Pigmented nevus
A pigmented nevus is usually a congenital, pigmented nevus cell of a benign character located on the surface of the skin (“birthmark”). But there may be age spots and acquired during life.
Content:
- Causes of a pigmented nevus
- Symptomatic manifestations of a pigmented nevus
- Types of pigmented nevi
- Treatment of pigmented nevi
Causes of a pigmented nevus
"Moles" appear in the embryo in the period of 10-25 weeks as a result of disruption of the structure of skin cells, which become capable of retaining a large amount of pigment. As a result, accumulations of nevocytes are formed, densely filled with a dye.
Mutations at the cellular level are triggered by the following factors:
- Hereditary predisposition;
- Unfavorable radiation background of the environment;
- Regular exposure to aggressive ultraviolet radiation on the skin of a pregnant woman;
- A daily diet rich in dyes, preservatives and GMO foods;
- The use of oral contraceptives shortly before the planned pregnancy;
- Treatment with hormonal drugs while carrying a child;
- Hormonal imbalance in the body of the expectant mother due to the threat of miscarriage;
- Tobacco smoking and alcohol consumption by a woman not only during pregnancy, but also in the previous 2-3 years before conception;
- Chronic infections of the urinary tract and the female reproductive system;
- Venereal diseases.
Symptomatic manifestations of a pigmented nevus
Pigmented neoplasms can be spotty, warty, nodular, or papular.
The color range of birthmarks ranges from light brown to black.
The outer surface of a nevus can either repeat the skin pattern or differ from it, that is, be either completely smooth, or bumpy, or folded, or papillomatous.
The variant of hair growth on the surface of the "mole" is possible.
By size, pigmented nevi are divided into 4 groups:
- Small - up to 1.5 cm.
- Medium - 1.5-10 cm.
- Large - 10-20 cm.
- Giant - more than 20 cm.
Less often, in 5% of cases, there are "family" foci of nevi (multiple), where the central spot of a larger size is accompanied by a large number of small spots. Such formations are located more often in the lower body, legs and on the upper back and chest.
Types of pigmented nevi
To determine the feasibility and method of treating a birthmark, it is necessary to determine which type of neoplasm belongs to, whether it is congenital or acquired.
- Dysplastic pigmented nevus is an acquired benign formation. It can be a separate element that has arisen on a healthy area of the skin, or be a component of a complex "family" focus. The spot is often irregular in shape, slightly rises above the surface of the skin, has indistinct borders, its color varies from reddish brown to dark red. The size of a dysplastic nevus is usually larger than a congenital one, sometimes reaching 12-13 mm. The traditional location is the chest, buttocks and scalp. This type of nevus, under certain circumstances, is prone to degeneration into a malignant tumor (melanoma);
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Borderline pigmented nevus is a congenital neoplasm that occurs in both adults and children. Its shape is similar to a flat dark nodule about 1 cm in size. A distinctive diagnostic feature of a borderline nevus is a completely smooth outer surface and the absence of hairs on it. Favorite places of education are the face, neck, palms, soles and external genitals. This type of "moles" requires close attention, because it can increase in size after any microtraumas and inflammatory processes, as well as during the period of hormonal changes in the body (puberty in adolescents);
- Blue or blue pigmented nevus - more likely to affect women than men. Acquired birthmarks of a bluish-bluish (less often brown) color in the form of single elements (hemispheres), slightly rising above the level of the skin, usually form in the face, lower limbs and buttocks. Their surface is soft, smooth, hair growth is absent. They are very rarely transformed into malignant neoplasms;
- A giant pigmented nevus is only a congenital skin pathology, it is never formed under the influence of extraneous factors! Rarely localized on the face, more often on the trunk, arms or legs. The spot grows with the child, can reach 25 cm in diameter, has an uneven porous or bumpy surface, sometimes with deep cracks. In addition to cosmetic discomfort, such a neoplasm poses a serious threat to human health. As a result of the slightest trauma to the surface of the spot, there is a risk of its degeneration into skin cancer.
Treatment of pigmented nevi
Conservative treatment of "moles" in the form of ointments, gels, lotions or compresses is out of the question. Treatment of congenital / acquired neoplasms is only surgical!
There are several ways to get rid of a pigmented nevus, but the main ones are surgical excision, laser treatment and cryodestruction:
- Surgical excision with the capture of areas of healthy surrounding skin and subcutaneous tissue is carried out in conjunction with a plastic surgeon, since the excision area can be quite extensive and require replacement of skin areas. After the operation, samples of the removed tissue are sent for histological examination to determine the malignancy or benignity of the neoplasm. In memory of the patient, postoperative scars and scars usually remain in place of the spot. If the patient refuses to undergo surgery, he needs constant monitoring by an oncologist. The frequency of visiting the doctor is at least 1 time per quarter. The patient is forbidden to self-medicate, it is recommended to avoid injury and exposure to UV rays;
- Laser treatment is a relatively safe way to remove small to medium-sized birthmarks that does not require general anesthesia. The laser beam penetrates a decent depth into the affected skin in a strictly limited perimeter. When treating large nevi with a laser, problems can arise: if the stain is not completely removed, the remaining part will continue to grow. In place of the removed large area of the skin, a white, devoid of pigment, scar remains, which will be noticeable on the skin of a dark shade;
- Cryodestruction is the treatment of small benign neoplasms by exposure to low temperatures (freezing), as a result of which the affected tissue dies off, and young and healthy skin grows under the formed scab (crust). The means used for freezing are liquid nitrogen and carbonic acid ice. No scars remain after the procedure. However, there is a risk of leaving a piece of an untreated nevus during cryodestruction. In this case, re-freezing is required, since the stain will begin to grow again. Compared to other methods of treating pigmented nevi, this is the most painless and safe.
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
