Papillomatous nevus of the skin

Mole is one of the most unusual natural ornaments on the human body. To some, it gives a kind of charm, and then it is considered very sweet. Others complain that a birthmark on some part of the body is not very desirable and convenient gift of nature. However, whichever gift requires special attention, since from an innocuous benign neoplasm it can turn into skin cancer, especially if it is often subjected to mechanical (or thermal, chemical, etc.) damage. And it's good if the birthmark is level with all the surrounding skin, when the probability of damage is relatively small. And if we are dealing with such a neoplasm as the papillomatous nevus, which is noticeably towering above the surface, the risk in one not the most beautiful day of hearing a terrible diagnosis becomes much higher.

What is the papillomatous nevus?

Birthmark - a natural markings on the body, which appear in humans often in infancy. It is with this that the name of the new formation, entrenched in the people, is connected. To people who have a lot of moles on their bodies, the attitude is special. It is believed that the one whom nature from birth has awarded a large number of dark marks, will be very happy in life.

But is it really so, another question, because moles (nevuses) are not always a safe ornament, which sometimes promises not so much happiness as human tragedy. And the more on the body of birthmarks, the more careful a person needs to be in life. He has to carefully protect the skin in places of localization of nevi from various injuries and active sunlight, regularly inspect it for changes in shape, color or size of birthmarks and visit the dermatologist more than once a year, and with any unusual changes in the growths.

Particularly hard for those who have on the body convex birthmarks, including papillomatous nevus. I must say that this kind of birthmark is a dubious ornament, most often found on the head and neck area. But its appearance is also possible on other parts of the body.

Papillomatous nevus is a cellular structure having an irregular convex shape, not very pleasant in appearance. It consists of a mole of several jointed elongated processes of the epidermis and has a dense structure, since it is covered with a stratum corneum consisting of melanocytes. Melanocytes (pigment cells) make the neoplasm even more noticeable, although its color can vary from corporal to dark brown.

When viewed with a magnifying glass on the surface of the papillomatous (warty) nevus, many papillae can be seen, so its surface appears uneven, bumpy. Quite often around such birthmark you can see a dark rim of brown color, the surface of which is flush with the rest of the skin.

As we have already said, a papillomatous nevus resembling a strange complex wart, because of which it is sometimes called a warty, not very pleasant looking form, which can cause fears of the owner of such an "adornment", heard of the danger of degeneration of moles into cancer the name "melanoma". Therefore, many people have the question whether the papillomatous nevus neoplasm, which has such an unusual structure and irregular shape, is dangerous, is dangerous, because it is believed that the birthmark is safe to have the right shape and symmetrical structure.

Doctors believe that in itself this kind of birthmark, which can equally appear both at the birth of a child, and throughout the life of a person, is generally not dangerous. It is a benign new growth consisting of normal, not malignant cells, and if it is not traumatized, it will remain so for life. But it is in this moment that lies the snag. Any convex birthmark is more likely to be injured than its flat relatives. And if, in addition, such formation is located on the scalp, then the risk of trauma increases several times, because even the usual daily hair combing procedure is a trauma to the nevus.

If the mole is located on the neck, it can be regularly rubbed with a collar, which is also considered a small, but a trauma. And if a nevi receives such trauma regularly, it can lead to a change in the properties of its cells, i.e. To their degeneration into malignant ones.

As we see, the papillomatous nevus can hardly be called an ornament because of its unsightly appearance, and the convex shape makes it not very safe because of the high risk of injuring the build-up. It is for this reason that doctors often insist on removing such neoplasms, not expecting them to turn into melanoma.

Causes of the papillomatous nevus

Papillomatous nevus - one of the poorly studied neoplasms on the human body. Over the reasons for his appearance, doctors are fighting to this day, but a proven final version has not yet been put forward. Studies are at the stage of hypotheses and the most logical, and therefore widespread of them was the version that the appearance of papillomatous nevi is one of the violations of the development of the child in the embryonic period, i.е. In the womb.

There is an assumption that due to malfunctions in the embryo's developing organs, a greater accumulation of melanocytes is observed in certain areas of the skin, which form a dark speck that can have a different color intensity depending on the amount of the pigment. Melanocytes form an intradermal nevus that grows together with the baby's body and can increase under the influence of certain factors both during intrauterine development and after the birth of the baby.

