Abstract：
BACKGROUND: Melanocytic nevi are frequently observed in the pediatric population. While newly acquired nevi can appear during childhood, congenital nevi can continue to grow and clinically change, making patient caregivers concerned. Reflectance confocal microscopy (RCM) in vivo is a noninvasive tool that might enhance the diagnostic accuracy of dermoscopy, reducing the rate of unnecessary surgical procedures. This study aimed to assess the utility of RCM in increasing the diagnostic accuracy of pediatric melanocytic nevi that show pigmentation changes or grow rapidly.
METHODS: Pediatric patients who presented between January 2022 and February 2023 in a single institution with rapidly growing melanocytic nevi or nevi that presented changes in the pigmentation were included in the study. All nevi were evaluated by means of dermoscopy and RCM.
RESULTS: Forty-two patients with a total of 42 melanocytic nevi were included. Most lesions showed a honeycombed pattern (n = 21, 50%). On RCM, only 3 of 42 nevi presented atypical cells within the epidermis (7.1%). Evaluation of the dermoepidermal junction (DEJ) revealed the predominance of the meshwork pattern (n = 22, 52.4%). Notably, features considered significant for atypical melanocytic nevi included 9 nevi with scant atypical melanocytes (21.4%) and 3 nevi with nonedge papillae (7.1%). None of the studied lesions required biopsy among this cohort.
CONCLUSIONS: Most rapidly growing and clinically changing nevi rarely exhibit single atypical cells in the DEJ. The RCM served as a valuable adjunct to dermoscopy, allowing reassurance in the evaluation of these lesions.
METHODS: Pediatric patients who presented between January 2022 and February 2023 in a single institution with rapidly growing melanocytic nevi or nevi that presented changes in the pigmentation were included in the study. All nevi were evaluated by means of dermoscopy and RCM.
RESULTS: Forty-two patients with a total of 42 melanocytic nevi were included. Most lesions showed a honeycombed pattern (n = 21, 50%). On RCM, only 3 of 42 nevi presented atypical cells within the epidermis (7.1%). Evaluation of the dermoepidermal junction (DEJ) revealed the predominance of the meshwork pattern (n = 22, 52.4%). Notably, features considered significant for atypical melanocytic nevi included 9 nevi with scant atypical melanocytes (21.4%) and 3 nevi with nonedge papillae (7.1%). None of the studied lesions required biopsy among this cohort.
CONCLUSIONS: Most rapidly growing and clinically changing nevi rarely exhibit single atypical cells in the DEJ. The RCM served as a valuable adjunct to dermoscopy, allowing reassurance in the evaluation of these lesions.
摘要：
背景：在儿科人群中经常观察到黑素细胞痣。虽然新获得的痣可以在童年时期出现，先天性痣可以继续生长和临床改变，让患者护理人员感到担忧。体内反射共聚焦显微镜（RCM）是一种非侵入性工具，可以提高皮肤镜检查的诊断准确性。减少不必要的外科手术。这项研究旨在评估RCM在提高表现出色素沉着变化或快速生长的小儿黑素细胞痣的诊断准确性方面的实用性。
方法：本研究包括在2022年1月至2023年2月期间在单一机构中出现快速生长的黑素细胞痣或出现色素沉着变化的痣的儿科患者。所有痣均通过皮肤镜和RCM进行评估。
结果：纳入42例患者，共42例黑素细胞痣。大多数病变呈蜂窝状（n=21，50％）。在RCM上，42个痣中只有3个在表皮内呈现非典型细胞(7.1%)。对表皮连接（DEJ）的评估显示网状结构占主导地位（n=22，52.4％）。值得注意的是,非典型黑素细胞痣的特征被认为是重要的，包括9个痣的非典型黑素细胞很少（21.4％）和3个痣的非边缘乳头（7.1％）。在该队列中，没有研究的病变需要活检。
结论：生长最快且临床变化最快的痣很少在DEJ中出现单个异型细胞。RCM是皮肤镜检查的有价值的辅助手段，在评估这些病变时可以放心。
方法：本研究包括在2022年1月至2023年2月期间在单一机构中出现快速生长的黑素细胞痣或出现色素沉着变化的痣的儿科患者。所有痣均通过皮肤镜和RCM进行评估。
结果：纳入42例患者，共42例黑素细胞痣。大多数病变呈蜂窝状（n=21，50％）。在RCM上，42个痣中只有3个在表皮内呈现非典型细胞(7.1%)。对表皮连接（DEJ）的评估显示网状结构占主导地位（n=22，52.4％）。值得注意的是,非典型黑素细胞痣的特征被认为是重要的，包括9个痣的非典型黑素细胞很少（21.4％）和3个痣的非边缘乳头（7.1％）。在该队列中，没有研究的病变需要活检。
结论：生长最快且临床变化最快的痣很少在DEJ中出现单个异型细胞。RCM是皮肤镜检查的有价值的辅助手段，在评估这些病变时可以放心。
