Nevus, birthmark, pigmented naevus (lat. nevus) is a congenital or acquired defect of the skin, benign tumor composed of cells of the epidermis (surface layer of the skin), dermis (deep layer of skin) and melanocytes – cells that are saturated with pigment melanin.
Moles proyavlyautsa in children starting from 2-3 months of life. The greatest number of them is formed in puberty under the influence of the pituitary hormone – melanotropin hormone. Also new lesions may appear in women during pregnancy, and old – vary in color and size.
In the medical basis for the classification of moles (nevi) is their histological origin, i.e., the tissues that are involved in the formation of a birthmark. So, moles are divided into:
Moles epidermal-melanocytic origin
• Nevus edge – congenital or acquired at an early age kind of birthmark. Mainly localized on the feet, hands and genitals. Clinically has the form of spots, at least – papules with a smooth surface dark brown, dark grey or black. The diameter of such growths usually does not exceed 1-2 mm. Has a tendency to malignancy (transformation into a malignant tumor).
• Intradermal Naevus (birthmark) – the most common type of nevus. Features of the localization has not. Clinically has a hemispherical shape, rising above the skin surface. Color can vary from brownish to almost black. The diameter of such spots about 1 cm.
• Complex nevus is a transitional form of congenital melanocytic nevus. Has no specific localization. Clinically presents a papule or group of papules (papulatus).
• Epithelioid nevus (nevus, Spitz, juvenile melanoma) – refers to benign miliitary tumors. Most often this type of moles represented odinochnym education with a smooth or bumpy surface red-brown color. There are also cases of multiple entities. The most common localization is the face and legs. Such moles are characterized by rapid growth to 1-2 cm in diameter, are easily injured and bleed. They exist for quite a long time, can spontaneously decrease in size.
• Nevus of bellanaboy cells – an extremely rare species of moles that do not have characteristic clinical picture. These moles have the appearance of spots or papules brown colour with a yellow rim. The main feature of these moles are increased cells and the presence of balloon cells, the number of which varies.
• Nevus of Setton – nevus surrounded by a region of depigmentation (discolored skin). Occur as single or multiple learning. Often appear at an early age and during pregnancy in women, in individuals with vitiligo and in individuals with autoimmune processes. Such moles are prone to spontaneous regression (reduction up to disappearance).
Moles dermaline-melanocytic origin
• “Mongolian spot” – type of birthmark in newborns in the sacrum, at least – the buttocks and thighs. Formed due to deposition of melanin in the deeper layers of the skin. Spot smooth, rising above the level of the skin, has green, blue and black colors. A diameter of about 6-10 inches. Presented as a one-spot and loose spots in the buttocks.
• Nevus of OTA — the kind of skin defect, represented by single spot or group merging smooth patches of dark blue. Pigmentation is around the eyes, in the cheekbones, cheeks and upper jaw. Is one-sided. Spots may also appear on the mucous membrane of the nose, throat and the sclera of the eye. Prone to malignancy, although cases of malignant degeneration is extremely rare.
• Nevus of ito – type of skin pigmentation with similar clinical picture with nevus of OTA. Distinguished by its localization. Most commonly located in the supraclavicular, cervical region, in the area of the scapula and deltoid muscle.
• Blue nevus . Defined two types of this skin defect:
Simple blue nevus – a single dense nodule with a smooth surface devoid of hair. Its color varies from light gray to almost black. The diameter of the tumors rarely exceeds 1 cm.
Cellular blue nevus is clinically different from simple for its size. Steam reaches 3 cm in diameter.
The main localization of blue nevus – back side of the hands and feet, lumbosacral and buttock. Is characterized by slow growth, prone to malignant transformation.
Moles of mixed origin
• Combined nevus is a skin defect, which combines features blue and limited or compound nevi.
• Congenital nevus is a benign pigmentary education, regarding the violation of specialization of melanoblasts (cells that produce melanin) in vnutriutrobno period of development. Congenital moles can be both correct and incorrect forms, with clear or blurry edges, light or dark brown. Their surface may be smooth, but also meet warty, papular, folded forms of congenital nevus. Often, the skin defect is covered by hair. Specific localization of congenital nevus no.
Externally, congenital birthmarks are virtually indistinguishable from acquired. The main difference is in the size of the spot. Most often the size of the congenital nevus exceeds 1.5 cm. There are also large nevi (about 20 cm) and giant – which occupies an entire anatomical region (torso, neck, limb). Another difference congenital nevus acquired from that this kind of nevi are located in all layers of the skin and has no tendency to spontaneous reduction and disappearance.
Moles melanocytic origin (precursors of melanoma).
• Dysplastic (atypical nevus, nevus Clark) is an acquired pigmentary education. Clinically presents spot or group of spots round or oval shape, with jagged edges and a Central papular element part extending over the surface of the skin. The coloration of such entities uneven. Color from various shades of brown and tan to light red. The size of atypical nevi greater than 6 mm in diameter, which is often larger than the size of other acquired moles.
The typical localization of Clark nevus – torso, arms, legs, the back surface of the feet, buttocks. Rarely these moles appear on the face.
