Dysplastic nevus
The content of the article:
- The reasons
- Classification
- Symptoms
- Diagnostics
- When to see a doctor right away
- Treatment
- Forecast
- Prevention
- Video
A dysplastic nevus is a neoplasm that belongs to the group of birthmarks (moles). It is formed by atypical cells and therefore there is a high risk of its degeneration into melanoma - a malignant skin tumor.
The disease can affect people of any age and gender. It is observed in about 5% of representatives of the Caucasian race. It is not inherited, but there is a hereditary predisposition to its development.
Dysplastic nevus is a precancerous form of age spots
The reasons
The appearance of a dysplastic nevus is associated with the accumulation of melanocytes on a local area of the skin. These cells produce a pigment called melanin, which gives color to human skin. The main physiological role of this pigment is to protect the skin from the aggressive effects of ultraviolet radiation. Normally, melanocytes are evenly distributed in the dermis and epidermis. But under the influence of various factors, these cells can migrate and accumulate in large numbers in a certain area.
Congenital forms of dysplastic nevus are formed even at the stage of intrauterine development of the fetus as a result of disruption of the migration of melanocytes into the skin from the neuroectodermal tube.
In the first days after the birth of a child, education is imperceptible. Then it appears and looks like a small dot measuring 1-2 mm. During puberty, the age spot begins to grow, and its diameter can reach 5-6 cm.
Dysplastic melanocytic tumor can be acquired in nature. In this case, the reason for the movement and accumulation of melanocytes in a limited area of the skin can be:
- exposure to ultraviolet radiation;
- human papillomavirus (HPV) infection;
- a sharp change in hormonal levels (puberty, pregnancy);
- decreased general or local immunity.
Classification
With congenital forms of dysplastic nevus, especially if similar formations are observed in several relatives of the patient, the risk of malignancy increases by more than 1000 times, and the acquired type of melanocytic tumor tenfold increases the likelihood of developing melanoma.
Depending on the degree of possible transformation into a malignant tumor and the characteristics of clinical manifestations, dermatologists subdivide dysplastic nevi into several forms:
| The form | Sign |
| Typical | The spot rises slightly above the skin surface. Its sizes range from 2-3 mm to 20-25 cm. The surface is colored non-uniformly in different shades of brown. |
| Lentigo | A flat formation of black or brown-brown color, which can reach a diameter of 20-22 cm. |
| Keratolytic | The neoplasm has a light brown bumpy surface. |
| Erythematous | It is characterized by the presence of a pinkish birthmark on the skin, the diameter of which can exceed 20 cm. |
| Family | The lesions are observed in many members of the patient's family. Often malignant. |
Symptoms
The disease is manifested by the appearance of one or more age spots on the skin. They have fuzzy fancy boundaries. The surface color is heterogeneous, variegated with areas from light brown to almost black. It is believed that the darker the color of the neoplasm, the higher the likelihood of its degeneration into melanoma.
Distinctive features that distinguish a dysplastic nevus from other forms of pigmentary formations are:
- large sizes;
- localization on the scalp, buttocks, chest;
- the presence of a lumpy, slightly elevated area (nodule) located in the very center of the age spot.
The patient does not have any subjective symptoms.
Diagnostics
Patients with age spots are shown a consultation with a dermatologist-oncologist. Be sure to carry out dermatoscopy - a modern method of non-contact diagnostics, which allows you to determine its nature from the very early stage of the appearance of a pigmented spot.
To confirm the diagnosis, a biopsy of the formation is performed, followed by a histological examination of the tissue obtained during the procedure. A biopsy can be:
- Puncture. It is performed under local anesthesia. A pigment spot is punctured with a special needle, and then the collected "column" of cells is squeezed out onto a glass slide using a syringe.
- Total. Depending on the size of the formation, the procedure is performed under local or general anesthesia. After processing the operating field, the surgeon completely excises the neoplasms with the capture of 3-5 cm of unchanged adjacent tissues. The wound is sutured and an aseptic bandage is applied.
As an alternative diagnostic method, cytological analysis of a smear-print or scraping from the surface of a pigmented neoplasm can be used. It is most informative in patients with cracks or bleeding areas on the surface of the neoplasm.
Currently, the method of computer diagnostics is widely used. A series of photographs of the dysplastic nevus are taken using a high-resolution digital camera. Then the resulting image is processed and analyzed by a special computer program.
In difficult diagnostic cases, an immunohistochemical study is performed. It allows you to determine the phenotypic type of tumor with an accuracy of 100%.
Differential diagnosis is carried out with the following diseases:
- melanoma;
- Dubreus melanosis (also called Dubreus syndrome);
- lupus;
- other forms of age spots.
When to see a doctor right away
Patients should be informed that a dysplastic nevus is a transitional form between a benign tumor and a malignant tumor. Therefore, they should check their spots regularly.
The main signs of possible malignancy are:
- asymmetry of the surface of the neoplasm;
- the appearance of thickened skin around the spot;
- change in color, shape, or size of the tumor;
- the appearance around the formation of a corolla pink;
- itching.
If any of the listed symptoms is found, the patient should immediately contact a dermatologist-oncologist.
Treatment
The main treatment for dysplastic nevus is to remove it completely. To accurately determine the boundaries of the formation, it must be examined before the intervention using a Wood lamp, which emits rays of the long-wavelength part of the ultraviolet spectrum. This can significantly reduce the risk of disease recurrence in the long term.
Before removal, the neoplasm is examined in the rays of a Wood lamp.
Both old and new single neoplasms are excised surgically with the capture of unchanged skin. In the future, the patient should be registered with an oncologist throughout his life.
In the presence of multiple lesions, their radical excision is not shown. Applications are performed with 5% fluorouracil solution. Patients should come for preventive examinations to the oncologist twice a year. The frequency of examinations increases during puberty, pregnancy, and taking oral contraceptives.
In some cases, it is possible to carry out a course of interferon therapy.
Forecast
The prognosis of the disease is determined by the presence of a hereditary predisposition and the stage of the pathological process.
Prevention
There is no specific prophylaxis that can reliably prevent the occurrence of this form of age spots. The main recommendation is to reduce the time spent in the open sun and avoid frequent visits to tanning salons.
For the timely diagnosis of malignancy, patients with dysplastic nevus should be monitored regularly by a dermatologist or oncologist. With early detection of melanoma, it is possible to carry out a full-fledged treatment that saves the patient's life.
Video
We offer for viewing a video on the topic of the article.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
Found a mistake in the text? Select it and press Ctrl + Enter.
