In the dermatology outpatient clinic, there are often patients who come to consult and ask for "pointing out the mole", some of them for aesthetic reasons; some of them have seen the science TV program or information, and come out of concern; of course, there is no lack of individual to listen to the "big fairy" point of viewers ......

However, is the "mole" in your eyes really a "mole"?

Basal cell carcinoma, seborrheic keratosis (senile warts), hemangioma (keratoderma), dermatofibroma, malignant melanoma ......

may be in your eyes are "moles", and is not black! Things that aren't black can be pigmented nevi, and things that aren't black can be pigmented nevi, or even malignant melanomas.

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So what is a pigmented mole? Are all moles suitable for "pointing out"? Can a pigmented mole turn into a malignant melanoma?

Let's take a look at Nevus pigmentosus:

Nevus pigmentosus, also known as nevus cellular nevus or nevus of melanocytic nevus, is a benign skin tumor of melanocyte origin , is very common, and almost everyone has it, from infancy to old age, it can occur, and it usually grows in number with age. They usually increase in number with age, and increase significantly during puberty. Women tend to have more moles than men, and white people have more moles than black people.

Moles are congenital and acquired, and can occur in any part of the skin. According to the depth of growth of nevi, they are divided into junctional nevi, compound nevi and intradermal nevi. Junctional nevi are usually hairless, mostly flat, darker in color, and occur at the junction of the epidermis and dermis, and are most common on the palms of the hands and feet, and in the vulva; intradermal nevi are usually hemispherical or tibial, with smooth or papillary surfaces, and may contain hair, and are more common in the head and neck area; composite nevi are somewhere in between, and are slightly elevated, and sometimes have hairs.

The development of pigmented nevi also has a mature to aging evolutionary process, after birth to 20-30 years of age gradually increased, and then began to decline steadily, along with the age of the gradual growth of deeper, bulging, the color is gradually fading, and may even be disappeared in old age. Most small moles, except for cosmetic needs, generally do not require treatment. However, moles that grow on the palm, metatarsal (zhi, sole of the foot), waist, shoulders, armpits, groin and other parts of the body that are prone to friction, or moles that occur in the mucous membranes of the oral cavity and vulva are often nevi, which should be observed with special attention, and should be excised in a timely manner when they are relatively large, rapidly expanding or partly elevated, or when there are ulcers or bleeding, and should be examined pathologically to confirm the findings.

Friends who have watched Feng Xiaogang's "Do Not Disturb 2" probably have heard of melanoma, which is a malignant tumor originating from melanocytes, with a high degree of malignancy, and a very high death rate in advanced patients.

So what are the characteristics and manifestations of a mole with malignant potential?

Asymmetry: the center of the mole draws a line, and the two ends are extremely asymmetrical;

Irregular edges, or the edges become unclear;

Color change: the color becomes uneven, varying in shades, or appearing in a variety of colors;

Large diameter: the diameter is more than 6mm;

Significant development: rapid enlargement in a short period of time, small hardness within the nevus. Expansion: in a short period of time, there are small hard lumps forming inside the nevus, the color deepens and brightens, and the nevus changes from smooth to rough, with vesicles, oozing, and bleeding;

Appearance of satellite foci: small nevi suddenly appear around the nevus, which seem to be surrounded by satellites;

From the statistical analysis of the medical literature, the preferred sites of malignant melanoma for the Chinese are the palms of the hands and feet and the nails of the fingers and toes; so these areas need to be more frequently treated, and the nevus should be more frequently treated. So moles in these areas need more vigilance. Trauma is an inflammatory stimulus that is a common trigger for melanoma. In addition, ultraviolet radiation is also a common cause of melanoma, and moles that are often exposed to the sun are prone to malignant melanoma. If a nevus at the site of a sunburn increases in size over a short period of time, you need to be vigilant. People with a family history of melanoma have a 10-20 times higher incidence of melanoma than ordinary people. Congenital moles, especially giant moles, have a higher risk of malignancy than acquired moles. Hair growth on a mole is not a sign of malignancy; if there is a hair follicle inside the mole, it will grow hair, but it does not increase the risk of malignancy of the mole.

What does a malignant melanoma look like?

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The rule of thumb for removing moles is: leave them alone, or be thorough!

Moles smaller than 2mm, flat moles can choose laser removal. Moles larger than 2mm are preferred for surgical removal.

Why don't dermatologists recommend laser cryotherapy for most moles?

1, most of the pigmented nevus cumulative dermis, treatment must break through the papillary layer of the dermis, laser and freezing and other open traumatic process is very easy to form a scar appearance results are not satisfactory.

2, laser, freezing treatment, with the destruction of the nevus cell nest, the color of the pigmented nevus will become lighter and lighter, but when the naked eye can not see the color does not mean that the nevus cell nest disappeared, so the laser freezing is often incomplete, the pigmented nevus prone to recurrence.

3. If repeated laser freezing treatment is repeated for recurrent nevi, and the nevus cell nests are not completely removed, this stimulus will greatly increase the chances of malignant transformation of pigmented nevi.

So what are the benefits of surgical removal of pigmented nevi?

1, surgical excision can ensure enough scope and depth to ensure that the mole cells are removed cleanly.

2, the cut specimen can be sent to the pathology examination, in order to prevent misdiagnosis, missed diagnosis, there is a tendency of malignant changes to be further processed and observation and follow-up.

For the "mole pointing" after the recurrence of the thing is still not a mole? How to make sure that the malignant melanoma is not treated as a benign mole?

With the existing experience, a large sample of clinical and pathological epidemiological investigation analysis shows that the recurrence of local treatment within a short period of time (6 months) are basically benign nevi, and the recurrence of the pigmentation of the original treatment of scars are limited; and malignant melanoma in situ recurrence in the majority of the postoperative 6 months after the operation, and often a few years later.

How about, for mole removal, we are not already a little bit in mind?

Lastly, I would like to remind you that you must go to a regular medical institution to remove moles. Without a qualified cosmetic surgery institution, you can't correctly distinguish between good and bad moles, and you'll have a lot of trouble.