Metcalf J S, Maize J C
Dermatol Clin. 1985 Apr;3(2):217-24.
It has been known for a long time that melanoma can have its origin in congenital or acquired melanocytic nevi. In regard to congenital nevi, there is sufficient evidence to state that large lesions (those greater than 20 cm in diameter) have a significant risk factor that is several-fold greater than for common acquired nevi. Prophylactic excision of such lesions should be strongly considered when it is feasible, but individual circumstances must be taken into account. The risk factors for small and medium-sized congenital nevi have not been accurately determined; therefore, no uniform recommendation can be made regarding their management. There is no objective evidence to indicate that common acquired nevi in any particular anatomic sites, such as volar or genital skin, are at greater risk for the development of melanoma than are any others. Patients with familial dysplastic nevus syndrome must be identified and followed carefully in order to recognize and eradicate evolving and early melanomas. The concept of the sporadic dysplastic nevus syndrome is intriguing and deserves careful study to further define the clinical and histologic diagnostic criteria that will enable accurate determination of its prevalence and risk factors.
长期以来，人们都知道黑色素瘤可能起源于先天性或后天性黑素细胞痣。关于先天性痣，有充分证据表明，大的损害（直径大于20厘米者）是一个重要的危险因素，其风险比普通后天性痣大几倍。在可行的情况下，应强烈考虑对此类损害进行预防性切除，但必须考虑个体情况。中小型先天性痣的危险因素尚未准确确定；因此，对于其处理无法给出统一建议。没有客观证据表明，在任何特定解剖部位（如手掌或生殖器皮肤）的普通后天性痣发生黑色素瘤的风险比其他部位更高。必须识别并仔细随访家族性发育异常痣综合征患者，以便识别和根除正在演变的早期黑色素瘤。散发性发育异常痣综合征的概念很有趣，值得仔细研究，以进一步明确临床和组织学诊断标准，从而能够准确确定其患病率和危险因素。
