Dysplastic nevus - 发育不良痣
Dysplastic nevi ― 建议西方人进行活检。
References
Dysplastic nevus ，也称为非典型痣或克拉克痣，引发了皮肤病学和皮肤病理学的争论。医生经常对这些痣进行活检，因为它们看起来异常并引起黑色素瘤的担忧。
A dysplastic nevus is also referred to as an atypical or Clarks nevus and has been the topic of much debate in the fields of dermatology and dermatopathology. It is an acquired mole demonstrating a unique clinical and histopathologic appearance that sets it apart from the common nevus. These moles appear atypical clinically, often with a fried-egg appearance, and are commonly biopsied by providers due to the concern for melanoma.
A dysplastic nevus is also referred to as an atypical or Clarks nevus and has been the topic of much debate in the fields of dermatology and dermatopathology. It is an acquired mole demonstrating a unique clinical and histopathologic appearance that sets it apart from the common nevus. These moles appear atypical clinically, often with a fried-egg appearance, and are commonly biopsied by providers due to the concern for melanoma.
Dysplastic nevi ，也称为非典型痣或克拉克痣，有时会导致黑色素瘤。约 36% 的黑色素瘤发现于发育异常痣附近。发育不良痣可能转变为黑色素瘤的迹象包括形状不均匀、色素变化较多或颜色呈灰色。这些癌症通常发生在较年轻的年龄（大约三十岁左右），可能是多发性的，并且通常发生在躯干上。从基因上来说， dysplastic nevi 介于良性痣和黑色素瘤之间。 但是，只有 20% 到 30% 的黑色素瘤来自现有的痣。由于大多数痣不会变成黑色素瘤，因此通常不建议预防性去除它们。
Dysplastic nevus, also called atypical or Clark nevus, can be precursor to melanoma, as the observation that 36% of melanomas have dysplastic nevi near the invasive tumor supports. Signs that a dysplastic nevus may have transitioned into a melanoma include asymmetry in contour, a noticeable increase in pigment variations, or a grayish tint indicating regression. These malignancies typically arise at a younger age (mid-thirties), are sometimes multiple, and are often found on the trunk. Molecularly, dysplastic nevi have a profile intermediate between benign nevi and malignant melanoma. While there is a recognized connection between dysplastic nevi and melanoma, it’s crucial to note that only about 20% to 30% of melanomas evolve from preexisting nevi. Given that the majority of dysplastic and typical nevi do not develop into melanoma, preventive removal of melanocytic nevi is not typically advised.
Dysplastic nevus, also called atypical or Clark nevus, can be precursor to melanoma, as the observation that 36% of melanomas have dysplastic nevi near the invasive tumor supports. Signs that a dysplastic nevus may have transitioned into a melanoma include asymmetry in contour, a noticeable increase in pigment variations, or a grayish tint indicating regression. These malignancies typically arise at a younger age (mid-thirties), are sometimes multiple, and are often found on the trunk. Molecularly, dysplastic nevi have a profile intermediate between benign nevi and malignant melanoma. While there is a recognized connection between dysplastic nevi and melanoma, it’s crucial to note that only about 20% to 30% of melanomas evolve from preexisting nevi. Given that the majority of dysplastic and typical nevi do not develop into melanoma, preventive removal of melanocytic nevi is not typically advised.
黑色素瘤是一种肿瘤，当黑色素细胞（负责肤色的细胞）癌变时形成。黑素细胞起源于神经嵴。这意味着黑色素瘤不仅可以在皮肤上生长，还可以在神经嵴细胞迁移的其他区域（例如胃肠道和大脑）中生长。早期黑色素瘤（0 期）患者的生存率高达 97%，而晚期（IV 期）患者的生存率则大幅下降至 10% 左右。
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
○ 癌症风险
正如美国白种人中所见，患有发育不良痣的人一生中患黑色素瘤的风险高于 10%。另一方面，没有任何发育不良痣的人患黑色素瘤的风险低于 1%。
○ 发育不良痣者的预防措施
通常建议进行皮肤自我检查来预防黑色素瘤（通过识别可以去除的非典型痣）或早期发现现有肿瘤。有皮肤癌或多发性非典型痣个人或家族史的人应该每年至少去看一次皮肤科医生，以确保他们没有患上黑色素瘤。
缩写 [ABCDE] 对于帮助医疗保健提供者和外行人员记住黑色素瘤的关键特征非常有用。不幸的是，对于普通人来说，许多脂溢性角化病、一些老年雀斑甚至疣可能具有 [ABCDE] 特征，并且无法与黑色素瘤区分开。
○ [ABCDE]
Asymmetrical：不对称的皮肤病变。
Border：病变边界不规则。
Color：黑色素瘤通常有多种不规则的颜色。
Diameter：大于 6 毫米的痣比较小的痣更可能是黑色素瘤。
Evolution：痣或病变的演变（即变化）可能表明病变正在恶化。