Zespół zmian atypowych a ryzyko rozwoju czerniaka
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Zespół zmian atypowych a ryzyko rozwoju czerniaka

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Z uwagi na zwiększone ryzyko występowania czerniaka, który rozwija się na podłożu zmian atypowych niezwykle istotna jest ich obserwacja. Jak wygląda zmiana atypowa oraz jakie objawy świadczą o konieczności pilnej interwencji chirurgicznej?

Zespół zmian atypowych charakteryzuje to, iż znamiona występują rodzinnie, pojawiają się licznie oraz mają bardzo małą lub bardzo dużą średnicę (5-15 mm). Ponadto krawędzie zmian są nieregularne i rozmyte, a ich zabarwienie jest niejednolite. Zmiany atypowe zazwyczaj są płaskie lub nierównomiernie wyniosłe. Ich kolor może być brunatny z różnymi odcieniami brązu, różowo brunatny, różowawy lub czarno szary w nieregularne paski.

Jeżeli wystąpiły objawy dotyczące zmian atypowych, takie jak szybkie i nierównomierne powiększenie znamiona, zmiana ubarwienia, reakcja zapalna wokół zmiany czy tendencja do rozpadu, można przypuszczać, iż zmiana atypowa przechodzi konwersję w stronę czerniaka. Wówczas niezbędna będzie szybka interwencja chirurgiczna.

Charakterystyczne wykwity skórne mogą wystąpić na skórze zarówno wystawionej na działanie promieni słonecznych, jak również owłosionej. Z uwagi na trudną obserwację znamion w takich miejscach, które dość często są również drażnione, ta druga lokalizacja jest najbardziej niebezpieczna.

Zespół zmian atypowych a ryzyko rozwoju czerniaka

Zespół znamion atypowych jest chorobą dziedziczną

Pomimo tego, że choroba ta jest dziedziczna, nie każda osoba z odziedziczonym wadliwym genem zachoruje na nią czy wystąpi u niej zaawansowany klinicznie przebieg choroby. Jednak w związku z tym, niezwykle istotny będzie wywiad z pacjentem. Jeżeli w rodzinie bądź u samego pacjenta odnotowano wcześniej przypadek czerniaka, ryzyko wystąpienia nowotworu skóry wzrasta.

Wykwit, którego źródłem jest zespół zmian atypowych może rozwinąć się na skórze niezmienionej chorobowo, jak również ze znamion już istniejących. Pierwsze zmiany mogą wystąpić już ok. 2 r.ż., natomiast najczęściej pojawiają się w wieku 20, a czasem 30 lat.

Ok. 20 proc. zmian ulega samoistnemu wycofaniu

Ryzyko rozwoju czerniaka ze znamion dysplastycznych jest czynnikiem indywidualnym, jednak ma związek z ilością zmian. Im więcej znajduje się ich na ciele, tym ryzyko wystąpienia czerniaka będzie większe.

Zespół zmian atypowych specjalista potwierdza za pomocą dermatoskopu i badań histologicznych. Jeżeli okaże się, iż zmiana ma postać czerniaka, należy skonsultować się z chirurgiem onkologiem. Początkowo znamiona poddawane są wnikliwej i częstej obserwacji pod kątem ewentualnej konwersji w stronę czerniaka. Te zmiany, w stosunku do których zachodzi duże ryzyko zezłośliwienia, powinny zostać usunięte chirurgicznie, uwzględniając przy tym niewielki margines zdrowej tkanki.

Ważne również, aby osoby z zespołem zmian atypowych unikały nadmiernego nasłonecznienia oraz stosowały kremy przeciwsłoneczne z wysokim filtrem.

Należy jednak pamiętać, iż nie każde, nawet licznie występujące znamiona będą oznaką zespołu zmian atypowych. Dlatego w przypadku pojawienia się różnego rodzaju zmian na ciele, należy skonsultować się z lekarzem specjalistą.

Źródło: onkolmed.pl

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