Dysplastic Nevus (Dysplastic Moles)
This term is a
term used for moles that have a different appearance than ordinary moles, that is, "atypical" appearance. Although they are sometimes called Atypical nevus due to their appearance, the most commonly used name is dysplastic nevus. Dysplastic moles are not moles that appear at birth. It may occur familially in one person (in different individuals within the family
) or it may occur without other individuals in the family. Their numbers may be one
or they may be many. They are most commonly located on the trunk and back. Although familial moles often appear until
adolescence, they can generally appear at any age. In appearance, they are larger than other ordinary, non-congenital moles. Their diameter is over 5-6 mm. They can be asymmetric
(it's not symmetrical when you fold it on top of each other on two separate axes). There may be light and dark brown
colored areas inside the mole. They may be puffier than the skin or at the same level as the skin
. There may be a raised area in the middle of the mole that is not swollen from the skin. If we think of the
part that is not puffy from the skin as the white of the egg and the fluffy part in the middle as the yolk, such an appearance can be described as a
fried egg. Since dysplastic moles differ from ordinary moles in appearance, they may raise suspicion of melanoma. Although some of their appearances resemble melanoma, these moles are benign. Like other moles, they can remain the same throughout life or change and turn into melanoma. Dermatologists may need a biopsy diagnosis in cases where they consider a mole to be dysplastic in appearance. The surgically removed mole is examined under a microscope in the pathology departments and the features of the dysplastic mole are observed in the tissue to confirm the diagnosis. The examining pathologist can grade the atypical features microscopically. The dermatologist can use this information when planning the follow-up of his/her patient.
Is the presence of dysplastic moles more risky for the development of melanoma?
The possibility of developing melanoma from an existing dysplastic mole is very rare. The expected feature is that the dysplastic
mole melts like other ordinary moles. It remains the same and does not change in adulthood. However, in the presence of
change, melanoma may develop. According to our knowledge, people with these moles
have a higher risk of melanoma that can develop on normal skin than people who do not have dysplastic moles. In other words, individuals with dysplastic moles have a higher risk of melanoma that can develop on normal skin
rather than developing on a mole. .
Should every dysplastic mole be surgically removed?
No. These moles are benign. In order to avoid unnecessary surgical expenses and scars that may occur on patients, surgical removal of moles should be considered only in cases where diagnosis is difficult or melanoma cannot be distinguished. In addition, removing all existing dysplastic moles does not reduce the patient's risk of melanoma that may develop on normal
skin.
Should individuals with dysplastic moles be followed?
Yes. The purpose of following up people who are detected to have dysplastic moles is to follow the changes that may develop in dysplastic moles and to detect new melanoma early. Patients are followed up with control periods between >. During these follow-ups, whole body
photography and, if necessary, dermoscopic examination (examination of the skin with light and magnification systems) and
follow-up are also performed.
Are there any precautions that patients with dysplastic moles should follow?
It would be appropriate for him to comply with the precautions regarding sun protection throughout his life, to examine himself at least twice a year and to go for check-ups at the intervals and periods determined by the dermatologist
CONGENITAL MOLES (Congenital nevus)
Congenital mole is the name given to brown moles that are present on the baby's body when he/she is born and may change over time. Small-sized moles are rarely present at birth and may appear in the first 2 years of life, which are called "late-appearing congenital moles".
How many types of congenital moles are they divided into?
Congenital moles grow in proportion to the child's body as it develops and grows. These moles are the final stage they will reach in adulthood. They are divided into 4 groups according to their size (diameter).
Those less than 1.5 cm are called "small congenital moles".
Those between 1.5-20 cm are called "medium-sized congenital moles."
Those larger than 20 cm. “large congenital moles”
Those larger than 40 cm are called “giant congenital moles”
How common are congenital moles?
Small congenital moles occur approximately once in 100 births. Large ones are seen once in 20 000 births and giant
congenital moles are seen once in 500 000 births.
What is the appearance of congenital moles?
Small and medium-sized congenital moles are usually sharply defined and flat. It appears as surface, light or dark brown
spots, and sometimes as rough brown bumps on top. There may be slight differences in the
colors on them (such as shades of brown, black, gray) and there may be hairs on their surfaces that are denser and more distinct than the surrounding skin. Over time, roughness on the surface or existing bumps may become more pronounced and thin hairs may thicken. Large-diameter congenital moles are in the form of raised plaques of brown
or black colored skin, often with cobblestone-like rough
bumps and hard hairs on them. It often contains different colors such as light-dark brown, black and grey. Giant congenital moles are usually located on a large part of the body, such as the back, and cover a large part of the skin.
Tiny and large brown and black bumps contain thick, hard hairs.
Large and giant congenital moles. There may be a few or many smaller diameter moles called "satellites"
around the moles.
Are congenital moles dangerous?
There are rare cases on congenital moles. However, a mole cancer called "melanoma" may develop, which originates from cells called melanocytes that give color to the skin. The risk of developing melanoma is related to the size of the mole. The risk for small
and medium-sized moles is very low and they usually appear after adolescence. For large and
giant congenital moles, the risk is significantly higher (4.5-10%) and the development of melanoma may occur in the early
ages, mostly before puberty. Especially for large and giant moles located on the head, neck and back,
birth In the presence of moles, a disease accompanied by central nervous system involvement called "neurocutaneous melanosis" may also be observed. In this case, symptoms such as constant sleepiness, restlessness, headaches, recurrent vomiting and epileptic seizures are often observed in the baby within the first 3 years of age.
How should congenital moles be followed?
>Follow-up of congenital moles varies from patient to patient. The location of the mole, its size, and its negative cosmetic and psychosocial effects should be taken into consideration. Congenital moles, which are small in size and have a smooth surface and are located in an area of the body that can be easily monitored, can be followed by dermatologists at regular intervals (such as 6 months-1 year). Follow-up should be done with dermoscopic examination. Dermoscopic
examination is a method of examining moles with a device called dermoscope. A dermoscope can be thought of as a magnifying glass with a special light
system. Thanks to this special light system, it allows the doctor to examine the upper layers of the skin. In this way, changes that may potentially occur in me in terms of cancer development
can be detected at an earlier stage. In fact, since the risk of developing cancer in small-scale moles is generally after the age of puberty, it is more logical to wait until the child is 12-13 years old, when he/she will be ready for local anesthesia, and in the meantime, it would be appropriate to follow up the mole. Moles in areas that are difficult to follow, such as the scalp, can be removed surgically immediately, if necessary, without any follow-up. Moles are often surgically removed at the earliest stage after being evaluated by a dermatologist.
Is it dangerous to surgically remove congenital moles?
Contrary to popular belief, removing moles does not pose a danger, on the contrary, it can cause cancer. Removing a suspicious mole at an early stage and with the appropriate technique can save lives.
Can the risk of developing cancer on congenital moles be reduced?
Sunlight is an additional risk factor in the development of cancer. For this reason, expose both me and the entire
skin outside the clothing to sunlight. It should be protected from heat. For this reason, you should not go out under the hot sun unless absolutely necessary between 10:00 and 17:00. When you have to go out, sun protection creams with a protection factor of at least 30 should be used, and bare skin should be covered with wide-brimmed hats and clothes.
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