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A pigmented nevus is usually a congenital pigmented formation of benign nevus cells located on the surface of the skin (“birthmark”). But there may be age spots and acquired during life.
Causes of pigment nevus
“Moles” appear in the embryo in the period of 10-25 weeks as a result of a violation of the structure of skin cells, which become capable of holding a large amount of pigment. As a result, clusters of nevocytes are formed, densely filled with a dye.
Mutations at the cellular level are provoked by the following factors:
Genetic predisposition;
Unfavorable radiation background of the environment;
Regular exposure to aggressive ultraviolet radiation on the skin of a pregnant woman;
Daily diet, “rich” in dyes, preservatives and GMO products;
The use of oral contraceptives shortly before the planned pregnancy;
Treatment with hormonal drugs during childbearing;
Disturbances in the hormonal balance 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 female reproductive system;
Venereal diseases.
Symptomatic manifestations of pigmented nevus
Pigmented lesions may be patchy, verrucous, nodular, or papular.
Color spectrum birthmarks vary from light brown to black.
Outside surface the nevus can either repeat the pattern of the skin, or differ from it, i.e., be either completely smooth, or tuberous, or folded, or papillomatous.
A 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 what type of neoplasm it belongs to, whether it is congenital or acquired.
dysplastic pigmented nevus – Acquired high-quality education. It may 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 raised 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 the 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);
Border pigment nevus – a congenital neoplasm, occurs in both adults and children. In its shape, it looks like 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 genitalia. This type of “moles” requires close attention, because it can increase in size after any microtrauma and inflammatory processes, as well as during the period of hormonal changes in the body (puberty of adolescents);
Blue or blue pigmented nevus – It affects women more often than men. Acquired birthmarks of a bluish-bluish (less often brown) color in the form of single elements (hemispheres), slightly elevated above the level of the skin, usually form in the face, lower extremities and buttocks. Their surface is soft, smooth, hair growth is absent. In malignant neoplasms are transformed very rarely;
Giant pigmented nevus – only congenital skin pathology, 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 traumatization of the surface of the spot, there is a risk of its degeneration into skin cancer.
Treatment of pigmented nevi
There can be no talk of conservative treatment of “moles” in the form of ointments, gels, lotions or compresses. 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 tissues are sent for histological examination to determine whether the tumor is malignant or benign. As a memory to the patient, postoperative scars and scars usually remain in place of the spot. If the patient refuses 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 injuries and exposure to UV rays;
Laser treatment is a relatively safe way to remove small to medium birthmarks that does not require the use of general anesthesia. The laser beam penetrates to a decent depth inside the affected skin in a strictly limited perimeter. When treating large nevi with a laser, problems can arise: if the spot 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 – treatment of benign neoplasms of a small size 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. There are no scars left after the procedure. However, there is a risk during cryodestruction to leave a piece of an untreated nevus. In this case, re-freezing is required, because the stain will begin to grow again. Compared to other methods of treating pigmented nevi, this is the most painless and safe.