Dysplastic skin nevus: degree, photo, treatment, reviews
Moles of various shapes and sizes are on the body of almost every adult. Some compare them with national signs, others do not pay attention to them. Only some citizens (most often ladies) start to worry about a mole if it appears on the face and spoils the appearance. But in this case, they turn to a cosmetologist, and not to a dermatologist or oncologist. However, birthmarks, called nevi in medicine, with a certain set of circumstances, degenerate into a malignant tumor of the skin, therefore, they must be taken very seriously. We offer detailed information on what is dysplastic nevus of the skin. The photos presented in the article will help to understand how the data of education looks like.
Many people know that our skin has high molecular weight pigment melanin. It is produced by the cells melanocytes to protect the inner layers of the dermis from ultraviolet rays. The most striking example is tan.The chocolate color of the skin is provided by melanin, which begins to be produced very actively when we stay in the sun for a long time. For reasons unknown so far, at some point the melanocytes in our body suddenly begin to move to one point, where a rather large number of them accumulate. In this place a special kind of birthmark appears, called a dysplastic nevus. The photo below shows how this formation might look. At its core, it is a nevoid tumor.
Its size can vary widely, depending on the number of myelocytes arriving at a given point. The form of dysplastic nevus is often oval, but there may be various variations. However, all such entities have a common pattern - they have no smooth boundaries. The color of these spots can be from light brown to dark brown. It depends on the fullness of the melanocytes pigment. Moreover, in different points of the same dysplastic nevus, the color can vary. Regarding the surface of the skin, these spots are completely flat or slightly bulging. They can appear on the body of men, women or children in any place and any quantity.
It was noted above that scientists cannot yet say with certainty that it provokes the migration of melanocytes.
There are only suggestions that some situations and circumstances can cause the appearance of a dysplastic nevus. These include:
- Hormonal adjustment.
- Acceptance of hormonal drugs.
- Infectious diseases.
- Hereditary predisposition.
- Adverse environmental conditions (radiation, toxic substances). Pregnant women are especially sensitive to these factors.
- A visit to the solarium.
- Long sunbathing.
- Inflammatory reactions in injuries of the skin of various etiologies.
- Weak immunity.
We draw your attention to the fact that dysplastic nevi are not a genetic disease, that is, they are not inherited. However, a person inherits a predisposition to their education.
With all the variety of shape, color, size and structure, all dysplastic nevi of the skin are divided into only two groups (taking into account the degree of possible transformation into melanoma):
- Sporadic (acquired).
Each group has its own subgroups and types of data formations. Let's take a closer look at each group of nevi.
They are called acquired progenitors of melanoma (skin cancer).
Education data can be single and multiple. The number of spots in the group is not limited.
There are two sporadic dysplastic nevi of two types:
- And - without rebirth in melanoma.
- C - with rebirth in melanoma.
In general, sporadic single nevi increase the risk of developing a malignant tumor by 7-70 times.
In form they are:
1. "Fried eggs". Such a nevus is a flat spot of brown shades with a towering part in the center. The size of the "fried eggs" may be as follows:
- Very small (from 1 to 15 mm).
- Medium (from 15 to 100 mm).
- Large (from 100 to 200 mm).
- Giant (more than 200 mm).
2. Lentigo. These formations are flat, with a smooth surface. Their color ranges from dark brown to black. The sizes are as follows:
- Medium (up to 100 mm).
- Large (over 100 mm).
3. Keratolytic dysplastic nevi (pictured below).
Keratolytic nevi have a tuberous surface of brown shades. In size, they are medium (up to 100 mm) and large (over 100 mm).
4. Erythematous.They are a pink birthmark. In size, erythematous nevi are large (up to 200 mm) and gigantic (more than 200 mm).
Their appearance on the skin is called dysplastic nevi syndrome.family. They can also be single and multiple (over 100 pieces). Appear on the body at any age, but more often in childhood or adolescence. In addition, the child can be born with a similar stain.
Their occurrence is associated with the transmission by inheritance of the predisposition to the formation of these formations. Scientists have found mutations in such people in the proto-oncogene CDK4 and in the tumor suppressor gene CDKN2a. These genes are activated by UV and immunosuppressants.
There are three types of family nevi:
- B - without rebirth in melanoma.
- D1 and D2 - with rebirth in melanoma.
If at least two close relatives have similar nevi, the risk of degeneration of the formation into melanoma increases 1000 times.
Nevi can appear on a person’s body throughout life. Most often they are observed on the chest, arms, scalp, and on the buttocks. On the lower limbs, nevi are very rarely formed.
As a rule, they do not cause concern, do not itch, do not hurt, do not bleed.
Understand that the skin appeared dysplastic nevus, it is possible in the form of education. It can be different, but the edges of the spots are always uneven. Some people notice a change in the color of the nevus. This may indicate a malignant degeneration, as well as hormonal alterations in the body. Therefore, it is not necessary to get upset before making a diagnosis.
Also, some are afraid of the rough or hilly surface spots and hairs growing out of it. In principle, these phenomena are considered characteristic of dysplastic nevi.
