤的风险。
