| BackgroundSkin melanocytic nevi and melanoma are the benign and malignant tumororiginated from melanocyte．According to the time of nevus appearance for birth orafter birth clinically, melanocytic nevi is divided into congenital and acquired nevus，part of the larger area of congenital pigmented nevus have certain chances ofbecoming milignant and more positive treatment；most of acquired melanocytic neviare benign pigmented nevus， because acquired melanocytic nevi have certainrelations with melanoma， the stimulus or inappropriate treatment can causemelanocytic hyperplasia，has certain malignant change of risk，the study report theincidence of melanoma are increasing year by year，although the skin melanoma inthe incidence of the population of China is very low，but the melanocytic nevus is acommon disease. Melanoma is the most common malignant skin cancer；Melanocyticnevus can is the precursor of melanoma． Melanoma those are treated early bysurgical resection can be cured. The differential diagnosis beween melanocytic neviand melanoma，especially in the early diagnosis of melanoma has always been theforefront and emphasis of research．Dermoscopy is a kind of exact and effective noninvasive technique for diagnosis and differential diagnosis of melanocyte tumor and non melanocyte tumor，benignmelanocyte tumor and malignant melanocyte，has higher accuracy and specificitythan the naked eye. The dermoscopy performance of benign melanocyte nevus is thebasic of the diagnosis and differential diagnosis of melanocytic tumors，and earlydiagnosis of melanoma. Currently，the domestic application of dermoscopy diagnosishas made great progress for impigmentary lesions，such as the research of thedremoscopy characteristics of pityriasis rosea，psoriasis，lichen planus，seborrheickeratosis，the application of dermoscopy has improved the accuracy in diagnosis ofno pigmentary lesions，now some study has been reported about the dermoscopycharacteristics of those nevus of the special parts，such as palms and soles．In recent years in abroad， some study have been reported about thecharacteristics of pigmented nevus are associated with genetic，age，insolation andlocation．Mainly according to the results of the study about the western caucasians，melanocytic nevus can be divided into small ball type, mesh type，starburst and blueuniform according to its etiology， epidemiology，clinical and pathological features，and their associated risk of progression. Which, in turn，according to the dermoscopycharacteristics of skin melanocytic nevus，we can predict the etiology，epidemiology,pathology and the risk of progression，and study of the dermoscopy characteristics ofskin melanocytic nevus can provide more effective basis for melanocyte nevusdiagnosis and treatment．But the population of China acquired skin melanocyticdermoscopy performance has so far failed to report．objectivesRecord crowd who has acquired melanocyte nevus in China，and the clinicalfeatures and dermoscopy characteristics,then we predict its etiology，epidemiology，pathology，and risk of malignant transformation according to the characters ofdermoscopy，improve the diagnosis accuracy and specificity of acquired melanocyticnevus，can acquire more effective identification of acquired melanocytic nevus andmelanoma，lay a foundation for the early diagnosis of melanoma． MethodsCollected115patients of acquired melanocytic nevusof the inpatient andoutpatient department of dermatology in the first affiliated hospital form zhengzhouuniversity in March1,2013to September31,2013. According to the comparisonbetween2mm with the diameter of skin lesions,we can divid them into experimentalgroup and control group, recorded in the patient’s demographic characteristics, thebrief history, skin lesion, and use the digital camera and lens make clinical anddermoscopy photos for each lesion of diameter bigger than2mm. Then thoseexperienced dermoscopy doctor descripte and analy all dermoscopy photos,thendiagnosis and analysis the lesion’s characteristics. Statistical experimentalgroup,control group, and all the patients,including the number of freckles, eye color,hair color, melanin value, the number of moles, gender, age, occupation, wear a hat,sunscreen, open an umbrella/skin type, total sunlight exposure time, skin disease, theclinical features of statistical patient skin and skin characteristics.Results1.In this study,there are115patients who has acquired pigment nevus, theexperimental group that is lesion diameter greater than2mm is80cases, thepercentage was69.6%, the biggest diameter of the lesion <2mm that is the controlgroup has35cases, accounted for30.4%, patients who has lesion <2mm range1-72, the number of nevus mean standard deviation/median26+/-12; The numberof patients with2mm or higher pigment nevus range1to24, average standarddeviation/median9+/-2;2. The study did not recruit types, each reason number of patients and theirpercentage respectively:11.9%patients don’t cooperate when collecting data, thepatient is not willing to participate in19.4%patients without access to melanin cellnevus/melanoma lesions in31%, due to the superposition of other skin diseases, maychange the acquired dark pigment nevus/skin melanoma cell changes in theappearance of4.8%, due to trauma, cryotherapy, branding agency, or laser surgery,the patient’s acquired melanocyte