Dysplastic nevus - 發育不良痣
Dysplastic nevi ― 建議西方人進行活檢。
References
Dysplastic nevus ，也稱為非典型痣或克拉克痣，引發了皮膚病學和皮膚病理學的爭論。醫生經常對這些痣進行活檢，因為它們看起來異常並引起黑色素瘤的擔憂。
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 ，也稱為非典型痣或克拉克痣，有時會導致黑色素瘤。約 36% 的黑色素瘤發現於發育異常痣附近。發育不良痣可能轉變為黑色素瘤的跡象包括形狀不均勻、色素變化較多或顏色呈灰色。這些癌症通常發生在較年輕的年齡（大約三十歲左右），可能是多發性的，並且通常發生在軀幹上。從基因上來說， dysplastic nevi 介於良性痣和黑色素瘤之間。 但是，只有 20% 到 30% 的黑色素瘤來自現有的痣。
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.
黑色素瘤是一種腫瘤，當黑色素細胞（負責膚色的細胞）癌變時形成。黑素細胞起源於神經嵴。這意味著黑色素瘤不僅可以在皮膚上生長，還可以在神經嵴細胞遷移的其他區域（例如胃腸道和大腦）中生長。早期黑色素瘤（0 期）患者的存活率高達 97%，而晚期（IV 期）患者的存活率則大幅下降至 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.
○ 癌症風險
正如美國白人中所見，患有發育不良痣的人一生中患黑色素瘤的風險高於 10%。另一方面，沒有任何發育不良痣的人罹患黑色素瘤的風險低於 1%。
○ 發育不良痣者的預防措施
通常建議進行皮膚自我檢查來預防黑色素瘤（透過識別可以去除的非典型痣）或早期發現現有腫瘤。有皮膚癌或多發性非典型痣個人或家族史的人應該每年至少去看一次皮膚科醫生，以確保他們沒有患上黑色素瘤。
縮寫 [ABCDE] 對於幫助醫療保健提供者和外行人員記住黑色素瘤的關鍵特徵非常有用。不幸的是，對於一般人來說，許多脂漏性角化症、一些老年雀斑甚至疣可能具有 [ABCDE] 特徵，並且無法與黑色素瘤區分開。
○ [ABCDE]
Asymmetrical：不對稱的皮膚病變。
Border：病變邊界不規則。
Color：黑色素瘤通常有多種不規則的顏色。
Diameter：大於 6 毫米的痣比較小的痣更可能是黑色素瘤。
Evolution：痣或病變的演變（即變化）可能表示病變正在惡化。