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Pregled madeza dermatoskopom

Većina ljudi ima madeže, bradavice, pigmentirane promjene i druge lezije na koži lica i tijela. Veliki dio tih promjena je dobroćudan i ne zahtijeva nikakav tretman osim redovitog praćenja.

Madeži

Madeži se mogu pojaviti bilo gdje na koži, pojedinačno ili grupirano. Obično su smeđe boje i različitog oblika. Smeđa boja madeža potječe od melanina, pigmenta koji stvaraju stanice koje se zovu melanociti. Većina madeža pojavljuje se do 20. godine života, iako neki nastaju tek u starijoj životnoj dobi. Izlaganje ultraljubičastom zračenju povećava broj madeža.
Određene vrste madeža predstavljaju veći rizik za pojavu zloćudnih promjena od kojih je najteži maligni melanom. Oko 30% malignih melanoma nastaje iz madeža. Izlaganje suncu ili umjetnom izvorima zračenja povećava rizik nastanka malignog melanoma. Osobe s velikim brojem madeža od prosjeka (100 i više) imaju također veći rizik za nastanak malignog melanoma.
Svaki pacijent bi rutinski trebao sam pratiti promjene na koži i zatražiti pregled liječnika ukoliko primijeti slijedeće promjene,prema ABCD pravilu :

A (asymmetry)- asimetrija, jedna polovica madeža ne odgovara drugoj polovici. Normalan madež je pravilnog oblika, uglavnom okrugao i simetričan. Sumnjivi (displastičan) madež je nepravilnog oblika, tj. asimetričan.

B (border)- rub je nepravilan, neoštro ograničen, širi se u okolicu s tračcima. Normalan madež ima pravilne rubove, a onaj koji zahtijeva kirurški tretman (displastičan) ima nepravilne i nejasne rubove.

C (colour)- boja. Normalan madež je jednobojan. Sumnjivi (displastičan) madež ima više boja i nijansi(smeđa,zelena,plava)

D(diametar)-promjer. Normalan madež najčešće je u promjeru manji od 6 mm.

U Poliklinici Labar pregledati ćemo Vaše madeže najnovijim dermatoskopom Dermalite koji mikrokamerom višestruko povećava određeno područje ljudske kože te omogućuje razlikovanje benignih od malignih promjena na koži. Dermatoskopski pregled se preporuča učiniti jednom godišnje, a osobama koje imaju puno madeža i češće. Iako najčešće pregled dermatoskopom pokaže da se radi o benignom madežu pacijenti žele da se madež ukloni zbog različitih razloga kao što je mjesto na kojem se nalazi madež(lice,dekolte), brige zbog mogućnosti nastanka karcinoma ili pak ponavljanja iritacija površine madeža aktivnostima kao što su brijanje, češljanje ili iritacija odjećom.

Kiruško uklanjanje kožnih promjena

Bolesnici s lipomima, cistama, madežima i bradavicama često dolaze plastičnom kirurgu s željom da se promjena na koži ukloni iako je bezopasna. Kada promjene na koži dosegnu određenu veličinu mogu pacijentu uzrokovati nelagodu radi pritiska na određene strukture,boli ili pak narušenog izgleda.
U lokalnoj anesteziji te se promjene brzo, efikasno i bezbolno mogu odstraniti u cijelosti,a korištenjem najfinijih kirurških konaca i preciznom kirurškom tehnikom ožiljak nakon samog zahvata gotovo da i neće biti vidljiv što je samim pacijentima vrlo bitna činjenica. Posebno je to bitno kad se odstranjuju promjene na licu i vidljivim dijelovima tijela koje ukoliko se nestručno tretiraju od nekvalificirane osobe mogu bitno i trajno narušiti izgled.
U jednom malom postotku određeni broj ljudi na strano tijelo kao što je kirurški konac reagira stvaranjem hipertrofičnog ožiljka ili keloida koji onda zahtijevaju posebni tretman.
Svaka promjena,pa i ona koja nije sumnjiva da je zloćudna,šalje se na patohistološki pregled koji nam onda daje konačnu potvrdu kliničke dijagnoze.
Zato nemojte čekati da se postojeći madeži promijene i da vas tada uhvati panika,nego već sad dogovorite konzultaciju i pregled dermatoskopom i osigurajte sebi miran san.

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