As already noted, such birthmarks are observed in children from birth. It's just that they are more visible in some, but in other tumors it is practically invisible. Nevertheless, during a person's life, nevuses tend to increase in size several times, so at some point even a previously undetected growth becomes visible.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11]

Risk factors

Since we are talking about violations of embryonic development, there must be some reasons for such violations, because nothing in this world happens just like that, spontaneously. The risk factors for all kinds of disruptions in the emerging human organism can be:

• exposure to a pregnant woman of ionizing radiation (for example, X-ray studies, being in a radioactive zone, regular long exposure to the open sun, etc.)
• all kinds of poisoning (food, chemical, medicinal, toxic), associated with intoxication of the mother's body, because toxins are transmitted to the baby by the blood,
• infectious lesions of the genitourinary and other systems (pathogenic organisms also release substances that poison our body, plus stagnation in the excretory system can provoke intoxication products of our vital activity),
• hormonal imbalance with an increase in the level of estrogen in the blood of a future mother.

The increased growth of neoplasm in children and adults can be triggered by exposure to sunlight (for example, a mole on the head can grow if a person does not wear headgear protecting the nevus from sunlight), the use of strong chemistry at home and at work, living in a zone with a high radioactive background, etc. But the growth of the papillomatous nevus does not at all mean its degeneration into a malignant neoplasm or other complication, if there are no suspicious symptoms (redness, inflammation, appearance of necrotic areas, bleeding, etc.).

[12], [13], [14], [15], [16], [17], [18]

Pathogenesis

Papillomatous nevus is a neoplasm of appearance reminiscent of a wart or papilloma. Quite often such growths are found in newborns, which is not a cause for concern. But unlike ordinary moles, the appearance of papillomatous nevi is not an alarming sign in adulthood.

In fact, warty birthmarks appear even at the time of the birth of a child, they simply might not be noticeable at first. But as it grows and rises above the skin, the new formation becomes more prominent, and even more so when it is located on the face or neck. A man grows up and a mole grows. Usually its growth stops after 30 years.

Papillomatous nevi, which can be intradermal or develop on the basis of intradermal education, are considered benign and do not belong to the group of high-risk dangerous degeneration. According to statistics, such moles are very rarely transformed into skin cancer, but since there is such a danger, one should not forget about it. Moreover, melanoma, which develops on the site of localization of a once innocuous mole, can have a rapid development. And in this case it is better to remove the often traumatized nevus in advance and prevent the development of melanoma, than to then try to treat a deadly disease.

Such growths on the skin quite often have a large size (from 1 cm or more). And the large moles, detected in infants, have a 5% tendency to degeneration into malignant neoplasms. Yes, the risk is relatively small, but it exists. And when it comes to a disease that is difficult to treat and can cause a patient's death, even a small probability becomes a big danger.

Let's not seriously frighten the reader, because the probability of malignancy of cells in the case of papillomatous nevus is very low. Therefore, do not worry much if the neoplasm is just a cosmetic defect with a low risk of damage in the home. Nevertheless, caution should be a part of the patient's life, which will help prevent malignancy and other complications of the warty nevus.

[19], [20], [21], [22], [23], [24], [25], [26], [27]

Symptoms of the papillomatous nevus

Externally, the papillomatous nevus does not much resemble a habitual birthmark. Instead of a nice dark speck we see a bulging bulge on the skin with a granular surface resembling a papilloma on a thick leg (if we look at a birthmark under a microscope, its similarity to the fruits of a mulberry will also be noticeable).

But unlike soft to touch papillomas, the warty nevus has a denser structure and horny layer. In addition, most often this new growth is pigmented, i.e. More dark compared with other areas of the skin. Nevus flesh color is rare. Most neoplasms have a pink, brown or even a rare black shade.

Despite the irregular shape of the warty nevus has clear outlines and clear boundaries. Many of the nevi have a dark bezel.

On the surface of such an unusual birthmark, it is often possible to find dark hair growing directly from the neoplasm and making it look like a fibroepithelial nevus.

Nevi with or without hairs can be located not only on the scalp. They are also often found on the neck and face. Less often the neoplasms choose the location of their localization of the armpits, skin areas under the mammary glands, the groin area, etc.

