[开放获取]   色素痣诊疗专家共识（2025版）

doi:10.35541/cjd.20240631

中华皮肤科杂志 ›› 2025, Vol. 58 ›› Issue (5): 387-395.doi: 10.35541/cjd.20240631

[开放获取] 色素痣诊疗专家共识（2025版）

中国中西医结合学会皮肤性病专业委员会皮肤肿瘤学组中国抗癌协会黑色素瘤专业委员会中国抗癌协会皮肤肿瘤整合康复专业委员会

中国中西医结合学会皮肤性病专业委员会皮肤肿瘤学组中国抗癌协会黑色素瘤专业委员会中国抗癌协会皮肤肿瘤整合康复专业委员会

收稿日期:2024-11-18 修回日期:2025-01-20 发布日期:2025-04-30
通讯作者: 李春英；高天文 E-mail:lichying@fmmu.edu.cn; gaotw75401@163.com
基金资助:
国家自然科学基金（82273716）

Expert consensus on diagnosis and treatment of pigmented nevi （2025 edition）

Skin Cancer Research Group, Committee on Dermatology, Chinese Association of Integrative Medicine; Melanoma Society of China Anti-Cancer Association; Society of Integrated Rehabilitation of Skin Tumors, China Anti-Cancer Association

Skin Cancer Research Group, Committee on Dermatology, Chinese Association of Integrative Medicine; Melanoma Society of China Anti-Cancer Association; Society of Integrated Rehabilitation of Skin Tumors, China Anti-Cancer Association

Received:2024-11-18 Revised:2025-01-20 Published:2025-04-30
Contact: Li Chunying; Gao Tianwen E-mail:lichying@fmmu.edu.cn; gaotw75401@163.com
Supported by:
National Natural Science Foundation of China（82273716）

摘要/Abstract

摘要： 【摘要】为规范和提高临床医师对色素痣的认识及诊治水平，中国中西医结合学会皮肤性病专业委员会皮肤肿瘤学组、中国抗癌协会黑色素瘤专业委员会及中国抗癌协会皮肤肿瘤整合康复专业委员会部分专家，遵循循证医学原则，整合国内外色素痣诊疗指南、共识和现有的研究结果，制订《色素痣诊疗专家共识（2025版）》。本共识涵盖的色素痣包括普通后天性色素痣、先天性色素痣、复发性色素痣、特殊人群（儿童、妊娠期）色素痣，针对不同类型色素痣的诊疗要点给出详细建议，旨在为色素痣的规范诊疗和管理提供参考。

关键词: 痣, 色素, 诊断, 治疗, 临床表现, 组织病理, 专家共识

Abstract: 【Abstract】 To enhance clinicians′ understanding of pigmented nevi and standardize their diagnosis and treatment, a group of experts from the Skin Cancer Research Group, Committee on Dermatology, Chinese Association of Integrative Medicine, the Melanoma Society of China Anti-Cancer Association and the Society of Integrated Rehabilitation of Skin Tumors, China Anti-Cancer Association, adhering to the principles of evidence-based medicine, integrated the latest Chinese and international guidelines, consensuses, and existing research findings to formulate the expert consensus on diagnosis and treatment of pigmented nevi （2025 edition） through two rounds of intensive revisions and discussions. This consensus covers various types of pigmented nevi, including common acquired pigmented nevi, congenital pigmented nevi, recurrent pigmented nevi, and pigmented nevi in special populations （children, pregnant women）, and offers detailed recommendations on the key points for the diagnosis and treatment of these types of pigmented nevi, aiming to provide a reference for the standardized diagnosis, treatment, and management of pigmented nevi.

Key words: Nevus, pigmented, Diagnosis, Therapy, Clinical manifestation, Histopathology, Expert consensus

中国中西医结合学会皮肤性病专业委员会皮肤肿瘤学组中国抗癌协会黑色素瘤专业委员会中国抗癌协会皮肤肿瘤整合康复专业委员会. [开放获取] 色素痣诊疗专家共识（2025版）[J]. 中华皮肤科杂志, 2025,58(5):387-395. doi:10.35541/cjd.20240631

Skin Cancer Research Group, Committee on Dermatology, Chinese Association of Integrative Medicine, Melanoma Society of China Anti-Cancer Association, Society of Integrated Rehabilitation of Skin Tumors, China Anti-Cancer Association. Expert consensus on diagnosis and treatment of pigmented nevi （2025 edition）[J]. Chinese Journal of Dermatology, 2025, 58(5): 387-395.doi:10.35541/cjd.20240631

