As indications to excision of the got pigmented nevus serve localization on a pilar part of a head, soles, in a perineum or on mucosas; occurrence of clinical signs of malignant transformation which concern:
– Nevus growth upwards;
– Augmentation of intensity of pigmentation, especially increase of non-uniformity of pigmentation;
– Signs of partial retrogress of a nevus;
– Occurrence of a pigmented areola of around slightly towering pigmented nevus;
– An inflammation, an itch, erosions and a nevus staxis.
The convex form – rose over skin level.
Change of the sizes, acceleration of growth of a nevus.
Wrong borders – the tumor has the cut up edges.
Asymmetry, one half of tumor isn’t similar to another.
Large in size, diameter of a tumor usually exceeds diameter of a pencil (6 mm).
Coloring irregular, randomly located brown, black, gray, pink and white sites.
Dysplastic nevus (an atypical birthmark) is a tumor caused by a proliferation (dysplasia) of intraepidermal melanocytes. And there is a risk factor for occurrence of a melanoma or its immediate precursor. Can appear at any age, including senile, but more often in the first 10 years of life. The quantity of the centers of a lesion can be various: one, a little or hundreds.
The nevus can be sporadic and family. The sporadic dysplastic nevus is transformed to a melanoma in 36 % of cases, family – in 70 %. The malignant degeneration of a nevus in a melanoma can occur in some months or years. The dysplastic nevus can be localized on any site of a body, at children quite often for the first time appears on a pilar part of a head.
The dysplastic nevus represents a nevus pigmentosus with separate slightly raised over level of a skin sites. Diameter of maculae is from 5 mm and more. It has the roundish or oval form, rough dim borders. Color of maculae irregular; in it various shades brown (light, dark, yellowish), red and pink colors, as a rule are combined. Intensifying of non-uniformity of pigmentation, especially occurrence of azygomorphous sites of dark black pigmentation or nodules in the nevus center testifies to transformation in a melanoma.
Treatment is made by surgical excising within healthy tissues. Patients shouldn’t sunbathe; to use photoprotective agents in solar weather. Patients and their close relatives need a regular dispensary observation.
Congenital nevus is the pigmental neoplasm which is the precursor of a melanoma. It appears since a birth. Any nevus in diameter more than 1,5 sm appears soon after a birth, it is necessary to survey as congenital nevus. Congenital nevus happens fine (diameter less than 1,5 sm), an average (to 20 sm) and huge, occupying the whole anatomic area or its bigger part (a trunk, an extremity, a head, a neck). The risk of development of a melanoma at a fine nevus makes 1–5 %, at large – 6,3 %.
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