Troup Ondřej, Růžičková A, Koy A, Woznica Vlastimil, Třešková Inka
Rozhl Chir. 2024;103(10):381-386. doi: 10.48095/ccrvch2024381.
The ambulatory surgeon deals daily with patients who come for various pigmented skin lesions. A number of patients come on the recommendation of a dermatologist, but for the majority of patients, the primary visit is directly to the surgical clinic. The reason for removing a pigmented lesion may be an unsatisfactory cosmetic appearance or frequent irritation due to inappropriate location of the lesion, but also the fear of the development of malignancy. Pigmented lesions of the skin are a very hetero-geneous group represented from benign nevi to malignant melanoma. They occur in all age groups. Congenital nevi and hemangiomas are most often treated at an early age, and the incidence of skin malignancies increases in older patients. The ambulatory surgeon is often faced with the decision whether and how radically the pigmented lesion needs to be removed. Skin lesions such as lentigo solaris do not need to be treated surgically. Other lesions, such as basal cell carcinoma, require radical excision and subsequent professional dispensary. However, the treatment of melanoma is complex, it is led by specialists in dermato-oncology centers and therefore interdisciplinary approach is neces-sary. Every ambulatory surgeon should be knowledgeable and experienced enough to be able to decide on the need for removal of pigmented lesions and, in case of uncertainty, refer the patient to a skin specialist. This article provides a brief overview and specifics of basic skin pigment manifestations and criteria for their surgical removal.
门诊外科医生每天都要接待因各种皮肤色素沉着病变前来就诊的患者。许多患者是在皮肤科医生的推荐下来的，但大多数患者是直接到外科诊所初诊。切除色素沉着病变的原因可能是外观不尽人意，或者病变位置不当导致频繁刺激，也可能是担心发生恶性病变。皮肤色素沉着病变是一个非常 heterogeneous 的群体，从良性痣到恶性黑色素瘤都有。它们在所有年龄组中都有发生。先天性痣和血管瘤最常在幼年时接受治疗，而老年患者皮肤恶性肿瘤的发病率会增加。门诊外科医生经常面临这样的决定，即色素沉着病变是否需要切除以及切除的彻底程度如何。诸如日光性雀斑样痣等皮肤病变无需手术治疗。其他病变，如基底细胞癌，则需要根治性切除并随后进行专业的随访。然而，黑色素瘤的治疗很复杂，由皮肤肿瘤学中心的专家主导，因此需要跨学科方法。每位门诊外科医生都应具备足够的知识和经验，以便能够决定是否需要切除色素沉着病变，如有不确定情况，应将患者转诊给皮肤科专家。本文简要概述了基本皮肤色素表现及其手术切除标准的具体情况。