参考文献 48

［1］	中国医疗保健国际交流促进会皮肤科分会, 中国医疗保健国际交流促进会华夏皮肤影像人工智能协作组. 黑素细胞肿瘤皮肤镜特征及组织病理特征相关性专家共识（2020）［J］. 中华皮肤科杂志, 2020,53（11）:859⁃868. doi: 10.35541/cjd. 20200430.
［2］	中国中西医结合学会皮肤性病专业委员会, 中华医学会皮肤性病学分会, 中国医师协会皮肤科医师分会. 反射式共聚焦显微镜在常见黑素细胞性皮肤肿瘤中的应用专家共识（2024版）［J］. 中华皮肤科杂志, 2024,57（9）:775⁃784. doi: 10.35541/cjd.20240237.
［3］	Hauschild A, Egberts F, Garbe C, et al. Melanocytic nevi［J］. J Dtsch Dermatol Ges, 2011,9（9）:723⁃734. doi: 10.1111/j.1610⁃0387.2011.07741.x.
［4］	Frischhut N, Zelger B, Andre F, et al. The spectrum of melanocytic nevi and their clinical implications［J］. J Dtsch Dermatol Ges, 2022,20（4）:483⁃504. doi: 10.1111/ddg.14776.
［5］	Ichii⁃Nakato N, Takata M, Takayanagi S, et al. High frequency of BRAFV600E mutation in acquired nevi and small congenital nevi, but low frequency of mutation in medium⁃sized congenital nevi［J］. J Invest Dermatol, 2006,126（9）:2111⁃2118. doi: 10. 1038/sj.jid.5700366.
［6］	Bauer J, Curtin JA, Pinkel D, et al. Congenital melanocytic nevi frequently harbor NRAS mutations but no BRAF mutations［J］. J Invest Dermatol, 2007,127（1）:179⁃182. doi: 10.1038/sj.jid. 5700490.
［7］	Roh MR, Eliades P, Gupta S, et al. Genetics of melanocytic nevi［J］. Pigment Cell Melanoma Res, 2015,28（6）:661⁃672. doi: 10.1111/pcmr.12412.
［8］	Van Raamsdonk CD, Bezrookove V, Green G, et al. Frequent somatic mutations of GNAQ in uveal melanoma and blue naevi［J］. Nature, 2009,457（7229）:599⁃602. doi: 10.1038/nature07586.
［9］	Schaffer JV. Update on melanocytic nevi in children［J］. Clin Dermatol, 2015,33（3）:368⁃386. doi: 10.1016/j.clindermatol. 2014.12.015.
［10］	Banky JP, Kelly JW, English DR, et al. Incidence of new and changed nevi and melanomas detected using baseline images and dermoscopy in patients at high risk for melanoma［J］. Arch Dermatol, 2005,141（8）:998⁃1006. doi: 10.1001/archderm.141. 8.998.
［11］	Berglund S, Johansson Backman E, Baldawi Z, et al. Incomplete excisions of melanocytic lesions: rates and risk factors［J］. Acta Derm Venereol, 2021,101（3）:adv00421. doi: 10.2340/00015555⁃3784.
［12］	Chang TT, Somach SC, Wagamon K, et al. The inadequacy of punch⁃excised melanocytic lesions: sampling through the block for the determination of "margins"［J］. J Am Acad Dermatol, 2009,60（6）:990⁃993. doi: 10.1016/j.jaad.2008.09.037.
［13］	Uguen A, Talagas M, Costa S, et al. A p16⁃Ki⁃67⁃HMB45 immunohistochemistry scoring system as an ancillary diagnostic tool in the diagnosis of melanoma［J］. Diagn Pathol, 2015,10:195. doi: 10.1186/s13000⁃015⁃0431⁃9.
［14］	Lezcano C, Jungbluth AA, Busam KJ. Comparison of immunohisto⁃chemistry for PRAME with cytogenetic test results in the evaluation of challenging melanocytic tumors［J］. Am J Surg Pathol, 2020,44（7）:893⁃900. doi: 10.1097/PAS.0000000 000001492.
［15］	Ohsie SJ, Sarantopoulos GP, Cochran AJ, et al. Immunohisto⁃chemical characteristics of melanoma［J］. J Cutan Pathol, 2008,35（5）:433⁃444. doi: 10.1111/j.1600⁃0560.2007. 00891.x.
［16］	Bastian BC, Olshen AB, LeBoit PE, et al. Classifying melanocytic tumors based on DNA copy number changes［J］. Am J Pathol, 2003,163（5）:1765⁃1770. doi: 10.1016/S0002⁃9440（10）63536⁃5.
