Intradermal nevus
The content of the article:
- Kinds
- Causes of occurrence
- Signs
- Diagnostics
- What is the danger of pigmented formations
- Therapeutic tactics
- How to reduce the risk of malignant nevus
- Video
Intradermal nevus is a type of nevus, or birthmark, which refers to benign pigmented neoplasms of the skin of a congenital or acquired nature. This type of nevus is formed when specialized skin cells - melanocytes, which produce the pigment melanin, accumulate in the deep layers of the dermis. It can be single and multiple, localized more often in the face, neck, trunk, occurs mainly in adulthood or old age. In most cases, it does not require treatment, but only monitoring over time. Removal is resorted to when traumatizing education and the risk of malignant degeneration.
Intradermal nevus usually has the form of a dome or wart, that is, it rises above the level of the skin
Kinds
A nevus, or birthmark, occurs on the surface of the skin from pigment cells with an excess of melanin pigment in them. The skin consists of a superficial layer - the epidermis and a deeper layer - the dermis. Depending on where melanocytes accumulate, several types of nevi are distinguished:
- epidermal, localized in the upper layer - the epidermis;
- borderline, located at the border of the epidermis and dermis;
- intradermal, formed in the thickness of the dermis.
Causes of occurrence
There can be several reasons for the formation of birthmarks.
| Cause | Characteristic |
| Hereditary predisposition |
The appearance of moles in a specific place on the human body can be genetically programmed. Congenital birthmarks are a defect of embryonic development, the basis of which is a violation of the process of movement of melanoblasts - precursors of melanocytes, from the neuroectodermal tube into the skin. The accumulation of pigment cells in the skin is responsible for the formation of nevi. |
| Ultraviolet radiation | One of the functions of the melanin pigment is to absorb ultraviolet rays. Due to this, the deep layers of the skin are protected from radiation damage. With excessive exposure to ultraviolet rays, the pigment is produced more intensively, which, in turn, provokes the formation of moles. The main source of natural ultraviolet radiation is the sun. In addition, it can be artificial sources used for various purposes, including artificial tanning. Prolonged exposure to the sun and abuse of a solarium is fraught with the development of pigmented formations. |
| Hormonal imbalance | Hormonal changes (adolescence, pregnancy, menopause) and surges (stress, endocrine pathologies, etc.) are provoking factors in the formation of pigmentary neoplasms of the skin. |
| Immunodeficiency states |
The appearance of many nevi, intradermal pigmented, including, in the case of acute inflammatory bullous dermatoses (skin diseases accompanied by the formation of blisters), after polychemotherapy is noted. Injuries, various viral infections that reduce the body's defenses stimulate the growth and increase in the number of moles. |
Signs
Pigmented formations, localized in the thickness of the dermis, usually have a domed or warty appearance. If we are talking about an intradermal papillomatous nevus, then it may resemble a papilloma in shape - a soft benign formation on a pedicle or broad base. The color ranges from light shades of brown to almost black. Sometimes there are almost no pigment intradermal formations of a whitish or pink color.
The sizes are different: from 1-2 mm to several centimeters. Normal, or melanocytic, nevi grow in size as the body grows. They are often not visible on the surface of the skin of newborns, but they begin to appear already in the first years of life. By size they are distinguished:
- small (from 0.5 to 1.5 mm);
- medium (up to 1 cm);
- large (more than 1 cm in diameter).
Intradermal moles can be single or multiple. Their number reaches its maximum in puberty. After 50 years, their number may gradually decrease. Localization is varied, more often - the skin of the face, neck, trunk.
