Drepper H
HNO. 1985 Jul;33(7):293-302.
The superficial angiomas and nevi arise from the endothelial cells, the pigment-cell-system or the epidermal cells. Hemangiomas are benign tumours of the endothelial cells appearing predominantly in female newborn infants. Depending on localisation, growth and proliferation there is a tendency for spontaneous involution. For irreversible dysfunction or anatomical deformities surgical resection during the growth phase of the hemangioma is indicated. Surgery may be necessary to improve the functional and esthetic appearance after spontaneous involution causing loose residual skin. Radiotherapy of the lesion is rarely indicated. Systemic steroid therapy in cooperation with the pediatrician should be reserved only for desperate cases such as Kasabach-Merrit-Syndrome. Port wine nevi without scars can be covered with skin tanning cosmetics. Argon-Laser-Therapy is not yet so selective that healing can be achieved with certainty and without scars. Clinical progression requires surgery, especially for racemose angiectasia. Arterial embolization should only be used under special conditions, and then only as pretreatment. Lymphangiomas are mostly angiectatic processes, especially of lymphatic vascular tissue and vessels. Even large cystic lymphangiomas can be treated quite well by surgery, but operations on large diffuse invasive lymphangiomas often cause lymphedema and infection similar to erysipelas leading to pseudorecurrence. The benign malformations of the pigment cell system require clear differentiation from malignant melanoma and its precursors. Malignant melanoma develops more frequently from congenital nevi of the deep type than from other pigmented lesions. Malignant melanomas arising from giant nevi are usually diagnosed too late so that almost all patients die. Removal of giant nevi as early as possible is recommended. The epidermal malformations, too, need accurate diagnosis. Multisymptomatic syndromes such as the Basal-Cell-Nevus-Syndrome, and vascular and pigment cell abnormalities require special care.
浅表血管瘤和痣起源于内皮细胞、色素细胞系统或表皮细胞。血管瘤是内皮细胞的良性肿瘤，主要出现在女性新生儿中。根据其位置、生长和增殖情况，有自发消退的趋势。对于不可逆的功能障碍或解剖畸形，在血管瘤生长阶段需进行手术切除。在自发消退导致皮肤松弛残留后，可能需要手术来改善功能和美观。很少对病变进行放射治疗。与儿科医生合作进行的全身类固醇治疗仅应保留给诸如卡萨巴赫 - 梅里特综合征等绝望病例。无瘢痕的葡萄酒色斑痣可用皮肤晒黑化妆品遮盖。氩激光治疗的选择性还不足以确保一定能实现愈合且不留瘢痕。临床进展需要手术，尤其是对于蔓状血管瘤。动脉栓塞仅应在特殊情况下使用，且仅作为预处理。淋巴管瘤大多是扩张性病变，尤其是淋巴管组织和血管的病变。即使是大的囊性淋巴管瘤也可通过手术得到很好的治疗，但对大的弥漫性浸润性淋巴管瘤进行手术往往会导致淋巴水肿和类似丹毒的感染，从而导致假性复发。色素细胞系统的良性畸形需要与恶性黑色素瘤及其前驱病变明确区分。恶性黑色素瘤更常由深部先天性痣发展而来，而非其他色素沉着病变。由巨大痣引起的恶性黑色素瘤通常诊断过晚，以至于几乎所有患者都会死亡。建议尽早切除巨大痣。表皮畸形也需要准确诊断。多症状综合征，如基底细胞痣综合征以及血管和色素细胞异常，需要特别关注。