［17］	Rhodes AR, Albert LS, Weinstock MA. Congenital nevomelano⁃cytic nevi: proportionate area expansion during infancy and early childhood［J］. J Am Acad Dermatol, 1996,34（1）:51⁃62. doi: 10.1016/s0190⁃9622（96）90834⁃8.
［18］	Krengel S, Scope A, Dusza SW, et al. New recommendations for the categorization of cutaneous features of congenital melanocytic nevi［J］. J Am Acad Dermatol, 2013,68（3）:441⁃451. doi: 10.1016/j.jaad.2012.05.043.
［19］	刘芳, 李璨宇, 方卉, 等. 婴幼儿先天性色素痣126例临床及病理特征分析［J］. 中华皮肤科杂志, 2021,54（1）:42⁃49. doi: 10.35541/cjd.20200754.
［20］	陈凤鸣, 亢寒梅, 高天文, 等. 先天性色素痣伴增生性结节10例临床病理分析［J］. 中华皮肤科杂志, 2021,54（9）:785⁃789. doi: 10.35541/cjd.20200945.
［21］	Hamming N. Anatomy and embryology of the eyelids: a review with special reference to the development of divided nevi［J］. Pediatr Dermatol, 1983,1（1）:51⁃58. doi: 10.1111/j.1525⁃1470. 1983.tb01092.x.
［22］	陈见友, 苏伟, 邓维, 等. 儿童阴茎分裂痣8例临床病理特征分析［J］. 中国皮肤性病学杂志, 2023,37（10）:1151⁃1155. doi: 10.13735/j.cjdv.1001⁃7089.202303063.
［23］	Bittencourt FV, Marghoob AA, Kopf AW, et al. Large congenital melanocytic nevi and the risk for development of malignant melanoma and neurocutaneous melanocytosis［J］. Pediatrics, 2000,106（4）:736⁃741. doi: 10.1542/peds.106.4.736.
［24］	Hale EK, Stein J, Ben⁃Porat L, et al. Association of melanoma and neurocutaneous melanocytosis with large congenital melanocytic naevi⁃⁃results from the NYU⁃LCMN registry［J］. Br J Dermatol, 2005,152（3）:512⁃517. doi: 10.1111/j.1365⁃2133. 2005.06316.x.
［25］	Alikhan A, Ibrahimi OA, Eisen DB. Congenital melanocytic nevi: where are we now? PartⅠ. Clinical presentation, epidemiology, pathogenesis, histology, malignant transformation, and neurocutaneous melanosis［J］. J Am Acad Dermatol, 2012,67（4）:495. doi: 10.1016/j.jaad.2012.06.023.
［26］	Lovett A, Maari C, Decarie JC, et al. Large congenital melanocytic nevi and neurocutaneous melanocytosis: one pediatric center's experience［J］. J Am Acad Dermatol, 2009,61（5）:766⁃774. doi: 10.1016/j.jaad.2008.11.022.
［27］	Neale H, Plumptre I, Belazarian L, et al. Central nervous system magnetic resonance imaging abnormalities and neurologic outcomes in pediatric patients with congenital nevi: a 10⁃year multi⁃institutional retrospective study［J］. J Am Acad Dermatol, 2022,87（5）:1060⁃1068. doi: 10.1016/j.jaad.2022.05.062.
［28］	Gout HA, Fledderus AC, Lokhorst MM, et al. Safety and effectiveness of surgical excision of medium, large, and giant congenital melanocytic nevi: a systematic review and meta⁃analysis［J］. J Plast Reconstr Aesthet Surg, 2023,77:430⁃455. doi: 10.1016/j.bjps.2022.10.048.
［29］	Krengel S, Marghoob AA. Current management approaches for congenital melanocytic nevi［J］. Dermatol Clin, 2012,30（3）:377⁃387. doi: 10.1016/j.det.2012.04.003.
［30］	Scard C, Aubert H, Wargny M, et al. Risk of melanoma in congenital melanocytic nevi of all sizes: a systematic review［J］. J Eur Acad Dermatol Venereol, 2023,37（1）:32⁃39. doi: 10.1111/jdv.18581.
［31］	Blum A, Hofmann⁃Wellenhof R, Marghoob AA, et al. Recurrent melanocytic nevi and melanomas in dermoscopy: results of a multicenter study of the International Dermoscopy Society［J］. JAMA Dermatol, 2014,150（2）:138⁃145. doi: 10.1001/jamadermatol. 2013.6908.
