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Melanozytäre Nävi

Wissenswertes für den Pädiater

Melanocytic nevi

What the paediatrician should know

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Zusammenfassung

Die melanozytären Nävi stellen die häufigste Subgruppe der Nävi dar. Für gewöhnliche erworbene melanozytäre Nävi spielen genetische Disposition und UV-Exposition (UV: ultraviolette Strahlung) eine zentrale Rolle, sodass eine adäquate Aufklärung über Sonnenschutz vordringlich ist. Kongenitale melanozytäre Nävi (KMN) weisen in Abhängigkeit von ihrer Größe Besonderheiten in Diagnostik und Therapie auf. Kleine und mittelgroße KMN haben ein geringes malignes Potenzial; Melanome entstehen darauf selten und erst im Erwachsenenalter. Bei großen KMN steigt mit zunehmender Größe auch das Melanomrisiko; bei Riesennävi wird es mit maximal 10% beziffert. Zudem besteht bei Lokalisation an Kopf und Rücken die Gefahr einer neurokutanen Melanozytose, insbesondere beim Vorliegen von Satellitennävi. Die Therapie erworbener und kongenitaler Nävi ist immer individuell, sie richtet sich nach Art, Größe, Lokalisation, Patientenalter und subjektiver Beeinträchtigung und beinhaltet unterschiedliche operative Maßnahmen oder bei fehlendem Malignitätsverdacht zumeist nur die regelmäßige klinische Kontrolle. Blauer Nävus, Halo- oder Spitz-Nävus sind besondere Varianten melanozytärer Nävi, die ebenfalls kurz besprochen werden.

Abstract

Melanocytic nevi are the most common type of nevi. Genetic predisposition and exposure to UV light are especially relevant for the development of common acquired melanocytic nevi so that education about sun protection is of outstanding importance. Congenital melanocytic nevi (CMN) possess some peculiarities depending on nevus diameter. Small and medium-sized CMN bear a minor risk of developing melanoma in later life. The malignant potential of large CMN corresponds to their size and is estimated to be maximally 10% for giant CMN. Moreover, large and giant nevi on the head or trunk may be associated with neurocutaneous melanocytosis – especially if satellite nevi are present. Treatment of acquired and congenital melanocytic nevi is adjusted to individual needs and depends on nevus subtype, size, body site and patient age as well as subjective discomfort. Treatment options include surgery or regular clinical follow-up in cases of unworrisome presentation. Distinct subtypes of melanocytic nevi such as blue nevus, halo nevus or Spitz nevus are also shortly discussed.

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  1. Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie , Universitätsklinikum Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Deutschland

    M. Wobser &  H. Hamm

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  1. M. Wobser
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  2. H. Hamm
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Correspondence to H. Hamm.

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Wobser, M., Hamm, H. Melanozytäre Nävi. Monatsschr Kinderheilkd 159, 1077–1084 (2011). https://doi.org/10.1007/s00112-011-2425-3

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