Background:Diagnosis of nevoid melanoma (NeM) is often difficult because NeM closely resembles a common nevus clinically and histologically.Methods:A retrospective study was conducted on 110 patients diagnosed with and/or treated for primary nevoid melanoma at the Veneto Institute of Oncology and at the University Hospital of Padua from August 1999.Results:Mean Breslow thickness was of 1.4 mm. Sentinel lymph node biopsy was conducted in nearly half of the patients, and positivity was detected in 16.7% of them. Twenty-four clinical and 23 dermoscopic pictures were collected. Papular and macular lesions prevailed over nodular and plaque-type lesions. Different hues of brown, pink, and red color were most represented. Twenty nevus-like NeMs and four multicomponent-pattern NeMs were observed. The Most frequent dermoscopic patterns for nevus-like NeM were atypical pigmented reticulum, irregular globules and dots, and hyperpigmented blotches. Atypical vessels, asymmetric peripheric striae, blue-white veil, and areas of regression were less frequent and prevailed in multicomponent pattern NeM. A structureless pattern was also featured. Many patients in the series had multiple melanomas. However, none of them had numerous multiple nevoid melanomas.Conclusions:NeM should not be regarded as a separate biological entity from classical melanoma, and the same histological and clinical prognostic factors apply to NeM. Clinically and dermoscopically, it often resembles benign nevi, although some clues such as evolution and some dermoscopic patterns could suggest malignancy. Clinical suspicion might prove crucial to further pathological analysis and recognition.
背景：痣样黑色素瘤（NeM）的诊断常具挑战性，因其在临床和组织学上与普通痣极为相似。方法：本研究对1999年8月以来在威尼托肿瘤研究所和帕多瓦大学医院确诊和/或治疗的110例原发性痣样黑色素瘤患者进行了回顾性分析。结果：平均Breslow厚度为1.4毫米。近半数患者接受了前哨淋巴结活检，其中16.7%检测呈阳性。共收集24张临床照片和23张皮肤镜图像。丘疹型和斑疹型病变较结节型和斑块型更为常见。棕色、粉红色和红色的不同色调最为多见。观察到20例痣样NeM和4例多组分模式NeM。痣样NeM最常见的皮肤镜模式包括非典型色素网、不规则球状和点状结构以及色素沉着斑。非典型血管、不对称周边条纹、蓝白幕和退行性区域较少见，多见于多组分模式NeM。无结构模式亦可见。本系列中许多患者患有多发性黑色素瘤，但无一例出现大量多发性痣样黑色素瘤。结论：NeM不应被视为与经典黑色素瘤不同的独立生物学实体，其组织学和临床预后因素与经典黑色素瘤相同。尽管NeM在临床和皮肤镜下常与良性痣相似，但某些线索如病变演变过程和特定皮肤镜模式可能提示恶性。临床怀疑对进一步的病理分析和识别至关重要。
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