［32］	Levy R, Lara⁃Corrales I. Melanocytic nevi in children: a review［J］. Pediatr Ann, 2016,45（8）:e293⁃e298. doi: 10.3928/19382359⁃ 20160720⁃07.
［33］	Pampena R, Piccolo V, Muscianese M, et al. Melanoma in children: a systematic review and individual patient meta⁃analysis［J］. J Eur Acad Dermatol Venereol, 2023,37（9）:1758⁃1776. doi: 10.1111/jdv.19220.
［34］	Muzaffar F, Hussain I, Haroon TS. Physiologic skin changes during pregnancy: a study of 140 cases［J］. Int J Dermatol, 1998,37（6）:429⁃431. doi: 10.1046/j.1365⁃4362.1998.00281.x.
［35］	Grin CM, Rojas AI, Grant⁃Kels JM. Does pregnancy alter melanocytic nevi?［J］. J Cutan Pathol, 2001,28（8）:389⁃392. doi: 10.1034/j.1600⁃0560.2001.028008389.x.
［36］	Strumia R. Digital epiluminescence microscopy in nevi during pregnancy［J］. Dermatology, 2002,205（2）:186⁃187. doi: 10. 1159/000063901.
［37］	Bieber AK, Martires KJ, Driscoll MS, et al. Nevi and pregnancy［J］. J Am Acad Dermatol, 2016,75（4）:661⁃666. doi: 10.1016/j.jaad.2016.01.060.
［38］	Chan MP, Chan MM, Tahan SR. Melanocytic nevi in pregnancy: histologic features and Ki⁃67 proliferation index［J］. J Cutan Pathol, 2010,37（8）:843⁃851. doi: 10.1111/j.1600⁃0560.2009. 01491.x.
［39］	陈凤鸣, 王雷, 高天文, 等. 先天性色素痣恶变98例临床及病理分析［J］. 中华皮肤科杂志, 2023,56（11）:1028⁃1034. doi: 10.35541/cjd.20210407.
［40］	Lin WM, Luo S, Muzikansky A, et al. Outcome of patients with de novo versus nevus⁃associated melanoma［J］. J Am Acad Dermatol, 2015,72（1）:54⁃58. doi: 10.1016/j.jaad.2014.09.028.
［41］	Pampena R, Kyrgidis A, Lallas A, et al. A meta⁃analysis of nevus⁃associated melanoma: prevalence and practical implications［J］. J Am Acad Dermatol, 2017,77（5）:938⁃945. doi: 10.1016/j.jaad. 2017.06.149.
［42］	Kinsler VA, O'Hare P, Bulstrode N, et al. Melanoma in congenital melanocytic naevi［J］. Br J Dermatol, 2017,176（5）:1131⁃1143. doi: 10.1111/bjd.15301.
［43］	Kinsler VA, Chong WK, Aylett SE, et al. Complications of congenital melanocytic naevi in children: analysis of 16 years' experience and clinical practice［J］. Br J Dermatol, 2008,159（4）:907⁃914. doi: 10.1111/j.1365⁃2133.2008.08775.x.
［44］	Krengel S, Hauschild A, Schäfer T. Melanoma risk in congenital melanocytic naevi: a systematic review［J］. Br J Dermatol, 2006,155（1）:1⁃8. doi: 10.1111/j.1365⁃2133.2006.07218.x.
［45］	Swerdlow AJ, English JS, Qiao Z. The risk of melanoma in patients with congenital nevi: a cohort study［J］. J Am Acad Dermatol, 1995,32（4）:595⁃599. doi: 10.1016/0190⁃9622（95）90343⁃7.
［46］	Sahin S, Levin L, Kopf AW, et al. Risk of melanoma in medium⁃sized congenital melanocytic nevi: a follow⁃up study［J］. J Am Acad Dermatol, 1998,39（3）:428⁃433. doi: 10.1016/s0190⁃9622（98）70319⁃6.
［47］	孙东杰, 高天文, 李春英, 等. 西安、重庆两所医院20年皮肤恶性黑素瘤回顾［J］. 中华皮肤科杂志, 2004,37（2）:97⁃99. doi: 10.3760/j.issn:0412⁃4030.2004.02.012.
［48］	Gandini S, Sera F, Cattaruzza MS, et al. Meta⁃analysis of risk factors for cutaneous melanoma:Ⅰ. common and atypical naevi［J］. Eur J Cancer, 2005,41（1）:28⁃44. doi: 10.1016/j.ejca. 2004.10.015.

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Expert consensus on diagnosis and treatment of pigmented nevi （2025 edition）

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