Moles or Melanocytic nevi are benign, flesh colored, pink, brown, or black colored papules or they may be flat in appearance. Moles are made up of cells or melanocytes that are filled with melanin. Melanin is the pigment that allows one to tan, when exposed to sunlight.
Sun exposed skin will have more moles. Moles can be present at birth and continue to develop and grow during teen years. How many moles a person has depends on their genetic predisposition.
Benign moles will characteristically have one color, have well defined borders, and are uniform in appearance, round or oval in shape. Have a diameter of 6mm or less and remain relatively unchanged in size and color. Moles can be associated with terminal hairs.
Moles are rarely present at birth. Most begin to appear at adolescence and early adulthood. New nevi occasionally arise in adulthood and few appear later in life.
Moles can undergo maturation as an individual matures and can go from flat to raised or accumulate additional pigmentation. A deepening of the color is usually based on the level and amount of melanin pigmentation contained within the lesion.
A growing or changing mole is a youngster is almost always harmless. In contrast, a changing mole in an adult, or bleeding from the growth should be examined and biopsied. Malignant transformation is represented by ABCDE: Asymmetry, Border irregularity, Color variation, Diameter (bigger than a pencil eraser), and Evolving or changing.Sometimes around the mole the skin can lighten or become de-pigmented. This appearance of a white ring around the mole gives the diagnosis of “Halo Nevus” and is usually a benign phenomenon. This can however indicate early signs of a condition called Vitiligo. Vitiligo is an autoimmune condition, where an individual begins to lose pigmentation of their skin. Melanomas that are regressing or disappearing can also be represented by a similar halo. When the diagnosis is in doubt, your dermatologist can take a biopsy of the lesion and establish the diagnosis.
Moles in general are harmless and safe to ignore. Grounds for removal or biopsy would be any mole that shows the signs represented with ABCDE. A mole that is traumatized by clothing, combing the hair or shaving can be justified and removed. A mole that is unsightly and causes undue anxiety can be removed for “cosmetic reasons”.
Moles can be removed by a simple shave approach, whereby a protruding growth is leveled and rendered flat. The color usually remains the same. Melanocytes may on pathological examination be found at the excision edge of the tissue. The lesion may redevelop as time passes. The definitive removal of a mole requires an elliptical excision, whereby full thickness skin is removed. This method removes the top and bottom of the lesion. The wound is sutured leaving a linear scar, which over time becomes less noticeable. Which method of removal is often based on the location, size, and the number of moles in question. Your dermatologist can assist you in making the best decision for you.
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