Dysplastic – from “dysplasia”. Dysplasia is an abnormal development of tissues: change of form, structure of cells, tissues, whole or organs. In the context of melanocytic nevi dysplasia involves the violation of the cellular tissue of the epidermis (surface skin layer). Depending on the severity of the dysplasia define three forms: mild, moderate and severe. Such formations are the most prone to malignant periodiniu.
Moles in norm and at a pathology
How to distinguish a normal mole from pathological? What is the difference between “safe” and “dangerous” pigmented lesions?
– soreness around the mole;
– moles increase in size;
– the appearance of additional moles of elements, the so-called “sattelitov”.
Nevertheless, it is necessary to distinguish between pathological and normal changes moles. The change in color, slow growth, the rise of the spots over the surface of the skin is common in adolescence, due to the influence of hormones. For the process of malignant transformation is characterized by rather rapid changes in size and surface topography birthmark.
In what cases can malignization nevus? Often, malignancy observed with the active impact ultravioleta, the injury of moles.
Remove or not to remove a mole?
Surgery is indicated not only when zlokacestvennom rebirth of birthmarks. Often, the pigmentation blemishes are purely cosmetic in nature. However, it is worth remembering that to remove moles yourself is contraindicated due to high risk of subsequent malignancy.
So, what can be attributed to the indications for removal? First of all, this trauma pigmented nevus, change its size and shape. Second, localization of the nevus in a vulnerable, open area. Often naevus can be injured by friction on clothes and other everyday conditions that also can lead to malignancy. In any case, the question birthmark removal should not be addressed independently. For different types of moles on their methods of solution to the situation, and therefore must abraitis the advice of a specialist.
Absolute contraindications to the removal of moles no. However, the procedure can be delayed by a relative (temporary) contraindications. These include: exacerbation of chronic diseases, inflamed or unhealthy appearance of the skin area on which you want to conduct the intervention as well as diseases of the cardiovascular system.
How remove moles?
First it should be noted that the removal of moles is engaged in a specialized doctor, because each of the types of moles requires a specific approach. Method of removal in the first place depends on the clinical case and the testimony, as the number of patients on such an issue mainly in two cases: if there are cosmetic defects and in case of malignant transformation of congenital or acquired education.
At the moment the medicine there are several methods for removing moles, including:
Removing moles using nitrogen (cryosurgery). This operation may require several sessions, as the depth of the impact of nitrogen on the fabric to control accurately is impossible. This method is dangerous complications in the form of a burn, which slows healing after surgery and may lead to scar formation.
Electrocoagulation. This type of operation implies a thermal effect on tissue with high frequency current produced around the deleted region. Subsequently removing moles formed wound, which is healing under the crust. This type of healing with proper care suggests a lack order to avoid visible scars.
Laser removal of moles. This option of removing age spots is the most suitable patients with complaints of aesthetic defect because you can conduct the removal without a trace. The procedure is not time consuming and most of the operations of laser removal does not take more than 2 minutes.
Radiosurgery. This is a non-invasive method of tissue dissection, in which the mole is removed with the help of radio waves. The method is the same as laser removal, leaves no scars on the skin, and therefore is widely used in cases of complaints against cosmetic defects. Also shown in cases of malignancy moles.
Surgical removal of moles. This method is most suitable for removal of large or deep moles, those that involve multiple layers of tissue and moles malignant. In this case, the operation is performed using a scalpel. Education excised within healthy tissue, which leads to the appearance of the scar. However, when the surgery is performed correctly and proper postoperative care, the scar becomes almost invisible.
the Premalignant and malignant moles should not be subjected to any cosmetic procedures. In these cases only required surgical intervention with complete excision of education, after which the removed material necessarily is sent for histological examination.
It should be noted that cosmetologists and surgeons could not reach a consensus, is it possible to use cosmetic methods of removing moles, including such common and convenient for the patient laser ablation, and cryotherapy and electrocoagulation. The fact is that even harmless in your opinion and esthetitian mole may be malignant or precancerous. Removing in this case a cosmetic defect, you will trigger the growth of cancerous tumors and the prognosis for you can be very unfavorable. So any birthmark in the first place is to show the surgeon, oncologist, not a beautician, and if necessary to resort to surgical removal.
Complications after surgery for removal of age spots can be scars, scars and burns in the case of using the cryogenic method, and also malignancy after incomplete removal of a mole.
Surgical removal of moles
Depending on the size and depth of the mole is removed with either a scalpel or a special tool. Mole on the photo below needs deep removal, consider the process in more detail.
Care after you remove moles
After removal of mole skin in any special care needs. However, to avoid the appearance of age spots at the site of the operation should follow some rules.
First, after removing moles on the skin remains crispy. It is strictly prohibited watering or tearing, as this can affect the healing process of tissues.
Secondly, you should avoid contact with cosmetics on the wound.
Third, protect the wound area from aggressive UV rays, especially in summer. However, after healing, also should be possible to protect the area in which the operation was conducted to remove as long as the area of removal will not cease to differ from the surrounding skin. It is recommended to apply to the area the cream with effect of UV protection.