With regard to the number of such tumors, they can be single or multiple, scattered throughout the body or located nearby in a restricted area. And if these growths did not grow, people would perceive them as ordinary birthmarks.

But papillomatous birthmarks tend to grow slowly and increase to large sizes, so on the body such formations look pretty ugly, leading the host of moles to despondency and even causing depression.

Papillomatous nevus is a non-inflammatory plan, so there should be no swelling and redness around it. On the surface of the neoplasm, which has a non-uniform, tubercular shape, nevertheless, there should be no purulent ulcers and bleeding cracks. The appearance of such symptoms may be the first sign of  inflammation and infection of a nevus due to damage to the comb, a collar of clothing, nails, etc., or to indicate the development of a malignant process, which is much less common.

On the malignancy of the cells of the mole, various changes can be said in it:

• nevus changed its color to a darker,
• on it appeared cracks and purulent-inflammatory foci,
• the shape of the neoplasm has changed,
• the edges of the build-up became uneven and indistinct,
• on the surface of the mole there appeared dots of a different color, dark foci of necrotic tissues, hairs began to drop out (if they had been there before),
• on the spot of the birthmark there was skin peeling, itching,
• the mole became painful,
• there were other multiple neoplasms of irregular shape (usually the papillomatous nevus grows to 30 years of age, if similar tumors appear later, this is an occasion to visit a dermatologist and conduct an appropriate examination, possibly even with the involvement of more than one specialist).

It should be understood that the rapid increase in any mole in size, the appearance of itching, swelling, pain, bleeding, and other unusual symptoms is a pathological process, because nevi are considered non-inflammatory tumors, and for them such behavior is uncommon. The appearance of such symptoms may indicate both the damage and infection of the mole, as well as the more sad consequences - the initial stage of  melanoma.

Despite the low risk of degeneration into a malignant neoplasm any changes in appearance and sensations in the place of the birthmark can not be ignored. This will help to avoid life-threatening complications.

Forms

So far, we have talked about the papillomatous nevus as a kind of cellular structure that towers over the patient's body. But they mentioned that such birthmarks may differ somewhat in appearance, which makes it possible to classify them, dividing them into separate types and forms.

The papillomatous intradermal nevus, or neoplasm of the verrux type, is a formation strongly resembling a papilloma or a wart. It appreciably rises above the skin, but practically does not differ from it in color or has a light brown or pale pink shade. For her, a characteristic rough surface, often a mole consists of two or more lobes (several moles, located in a small area tightly to each other). Such a mole grows very slowly, it becomes inflamed and bleeds in single cases, is practically not inclined to degeneration into a malignant tumor.

Papillomatous and verruzic nevuses are not different types of moles. The warty nevus  is one of the varieties of the verrucous mole, which has a convex shape and a tuberous structure. Verrux nevus  can also be keratotic (strongly dense with a thick horny layer) or ichthyosiform (growths similar to the papilloma, sometimes have bubbles on the surface, then they are called bullous).

Papillomatous melanocytic nevus  is a pigmented type of convex neoplasm that can have both an intradermal and a borderline character. Such birthmarks often appear on open areas of the skin (on the neck, face, under the mammary glands, etc.), not covered with hair. Their color is determined by a large number of melanocytes in the middle and surface layers of the skin, so the nevus can be either brown or almost black.

Melanocytes - cells that are found in large numbers on the surface of the  papillomatous pigmented nevus are more prone to degeneration. Their presence in the upper layers of the skin makes these cells more sensitive to the negative effects of sunlight and mechanical trauma, which sometimes leads to the malignancy of nevus cells (albeit extremely rare). This is more common for border nevuses with localization of melanocytes in the epidermis.

The hair type of the papillomatous nevus is characterized by the fact that one or several rather long hairs can be found on the surface of such neoplasms. Moles, which grow hair, are considered completely safe. But if a person pulls out hairs growing on a mole, he will injure the cells of the neoplasm, and they can behave unnaturally in this case. The development of melanoma can also be indicated by the situation when the hair on the mole falls out on its own and does not appear any more.

Such a variety as the  papillomatous mixed nevus is  sometimes also called complex, since nevocytes (germinal cells of a birthmark) can be located both in the middle layer of the dermis and at the border with the epidermis. If such a neoplasm consists of several nearby moles, then a part of the papillae on it may have a lighter shade. The surface of this nevus is even more uneven.

