Lancet | 中国龙纹身中的黑色素瘤

发表年份：2015.12
发表杂志：Lancet

作者团队：Georgi Tchernev, Anastasiya Atanasova Chokoeva, Dr

研究方向：黑色素瘤

论文题目：
Melanoma in a Chinese dragon tattoo

论文摘要：
A 42-year-old white man presented to our clinic in October, 2015, with itching in the nasolabial fold and around the eyebrows, with accompaying erythema and desquamation consistent with seborrhoeic dermatitis. We noted multiple naevi on whole body dermatological examination, as well as a multicoloured tattoo of a Chinese dragon covering almost his entire back, arms, and chest. On closer inspection he had one clinically dysplastic pigmented naevus, sited within a scale of the dragon's tail (figure). He reported having the tattoo done 1 year previously, but the naevus had been present at least 5 years earlier, and the tattoo artist had purposefully worked around the existing lesion. The patient had type II skin with blonde hair and blue eyes, and had previously worked in the French Foreign Legion during which time he had had prolonged sun exposure. He reported no medical history apart from multiple painful sunburns in childhood, took no medication, and family history for dermatological disease was negative. We did total surgical excision with 1 cm surgical margins. Histological examination confirmed the diagnosis of superficial spreading melanoma with tumour thickness 0·26 mm, and the tumour was classified as IA according to the American Joint Committee on Cancer (AJCC) staging system. Additional screening tests were within the normal range. We have given sun care education and planned follow-up in line with the AJCC recommendations for melanoma stage IA. The patient remains well with no signs of further disease.

42岁白人男性，2015年10月就诊，鼻唇沟及眉毛周围瘙痒，伴有脂溢性皮炎的红斑、脱屑。我们注意到全身皮肤检查有多个痣，以及一个中国龙的多色纹身，几乎覆盖了整个背部、手臂和胸部。经过仔细检查，他发现了一个临床发育不良的色素痣，位于龙尾巴的鳞状范围内(图)。他报告说，纹身是在一年前做的，但痣至少在5年前就出现了，纹身师有目的地围绕现有的病变工作。患者为II型皮肤，金发碧眼，曾在法国外籍军团工作，长时间暴露在阳光下。除了童年时期多次疼痛的晒伤外，他没有任何病史，没有服用过药物，家族皮肤病史阴性。我们做了全手术切除，切缘为1cm。组织学检查证实为浅表扩散性黑色素瘤，肿瘤厚度为0·26 mm，根据美国联合癌症委员会(AJCC)分期系统将肿瘤归类为IA。其他筛查测试均在正常范围内。我们已经按照AJCC的建议对IA期黑色素瘤进行了防晒教育和计划随访。病人情况良好，没有进一步恶化的迹象。