Melanocytic nevi (moles) are benign skin growths composed of cells derived from melanocytes, the pigment-producing cells of the epidermis. They are common and usually appear during childhood and adolescence, and their number can vary considerably between individuals.
Classification of melanocytic nevi
**1. Congenital melanocytic nevi**
- Present at birth or appear in the first months
- They can be small (20 cm)
- Large and giant ones carry an increased risk of developing melanoma
**2. Acquired melanocytic nevi**
- Appear during childhood and adolescence
- They are:
• Junctional – flat, brown, with melanocytes in the epidermis
• Compound – slightly raised, mixed localization of cells
• Intradermal – lighter, dome-shaped, melanocytes only in the dermis
**3. Atypical (dysplastic) nevi**
- Nevi with an atypical appearance, asymmetry or irregular color
- They may resemble melanoma, but are benign
- Increased risk with multiple atypical nevi and family history of melanoma
Factors influencing development
- Genetic predisposition
- Exposure to ultraviolet (UV) radiation
- Hormonal changes (puberty, pregnancy)
- Skin phototype – lighter skin with more nevi
When should we see a dermatologist?
When a new pigment formation appears after the age of 30
When there is a change in the size, shape, color, or surface of an existing mole
If there is bleeding, itching, redness or pain
In the presence of multiple atypical nevi or a family history of melanoma
Clinical features
Melanocytic nevi are usually:
- With uniform pigmentation (brown, black, flesh)
- With regular borders and symmetrical shape
- Relatively small (<6 mm)
- Stable over time
Atypical nevi may have:
- Asymmetry
- Irregular edges
- Heterogeneous color
- Diameter over 6 mm
- Progressive change
Diagnosis and follow-up
- Clinical examination by a dermatologist
- Dermatoscopy – visualization of the pigment structure
- Digital dermatoscopy and phototracking – in patients with multiple or atypical nevi
- Biopsy or excision if melanoma is suspected
Treatment
In most cases, melanocytic nevi do not require treatment, only monitoring. Removal is recommended for:
- Clinical suspicion of melanoma
- Location of areas with chronic irritation (belt, bra, folds)
- Cosmetic considerations
Removal methods:
- Surgical excision (gold standard)
Melanocytic nevi are common and usually harmless skin growths. Regular self-examination and preventive examinations by a dermatologist are key to early detection of possible malignant transformations.
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