Symptoms of nevus degeneration into melanoma
The most characteristic signs that people who have nevus on their skin should pay attention to are:
- Change the color of education.
- There is itching, peeling, burning and other unusual sensations.
- Pink or red rim around the formation, indicating the beginning of the inflammatory process.
- The appearance on the surface of the nevus nodules.
- The rapid increase in size.
- Seal nevus.
- The formation of microcracks, the expiration of the exudate.
If one or more symptoms appear from the above list, you should immediately go to a doctor.
Difference from Melanoma
Almost every person who has birthmarks on his body is interested in the differences between dysplastic nevus and melanoma. Unfortunately, there is no clear answer to this question. These two formations are so similar that even laboratory and instrumental diagnostics do not provide a correct diagnosis. In the eye it is not always possible to determine exactly what appeared on the skin. Push the idea that the nevus began to degenerate into melanoma, may be the signs given above. Some assumptions can be made by carefully examining education.
The photo presented above clearly demonstrates what a malignant tumor looks like. In melanoma, the edges are, as a rule, always more “torn” than in a nevus, and the color is darker. Another relative difference is the more pronounced asymmetry observed in melanoma.
When a dysplastic nevus appears on the skin, you need to contact a dermatologist. If necessary, he can refer a patient to an oncologist. At the reception, the doctor conducts a visual inspection of education and finds out the following data:
- Do close relatives have similar moles?
- How long has education come about?
- What does the patient have to do with it?
- Whether or not a nevus appears bothers him.
Visual assessment is often carried out using a dermatoscope (works on the principle of a microscope, that is, it multiplies the birthmark).
Dysplastic nevus is required to differentiate from melanoma.
With the help of histological studies can distinguish three degrees of development of a nevus:
- I - chains of enlarged melanocytes are visible.
- II - the presence of clusters of melanin. Outwardly, they resemble a honeycomb.
- III - signs of melanocytic atypia increase, bridges appear between individual clusters.
Often, even with the help of histology, it is very difficult to detect the initial stage of transformation into melanoma.
Observation tactics are used for such characteristics of a nevus:
- He does not bother the patient.
- It has no nodules, cracks, ulcerations on its surface.
- Does not have a pink rim.
- Color varies (light brown gamma).
The following tests can be assigned to the patient:
- Biopsy. It is performed with a special needle under local anesthesia.They can perform a biopsy of a nevus located on the body of a patient or already removed.
- Cytological examination. For this analysis, a scraping of cells from the surface of a nevus is taken, an exudate (if any), an imprint smear to study the nature of the cells.
- Immunohistochemistry. This is the most reliable method.
- Echography. It is prescribed if the dysplastic nevus is large. With the help of this study, they clarify the parameters for the penetration of a nevus into the skin.
- Thermometry. The method is based on measuring the temperature at the site of nevus formation and adjacent tissues. If the formation turned into melanoma, there is a difference in values.
Many patients are interested in whether to remove a dysplastic nevus. According to medical statistics, nevus degeneration into melanoma is observed in 1 case out of 10,000. Therefore, doctors often stop on further observation of the development of education. It is practiced in the following cases:
- Nevus does not bother the patient.
- It has no nodules, cracks, ulcerations on its surface.
- Does not have a pink rim.
- Its color varies in light brown shades.
The decision to remove a nevus is made only by the attending physician. It is performed only with a single dysplastic nevus. Removal can be done in several ways:
- Surgical excision. It is performed with a classic scalpel. If the formation is not very large, the operation is performed under local anesthesia. In cases where the size of a nevus is large enough or it is located in a hard-to-reach place, an excision can be performed under general anesthesia. After surgery, a scar may remain.
- Cryodestruction The method is based on freezing tissues with liquid nitrogen and their subsequent removal. The operation is painless. After it there is practically no scar, but it can only be performed if the nevus has small dimensions.
- Removal by laser. Removed formations up to 20 mm. The operation is almost painless. Only a few patients report skin tingling at the site of laser exposure.
- Electrocoagulation. The operation is identical to that performed by the laser, but in this case, the skin is affected by electricity.
In all cases, the stain is examined using a Wood's lamp, which allows you to see how much the formation has spread in the tissues.
In the presence of multiple nevi, the patient is prescribed applications with the drug "Fluorouracil 5%."These patients must undergo an examination every six months.
Since there is no exact information about the causes of dysplastic nevi, preventive measures to ensure that these formations do not appear on the skin are not developed. Doctors advise patients to avoid prolonged exposure to the sun, regularly visit a dermatologist or oncologist to observe the dynamics of the development of a nevus, to engage in strengthening the immune system.
In private and public medical institutions, operations are often performed to remove dysplastic nevi. Patient reviews of the procedure are generally favorable. People show that the removal is quite painless, it is performed within 5-10 minutes. There is some difference of opinion about the price. It depends on the localization of education and its size. Each clinic has its own price list. In Moscow, the average operation costs up to 3,500 rubles. The cost of histological examination of biomaterial and consultation with a doctor is not included in this amount.