One of the most insidious diseases is Dubrey's melanosis. ICD-10 classifies it as a preinvasive type of cancer. A separate code in the classifier is not assigned to the disease, but it is usually classified as D22 (melanoform nevus) or C43 (malignant melanoma of the skin). The pathology itself is quite difficult to diagnose, and even an experienced oncologist cannot make a prognosis. That is why it is so important to know its symptoms in the early stages.
Medical certificate
Dubrey's melanosis is a malignant skin disease. It is characterized by a pigmented lesion that captures the epidermis and dermis. The tumor itself consists predominantly of atypical melanocytes.
For the first time, a detailed description of the pathology was presented by dermatologist Hutchinson. She later attracted the attention of the French physician Dubreuil, after whom she was named.
A distinctive feature of the tumor is considered to be slow development. Most often it is localized on the face in older women. Among the representatives of the stronger sex, such a diagnosis occurs in exceptional cases. Spotfor quite a long time, it may not be manifested by external deformations. However, under the influence of certain factors, it begins to increase in size. Gradually, the clinical picture is supplemented by other signs of malignancy.
Main reasons
The exact cause of Dubreu's melanosis is still unknown. Doctors identify a group of certain factors, the presence of which increases the likelihood of pathology. Among them, the most common are the following:
- light skin;
- age over 50;
- constant exposure to direct sunlight;
- tanning bed abuse;
- mechanical trauma to the pigment spot.
Among the representatives of the black race, Dubrey's melanosis is practically not found.
Clinical picture
The main manifestation of the pathology is a brown spot. As a rule, it is flabby and dim. The shape of the neoplasm is irregular, but the boundaries are very clear. Its coloration is almost always uneven. Shades can vary from brownish to black. Sometimes the pathology takes the form of a black blob on a brown background.
Spots with Dubreu's melanosis are most often localized on open areas of the skin, for example, on the face. Their size can vary from a few millimeters to a couple of centimeters. Spot growth is slow. However, the risk of vertical growth is quite high. In this case, as a rule, the transformation of melanosis into melanoma occurs. Other symptoms of malignancy includehighlight:
- appearance of dark areas;
- blurred boundaries of neoplasm;
- change size and shape;
- appearance of areas of cicatricial atrophy.
Sometimes melanosis affects the skin around the eyelids and even the conjunctiva of the eyes. The cornea is rarely affected.
Stages of development
In its development, melanosis named after Dubrey goes through 3 stages. At the initial stage, an increase in the number of melanocytes is observed. The second stage is characterized by pronounced proliferation, accompanied by manifestations of athymia of methanocytes. At the third stage, atypical elements begin to grow into the skin.
Determination of the exact stage of the pathological process allows you to choose the most effective treatment, give a prognosis for recovery.
Diagnostic Methods
When neoplasms appear on the skin of any etiology, it is necessary to seek advice from a dermatologist. In case of suspicion of oncology, the doctor will refer you to a specialized specialist - an oncologist.
Diagnosis of Dubrey's melanosis begins with an examination, a study of the patient's history. It is important for a doctor to know under what conditions a neoplasm appeared, what factors preceded this process. After that, a detailed examination is scheduled. It usually consists of the following activities:
- Dermatoscopy. Used to assess the shape, pigmentation and structure of the neoplasm.
- Morphological analysis of tissues. Used to determinethe number of melanocytes, changes in the epidermis. During the analysis, some of the affected skin is taken from the patient.
- Testing for tumor markers. It is carried out to exclude the malignancy of the pathology.
- Scintigraphy. During the procedure, the skin is examined using radioactive phosphorus.
It is worth noting that a biopsy is not performed as a diagnostic method. The thing is that with this method of examination, the risk of tissue infection is too high.
Differential Diagnosis
As can be seen from the photos presented in our article, Dubrey's melanosis can be mistaken for other skin diseases. The most common mistake among doctors when making a diagnosis is taking the described pathology for senile keratosis. This is also a precancerous condition, which quickly transforms into a malignant process. For the patient, both diseases are very dangerous and require appropriate treatment, constant monitoring by a specialized specialist.
Another common mistake is mistaking melanosis for basalioma pigmentosa. The differences in this case are very significant. For example, basalioma grows exclusively in soft tissues, and melanosis can affect the entire body. The latter is easily confused with aggressive melanoma. That is why differential diagnosis plays an important role in confirming the underlying disease.
Features of therapy
Treatment of Dubreu's melanosis requires an exceptionally qualified approach. The main method of influencingpathology is considered to be surgical intervention. During the procedure, the specialist cuts out the neoplasm along with the subcutaneous tissue.
Excised material must be sent for research. Patients with Dubrey's melanosis who have had histology taken receive a response about the presence or absence of cancer cells. This approach allows timely suspension of the malignant process.
Sometimes a wide excision of the neoplasm is required. In this case, the operation is carried out in stages and always with the use of plastic correction of the skin. The scope of intervention also expands if the pathology “wakes up”, metastases appear in the lymph nodes.
When surgery is contraindicated or not available, the patient is advised to undergo radiation therapy. It has been proven that the pathological elements of the neoplasm are sensitive to close-focus X-ray therapy.
Help of traditional medicine
Recipes of folk healers can only be used as an example of an aid in the fight against melanosis. In addition, a preliminary consultation with the attending physician is mandatory. Some medicinal herbs have contraindications for use for a particular patient. Others can even aggravate the course of the pathology, and their use is accompanied by a mass of side effects in this particular skin ailment. That is why modern medicine categorically does not recommend self-medication.
The use of various folk remedies is directed,first of all, to reduce the intensity of the inflammatory process on the skin, strengthening the body's immune defenses. Among local remedies, flaxseed oil is especially effective. It should be thoroughly mixed with honey in equal proportions, and then applied to the affected area twice a day.
To strengthen the immune system, folk healers recommend taking tincture of aconite tubers. The drug is used 20 drops at a time, but three times a day. It is better to repeat the procedure before the main meals. You can also use tincture of kopechnik. To prepare it, you need about 50 g of dry raw materials, pour 0.5 liters of vodka. The tincture should be put in a dark place for 15 days, then strain. It is recommended to take the resulting remedy in a teaspoon once a day.
Prognosis for recovery
Prognosis for Dubreu's melanosis is disappointing. In the absence of timely and high-quality therapy, the transformation of pathology into cancer is observed in 40-75% of cases. The process itself takes about 15 years, but sometimes it goes several times faster.
In 10% of cases, neoplasm cells metastasize to the skin. Such an outcome is very dangerous and in most situations leads to death.
Prevention Methods
After surgery, a patient with melanosis should be registered in the dispensary. In addition, he needs to regularly undergo examinations by an oncologist and a dermatologist, and undergo a series of tests.
Is it possible to prevent the development of Dubreu's melanosis on the face? Photos of patientswith a similar diagnosis make you think about this issue. Specific preventive measures have not been developed. However, doctors give several recommendations to minimize the risk of developing pathology.
First of all, it is necessary to approach sunbathing with all responsibility. The doctor recommends sunbathing before lunch or in the evening. In this case, it is necessary to use skin protection products (creams, lotions), avoid direct sunlight. Fair-skinned people should avoid tanning altogether.
The rest of the prevention rules come down to maintaining a he althy lifestyle, eliminating addictions and stressful situations. These principles apply to all cancer pathologies.