Diagnostics
| Diagnostic method | Description |
| Patient interview | The doctor finds out when the neoplasm appeared, whether there was a change in its color, shape, diameter. If there were any, then how long ago and how they were provoked. The presence and severity of clinical symptoms is specified. |
| Visual inspection | The location, size, shape, color of the mole is evaluated. This helps to make a preliminary diagnosis. |
| Dermatoscopy | A method that allows you to assess skin neoplasms of the superficial and deeper layers. It is performed using a dermatoscope. The procedure does not imply violation of the integrity of the skin. The advantages of the method also include high sensitivity and specificity. Digital dermatoscopes allow you to capture the image and store the photo in an electronic database, which facilitates the monitoring process. Examination under magnification allows for differential diagnosis between benign and malignant intradermal pigmented lesions. |
| Taking fingerprints | If a nevus is present, a biopsy (taking a tissue sample for histology) is usually not done. Any traumatic effect can give an impetus for the malignant transformation of some types of pigmented formations, especially borderline ones. If a patient consults a doctor with an injured mole, then it is permissible to take a smear from its surface, since the integrity of the formation is already broken and there is often a discharge. In the laboratory, the smear is examined by a cytologist. |
Dermatoscopy is an informative method for diagnosing nevi
What is the danger of pigmented formations
Intradermal nevus is a benign neoplasm, but the action of ultraviolet radiation, mechanical trauma, especially multiple ones, increase the risk of its degeneration into melanoma. The latter is one of the most aggressive human malignant tumors.
Early clinical manifestations of melanoma can be:
- discoloration of the formation (intense pigmentation, its unevenness);
- fast growth;
- itching;
- ulceration, inflammatory changes, bleeding.
The occurrence of one or more of the listed symptoms requires immediate attention to a specialist.
Therapeutic tactics
Most intradermal pigmented nevi are safe and do not require treatment, only dynamic observation. It is necessary to remove moles if their integrity is violated, especially repeatedly. This is usually due to their localization, which does not allow avoiding periodic mechanical trauma: on the palms, soles, in the neck, at the waist. Often, age spots are removed for aesthetic reasons.
There are several ways to remove intradermal pigmentary neoplasms.
| Method | Description |
| Surgical removal | A traditional technique in which a mole is resected with a scalpel under local or general anesthesia. The disadvantages of the method include the appearance of scars formed after excision. However, the nature of the postoperative scar depends largely on the suture material and the qualifications of the operating doctor: it is possible to impose an almost invisible cosmetic suture. |
| Radio wave excision | A non-contact technique based on the use of high frequency radio waves. The necessary effect is achieved due to the thermal energy generated in the tissue when exposed to high-frequency radio waves emitted by a special device "Surgitron". Sterility, bloodlessness, low trauma, absence of noticeable scars after healing of a postoperative wound are the indisputable advantages of the method. |
| Electrocoagulation | Conversion of high-frequency current into thermal energy is the main principle of operation of an electrosurgical high-frequency device used in dermatology for excision of intradermal neoplasms. The technique allows to coagulate vessels damaged during surgery, which reduces the time of surgery and blood loss. |
| Cryodestruction | The method is based on the effect of low temperature on tissue. To achieve the desired effect, liquid nitrogen is most often used as a cooling solution, supplied through a special cryoprobe. During cryodestruction, the surrounding tissues are practically not damaged, bleeding does not occur, and rough scars are not formed during the healing process. |
| Laser removal | The technique involves the use of a carbon dioxide or neodymium laser. The advantages of laser removal include the ability to accurately dose the radius and depth of exposure, the ability to maintain the integrity of the surrounding tissues. After removing small formations, practically no traces remain. |
Electrocoagulation is one of the most effective methods for removing benign skin lesions
It is possible to choose various methods of removing moles only being absolutely sure of their benign nature. In case of traumatization of education, the slightest suspicion of its malignancy, one should resort only to surgical excision, which should be carried out by an oncologist. It is necessary to remove it radically, a subsequent histological examination is mandatory.
How to reduce the risk of malignant nevus
To eliminate the risk of malignant degeneration of a mole, you should:
- avoid excessive sun exposure;
- do not overuse artificial tanning;
- prevent injury;
- visit a dermatologist if any suspicious signs appear.
It is necessary to regularly monitor the appearance and number of moles. Immediate appeal to a specialist when changing their contours, size, color will prevent the development of melanoma.
Video
We offer for viewing a video on the topic of the article.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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