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Erschienen in: hautnah 4/2016

01.10.2016 | Onkologie

Strategien zur nichtinvasiven Diagnostik des Melanoms

verfasst von: Dr. C. Fink, PD Dr. H. A. Haenssle

Erschienen in: hautnah | Ausgabe 4/2016

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Zusammenfassung

Bei fortgeschrittenen Melanomen gelingt eine Diagnosestellung meist durch eine Untersuchung mit dem bloßen Auge, gefolgt von einer chirurgischen Exzision und einer histopathologischen Befundung. Im Rahmen von Screeninguntersuchungen zwecks einer Melanomfrüherkennung, insbesondere bei Patienten mit sehr vielen Nävi, geht es jedoch um die Differenzierung atypischer, aber benigner Nävi von In-situ-Melanomen oder initial invasiven Melanomen. In dieser Situation besteht ein Bedarf an zusätzlichen, nichtinvasiven Untersuchungstechnologien, die den Dermatologen bei der Entscheidung für oder gegen eine Exzisionsbiopsie unterstützen. Die Dermatoskopie konnte ihren Zusatznutzen in Metaanalysen bestätigen und ist seit vielen Jahren ein fester Bestandteil in der dermatologischen Diagnostik. Ergänzend können dynamische Veränderungen oder eine Neuentstehung von Pigmentmalen mithilfe der sequenziellen digitalen Dermatoskopie oder der (automatisierten) Ganzkörperfotografie erfasst werden und so sinnvoll zur Melanomfrüherkennung beitragen. Neben diesen etablierten Untersuchungstechniken sind in den letzten Jahren zahlreiche Medizinprodukte durch die amerikanischen und europäischen Behörden für die nichtinvasive Diagnostik kutaner Neoplasien zugelassen worden. Diese Geräte basieren dabei auf physikalischen Verfahren wie der konfokalen Laserscanmikroskopie, der Multispektralanalyse, der elektrischen Impedanzspektroskopie oder der Raman-Spektroskopie. Weitere Technologien befinden sich noch auf dem Sprung von einer bisher mehr experimentellen hin zu einer klinischen Anwendung. Diese Arbeit gibt einen Überblick über die verschiedenen Technologien und beleuchtet deren Indikation und Zusatznutzen für den anwendenden Dermatologen.
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Metadaten
Titel
Strategien zur nichtinvasiven Diagnostik des Melanoms
verfasst von
Dr. C. Fink
PD Dr. H. A. Haenssle
Publikationsdatum
01.10.2016
Verlag
Springer Vienna
Erschienen in
hautnah / Ausgabe 4/2016
Print ISSN: 1866-2250
Elektronische ISSN: 2192-6484
DOI
https://doi.org/10.1007/s12326-016-0207-3