發表年份：2015.12
發表雜志：Lancet

作者團隊：Georgi Tchernev, Anastasiya Atanasova Chokoeva, Dr

研究方向：黑色素瘤

論文題目：
Melanoma in a Chinese dragon tattoo

論文摘要：
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歲白人男性，2015年10月就診，鼻唇溝及眉毛周圍瘙癢，伴有脂溢性皮炎的紅斑、脫屑。我們注意到全身皮膚檢查有多個痣，以及一個中國龍的多色紋身，幾乎覆蓋了整個背部、手臂和胸部。經過仔細檢查，他發現了一個臨床發育不良的色素痣，位于龍尾巴的鱗狀范圍內(圖)。他報告說，紋身是在一年前做的，但痣至少在5年前就出現了，紋身師有目的地圍繞現有的病變工作。患者為II型皮膚，金發碧眼，曾在法國外籍軍團工作，長時間暴露在陽光下。除了童年時期多次疼痛的曬傷外，他沒有任何病史，沒有服用過藥物，家族皮膚病史陰性。我們做了全手術切除，切緣為1cm。組織學檢查證實為淺表擴散性黑色素瘤，腫瘤厚度為0·26 mm，根據美國聯合癌癥委員會(AJCC)分期系統將腫瘤歸類為IA。其他篩查測試均在正常范圍內。我們已經按照AJCC的建議對IA期黑色素瘤進行了防曬教育和計劃隨訪。病人情況良好，沒有進一步惡化的跡象。