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斑片状皮肤黑素细胞增多症:鉴别诊断与管理

Patchy Dermal Melanocytosis: Differential Diagnosis and Management.

作者信息

Zhu Jiafang, Cen Qingqing, Chang Rui, Han Yue, Lin Xiaoxi

机构信息

Department of Laser and Aesthetic Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Dermatology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

J Cosmet Dermatol. 2025 Jan;24(1):e16607. doi: 10.1111/jocd.16607. Epub 2024 Nov 1.

Abstract

BACKGROUND

Nevus of Ito and Mongolian spots are distinct clinical presentations of patchy dermal melanocytosis, characterized by similar dermatological manifestations that can pose diagnostic difficulties for clinicians.

AIM

This review aims to consolidate current understanding and research advancements on these conditions to facilitate clinical diagnosis, differential diagnosis, and management.

METHODS

A comprehensive search of databases including PubMed and Google Scholar was conducted, along with an analysis of pertinent literature retrieved from reference lists spanning nearly four decades.

RESULTS

Epidemiological, clinical, and pathological profiles exhibit nuanced differences between the two conditions, with unique expressions under electron microscopy and the regression possibility. It is noteworthy that most Mongolian spots naturally fade with advancing age, in contrast to nevus of Ito, which persist and may potentially evolve into malignant lesions. While picosecond laser treatment has shown greater efficacy than nanosecond lasers, the lower-energy approach holds particular promise in pediatric cases. The therapeutic landscape for patchy dermal melanocytosis is evolving, shifting from selective photothermal action to photomechanical or subcellular photothermal modalities.

CONCLUSION

This review underscores the importance of meticulous clinical assessment and the potential of innovative therapeutic approaches in managing these conditions.

摘要

背景

伊藤痣和蒙古斑是斑片状皮肤黑素细胞增多症的不同临床表现,其特征为相似的皮肤病学表现,这可能给临床医生带来诊断困难。

目的

本综述旨在巩固目前对这些病症的认识和研究进展,以促进临床诊断、鉴别诊断和治疗。

方法

对包括PubMed和谷歌学术在内的数据库进行了全面检索,并对从近四十年的参考文献列表中检索到的相关文献进行了分析。

结果

这两种病症在流行病学、临床和病理特征上存在细微差异,在电子显微镜下有独特表现且有消退可能性。值得注意的是,大多数蒙古斑会随着年龄增长自然消退,而伊藤痣会持续存在并可能演变成恶性病变。虽然皮秒激光治疗已显示出比纳秒激光更高的疗效,但低能量方法在儿科病例中尤其有前景。斑片状皮肤黑素细胞增多症的治疗格局正在演变,从选择性光热作用转向光机械或亚细胞光热模式。

结论

本综述强调了细致临床评估的重要性以及创新治疗方法在处理这些病症方面的潜力。

相似文献

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Dermal melanocytosis and associated disorders.皮肤黑素细胞增多症及相关疾病。
Curr Opin Pediatr. 2015 Aug;27(4):480-5. doi: 10.1097/MOP.0000000000000247.
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Dermal melanocytosis: a clinical spectrum.皮肤黑素细胞增多症:一种临床谱
Australas J Dermatol. 1996 Feb;37(1):19-25. doi: 10.1111/j.1440-0960.1996.tb00989.x.
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Congenital segmental dermal melanocytosis in an adult.成人先天性节段性皮肤黑素细胞增多症
Arch Dermatol. 1992 Apr;128(4):521-5. doi: 10.1001/archderm.1992.01680140101012.

本文引用的文献

2
High-fluence 1064nm Q-switched Nd:YAG laser treatment for ectopic Mongolian spot.1064nm 高能量 Q 开关 Nd:YAG 激光治疗蒙古斑。
J Dermatolog Treat. 2023 Dec;34(1):2255057. doi: 10.1080/09546634.2023.2255057. Epub 2023 Oct 2.

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