- 作者：Holger A. Haenssle ; Kjell M. Kaune ; Timo Buhl ; Kai-Martin Thoms ; Michael Padeken ; Steffen Emmert ; Michael P. Schö ; n
- 关键词：dermatoscopy ; digital dermatoscopy ; melanoma ; nevus spilus
- 刊名：Journal of the American Academy of Dermatology
- 出版年：2009
- 出版时间：August 2009
- 年：2009
- 卷：61
- 期：2
- 页码：337-341
- 全文大小：1642 K
Background
Nevus spilus (NS) defines a café-au-lait macule with superimposed maculopapular speckles. Although the café-au-lait macule often presents at birth, the darker pigmented speckles increase in number and size during a period of several years. The need for close follow-up of patients with NS is underlined by reports of several cases of cutaneous melanoma developing within such lesions.Methods
We followed up 4 adult patients (3 male, one female; mean age 38 years) with unilateral segmental NS of the thoracic or abdominal region. The NS was present at birth in all 4 patients. Follow-up by sequential digital dermatoscopy and digital overview images was scheduled every 6 to 12 months.
Results
During surveillance (mean follow-up time, 8.15 years), 3 melanocytic lesions were excised. In one patient focal enlargement prompted excision of two dysplastic compound nevi. In another patient new black dots and focal peripheral hyperpigmentation were detected by comparison with previous images. Histologic analysis confirmed the diagnosis of invasive melanoma (Breslow thickness, 0.6 mm).
Limitations
This observational clinical study included a small number of patients. Sequential digital dermatoscopy of large NS in children may lead to unnecessary excisions because of physiologic changes.
Conclusion
We suggest close follow-up of patients with segmental NS whenever complete excision is not possible. In adults, follow-up by digital dermatoscopy and excision of lesions with dynamic changes may assist in the early detection of melanoma.