先天性巨痣的治疗进展  

Progress of Treatment on Giant Congenital Melanocytic Nevus

作　　者：李越(综述) 刘浥 吴信峰(审校) LI Yue;LIU Yi;WU Xin-feng(Department of Plastic Surgery,Hospital for Skin Diseases,Chinese Academy of Medical Sciences,Peking Union Medical College,Nanjing 210042,Jiangsu,China)

机构地区：[1]中国医学科学院皮肤病医院整形美容外科,江苏南京210042

出　　处：《中国美容医学》2020年第6期181-185,共5页Chinese Journal of Aesthetic Medicine

摘　　要：先天性巨痣(Giant Congenital Melanocytic Nevus,GCMN)常定义为成年后直径大于20cm的先天性色素痣。其发病机理目前多认为是黑素母细胞于妊娠5~25周内,由神经嵴向皮肤及软脑膜的迁移异常所致。巨痣不但严重影响外观(典型表现呈"衬衫状"、"套衣状"),且常伴溃疡、瘙痒、疼痛、少汗、多毛等表现,造成患者及其家属的巨大痛苦;此外,巨痣尚可继发恶性黑素瘤(5%~10%)及神经皮肤黑变病(neurocutaneous melanosis,NCM)。国内外治疗巨痣方法各异,包括传统的手术、激光、磨削、剥脱以及新近的Integra人工真皮、体外培养自体表皮移植(CEA)、脱细胞真皮基质(ADM)等。上述方法各有利弊,临床上常需采取综合治疗,制定个体化方案。The most common definition of Giant Congenital Melanocytic Nevus(GCMN)is the nevus whose diameter is greater than twenty centimeters in adults.The pathogenesis of GCMN is now widely considered as an abnormal migration of melanocytic blast cells from neural crest to leptomeningea and skin during the fifth to twenty fifth pregnancy.GCMN not only severely affects appearance(typical manifestations is“garment”or“T-shirt”shapes),but also brings about a series of clinical manifestations like ulcer,itch,pain,less sweat and much hair,making the patients and their family members suffer a lot.In addition,GCMN can transfer to melanoma(5%-10%)and NCM(neurocutaneous melanosis).There have been many methods of treatments including conventional surgery,laser,dermabrasion,and chemical peel,and some novel methods like Integra artificial dermis,cultured epidermal autograft and artificial dermis matrix and so on.Every method above has its own advantages and disadvantages,needing us to take comprehensive treatments and make individualized plans.

关 键 词：先天性巨痣 恶性黑素瘤 综合性治疗 个体化 

分 类 号：R739.5[医药卫生—肿瘤]