nevus/melanoma skin lesion (s) lost its original appearance (s) of4.8%, the qualified detected in the abnormal skin26.2%, other0%.3. Statistics for all patients, male: female activity8, age range is5.5years old-83years old,43.27+/-28, classifications:2(12.2%), three (13.9%), four types of8.7%, five categories accounted for21.7%, six (7.8%),8class accounted for35.7%;Freckles patients,20(17.4%), divide people’s face, pale brown, freckles10-50,35+10, never wear sunglasses92.2%, while going out with sunglasses for less than50%(7.8%), never wear a hat/74.8%open an umbrella, less than50%(18.3%), open anumbrella hat/hat/more than50%(7.0%), open an umbrella never81.7%sunscreen,sunscreen less than50%(14.8%), sunscreen more than50%(3.5%); All are Ⅲ orⅣskin types;52.2%52.2%52.2%eyes, light brown, brown, dark brown,47.0%haircolor black, brown,2.6%,46.1%dark brown, light brown4.3%, lateral flexion andmelanin stretch test value range of19-99respectively, and20-99lancet51++11and20. Patients total sunlight exposure time range456.510037.5,781-106. All withouthistory and family history of melanoma,4. The control group which was detected in diameter <2mm, male: female thatis, the age range of9years old-83years old,35.25+/-38, according to the nationalclass divided into eight categories: category accounted for5.7%, three (17.1%), fourtypes of2.9%, five categories accounted for22.9%, six (8.6%),8class accounted for42.9%; Freckled patient number of three people, accounting for8.6%, average20.3,and97.1%never wear sunglasses when going out, wearing sunglasses is less than50%(50%), never wear a hat/82.9%open an umbrella, less than50%(11.4%), openan umbrella hat/cap/an umbrella is more than50%(50%),88.6%never use sunscreen,sunscreen less than50%(8.6%), sunscreen is more than50%(2.9%).48.6%48.6%48.6%eyes, light brown, brown, dark brown,54.3%hair color black, brown,2.9%,40%dark brown, light brown2.9%, lateral flexion and melanin stretch test valuerange is24-99respectively and35-99,55++14and23; Patients total sunlightexposure time range547.510037.5,791-164.5. No adjuant mitotane lesions diameter2mm or greater, male: female1,emit,41.5age range to5.5-75-45, classifications:2(15%), three (12.5%), four typesof11.2%, five categories accounted for21.2%, six (5.2%),8class accounted for22.6%; Freckled patient number of17people, accounting for21.2%, freckles number 10to5016+169, never wear sunglasses90%, while going out with sunglasses forless than50%50%,71.2%, open an umbrella never wear a hat/cap/less than50%(21.3%), open an umbrella hat/more than50%(7.5%), open an umbrella never78.8%sunscreen, sunscreen is less than50%(17.5%), sunscreen is more than50%(3.7%).53.8%53.8%53.8%eyes, light brown, brown, dark brown,43.8%hair color black,brown,2.5%,48.8%dark brown, light brown5%, lateral flexion and melanin stretchtest value range respectively19-20-96.3,93.7and19and35+45+27. Patients withtotal sunlight exposure time range456.59125571-120.6. Acquired pigment nevus clinical manifestations, location scalp departmentrespectively3.5%,20%facial, neck,11.4%,1.5%of your ear, ear, the top1.1%, earsafter the1.3%,37.8%, trunk limbs are21.8%,1.3%, palm and plantar vulva0.2%;Color is nude5.5%and0.2%, pink or red powder color0.2%,44.6%light brown,dark brown26.6%, black4.4%, blue0.9%,0.6%, gray film of8.6%,0.2%blue gray,dark brown gray2.6%,5%JianZong gray, JianZong pink0.4%; Rough surfacecharacteristics for smooth81.7%,12.1%,1.7%folds, papillary4.6%; A flat69.2%,slightly raised23.1%, obviously swelled7.9%; No obvious symptoms99.1%,0.9%of itching, pain; The range of2mm to9mm. Diameter,4-2.1.7. Skin for mirror characteristics: divided into27.2%net shape structure, spheres,9.2%,53.4%, nonspecific structure ball on the edge of the mesh structure is0.2%, thestructured fringes of spherical structure of1.1%,0.2%no structured mesh structure,on the edge of the ball1.5%no structure shape, the edge of the mesh withoutstructure of6.1%,0.4%lattice structures, parallel groove structure is0.4%.Conclusions1.Collect acquired melanocyte nevus women more, multiple age in middle age,eyes and hair color is brown or light brown pigment nevus number is more, easy tosee freckles, sun protection is poorer and more occupational exposure to sunlightpatients out pigment nevus number is more, high value, melanin pigment nevusdiameter <2mm patients less number of moles, flexed lateral melanin value ishigher. 2. Acquired melanocyte nevus is located in the most torso, limbs, face and neck,palmoplantar less, vulva and mucous membrane is rare; Most common light brown,brown and dark brown, black and nude uncommon; Most common surface smooth,coarse sample times, accidentally visible papillary and folds; Surface smooth, themost common findings and the slightly raised obviously swelled rare.3. The acquired skin melanocyte nevus dermoscopy characteristics isdiversiform, have pigment, point/globular structure, stripes, blue and white "veil",pigmentation, acne sample opening and exogenous nipple sample opening, regularity,homogeneous structure, pigment is the most common network structure.4. Acquired melanocyte nevus dermoscopy characteristics help to improve thediagnosis of acquired melanocyte nevus accuracy and sensitivity, especially to helpidentify the pigmentary skin and melanoma. |
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