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melanocytic nevus (mole)
Etiology:
1) clustering of melanocytic nevus cells in the skin
2) sun exposure is a key factor
Epidemiology:
1) one of the most common acquired neoplasm in Caucasians
2) most adults have about 20
Pathology:
* histopathology images [4]
Clinical manifestations:
1) generally asymptomatic, cosmetic
2) new nevi commonly form through middle age, especially in sun- exposed areas & tend to regress with older age
* images [4,5]
Laboratory:
1) clinical diagnosis generally sufficient
2) skin biopsy if lesion has malignant characteristics
Differential diagnosis:
1) malignant melanoma
2) basal cell carcinoma
Management:
1) most nevi do not require treatment
2) nevi with malignant potential
a) careful observation
b) excision with adequate margins with histopathology
3) patient education
a) observe for signs of malignant changes
1] changes in borders (asymmetry, irregularity)
2] changes in pigmentation (more varied or stippled)
3] crusting or bleeding
4] pruritus, pain, or tenderness
b) sunscreen or avoidance of sun exposure
4) referral to dermatology
- multiple melanocytic nevi & a family history of melanoma
- dysplastic nevus syndrome
Related
clinical features distinguishing atypical from benign nevi
dysplastic nevus syndrome (inherited familial atypical mole & melanoma syndrome)
Specific
compound nevus
congenital melanocytic nevus
dermal melanocytic nevus (basal cell nevus)
dysplastic (Clark's) melanocytic nevus
halo nevus
junctional melanocytic nevus
Mongolian spot
nevus of Ota
nevus spilus
Spitz nevus; spindle cell nevus; epithelioid nevus
General
melanocytic neoplasm
nevus
References
- Saunders Manual of Medical Practice, Rakel (ed), WB Saunders,
Philadelphia, 1996, pg 960-61
- Color Atlas and Synopsis of Clinical Dermatology, Common
and Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY,
1997, pg 132-139
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015
- McCalmont T, Elston DM (images)
Medscape: Melanocytic Nevi
http://emedicine.medscape.com/article/1058445-overview
- DermNet NZ. Benign melanocytic lesions (images)
http://www.dermnetnz.org/doctors/lesions/melanocytic.html
- What You Need To Know About Moles and Dysplastic Nevi
http://www.cancer.gov/templates/doc.aspx?viewid=c3508072-3797-40c7-848b-7bbbe9ce16d4