Altınöz Güney Cansu, Şener Sertaç, Orhun Huban Sibel, Kılınç Fadime, Akbaş Ayşe, Aktaş Akın
Department of Dermatology, Dinar State Hospital, Afyonkarahisar, Turkey.
Private Practice, Ankara, Turkey.
Arch Dermatol Res. 2025 Mar 17;317(1):585. doi: 10.1007/s00403-025-04089-y.
A dysplastic nevus (DN) is an acquired melanocytic nevus that displays clinical and histological features similar to malign melanoma (MM). This study aims to evaluate the demographic and clinical characteristics of DN and primary cutaneous MM, as well as assess the accuracy of pre-biopsy diagnoses. We retrospectively analyzed 206 histopathologically confirmed cases of DN (n = 185) and MM (n = 21) from 159 patients at a tertiary care center. The biopsy samples had been sent from both dermatology and other surgical departments. The study included 21 patients with MM and 139 with DN; one patient had both conditions. The mean age was 60.6 ± 15.9 years for MM patients and 34.7 ± 14.9 years for DN patients, both with a slight male predominance. Melanomas were predominantly on the face (42.9%), whereas DN lesions were mostly on the trunk (76.8%). Breslow thickness analysis showed 33.3% of MM tumors were < 1 mm and 28.6% were > 4 mm. In 90.5% of MM cases and 71.4% of DN cases, preliminary diagnoses of MM and/or DN were noted on pathology request forms. Overall, pre-biopsy diagnoses were consistent with final diagnoses in 73.3% of the 206 lesions. Diagnostic accuracy was higher in dermatology compared to other surgical departments (85.8% vs. 50%, p <.00001) and was better for trunk and feet locations compared to unspecified areas (p = .023 and p = .044, respectively). The study highlights the need for dermatology consultation before excising nevi or suspicious lesions and emphasizes early melanoma detection. Despite the small sample size, it underscores the importance of enhanced screening methods and awareness campaigns.
发育异常痣（DN）是一种后天性黑素细胞痣，其临床和组织学特征与恶性黑色素瘤（MM）相似。本研究旨在评估发育异常痣和原发性皮肤恶性黑色素瘤的人口统计学和临床特征，并评估活检前诊断的准确性。我们回顾性分析了一家三级医疗中心159例患者的206例经组织病理学确诊的发育异常痣（n = 185）和恶性黑色素瘤（n = 21）病例。活检样本来自皮肤科和其他外科科室。该研究包括21例恶性黑色素瘤患者和139例发育异常痣患者；1例患者同时患有这两种疾病。恶性黑色素瘤患者的平均年龄为60.6±15.9岁，发育异常痣患者为34.7±14.9岁，两者均以男性略占优势。黑色素瘤主要位于面部（42.9%），而发育异常痣病变大多位于躯干（76.8%）。Breslow厚度分析显示，33.3%的恶性黑色素瘤肿瘤<1mm，28.6%的肿瘤>4mm。在90.5%的恶性黑色素瘤病例和71.4%的发育异常痣病例中，病理申请表上记录了对恶性黑色素瘤和/或发育异常痣的初步诊断。总体而言，206个病变中有73.3%的活检前诊断与最终诊断一致。与其他外科科室相比，皮肤科的诊断准确性更高（85.8%对50%，p <.00001），与未指定区域相比，躯干和足部位置的诊断准确性更好（分别为p = .023和p = .044）。该研究强调了在切除痣或可疑病变前进行皮肤科会诊的必要性，并强调早期黑色素瘤的检测。尽管样本量较小，但它强调了加强筛查方法和提高认识活动的重要性。