In addition to various types of papillomatous nevus. There are also 2 forms of similar neoplasms: organic and desymminated.

Organic (localized) form of warty nevi is considered more common. In this case, we are talking about single neoplasms, as well as several moles located close to each other in a restricted area of the body. Moles can be the same color or have different colors, up to bispigment or gray. This form is considered safe due to the fact that it does not talk about any health disorders in humans.

Dessiminated (systemic) form is characterized by the appearance on the body of multiple pigmented nevuses resembling warts. And there are birthmarks on different parts of the body. This form does not always indicate the danger of health problems, but it is often enough to testify to serious neurological problems. Multiple moles can be observed on the body of patients with lesions of the central nervous system, and in particular with epilepsy.

Nevus in the systemic form may behave inadequately. For example, grow throughout the life of the patient or dry up and fall off without any impact on them from the outside.

[28], [29]

Complications and consequences

Although the papillomatous nevus itself does not pose a health hazard, and in most cases it is regarded as an unaesthetic cosmetic defect, one can not carelessly treat a neoplasm. The fact that he is rarely inclined to grow into melanoma does not mean that it is impossible at all. The degeneration of the papillomatous nevus, as well as the malignancy of the usual birthmark, can be triggered by ordinary household trauma (the same hair combing), and if it is repeated regularly, it is unlikely that everything will go without consequences, especially if it is a pigment nevus.

But a certain risk of developing melanoma is not the only danger that a safe "wart" in itself can conceal. Severe damage to the nevus during combing and washing the head, during hygiene procedures, with irritation by the collar of clothes or by pure chance with the formation of a bleeding wound is fraught with the possibility that an infection that can cause inflammation and suppuration of the nevus tissues can enter the blood. The presence of a bacterial or viral infection in the bloodstream is also fraught with generalization of the process (sepsis), which leads to disruption of the work of various organs and body systems.

But that's not all. Unlike a lovely mole, a papillomatous nevus can not be considered a cute and attractive adornment on the body. Many people who are lucky enough to own such a gift of nature are very worried about the unattractiveness of this cosmetic defect. A brown or black wart on the face, and even with dark hairs growing out of it, can hardly brighten anyone.

Large pigmentless pigmented neoplasms are visible even on the scalp, if the hair is not thick enough for a person. The very appearance of such a birthmark in adolescence and adulthood can be a shock to a person. The nevus, which has a strange appearance and resembles a malignant birthmark, will cause strong emotional experiences, sometimes reaching depression.

Insecurity due to a cosmetic defect in conjunction with feelings about the safety of a neoplasm is a strong blow to the psyche, especially in adolescence. The teenager still does not think about the fact that the nevus can be safely removed by contacting a medical institution. Young people at this age tend to hide their problems and try to solve them on their own, for example, removing the nevus at home in the absence of necessary research, without sterility compliance by questionable methods, which is fraught with complications not only psychological but also physical.

Sometimes the medical removal of the papillomatous nevus is the only correct solution to the problem. And not only when the birthmark is constantly injured, but even in cases where the presence of such a cosmetic defect causes serious psychoemotional disorders and pushes people to ill-considered actions.

[30], [31], [32], [33], [34], [35], [36]

Diagnostics of the papillomatous nevus

No matter how diligently we now describe the appearance and symptoms of the papillomatous nevus, we can determine by an unprofessional glance that it is not so easy for you to see this neoplasm in front of you. The similarity of the warty birthmark to other growths and modified ordinary nevi makes the diagnosis very difficult. If such a neoplasm is found, especially if it appeared in adulthood, one should not rely heavily on one's own strength. It is better to spend several hours on a campaign to the doctor than to study the strange tubercle in front of the mirror every day and worry about its safety, inconvenience, unaesthetic, etc.

Some patients believe that while the mole does not bother and does not hurt, it's all right and there are no reasons for visiting the dermatologist. But we must always remember that melanoma can also start painlessly, and when pain appears, time will be lost. So it's better to be safe and immediately show a strange new growth to a specialist. Especially since the diagnosis does not take much time and effort.

In occasion of various neoplasms on a skin it is accepted to address to the expert to the dermatologist. An experienced doctor, even without special research and analysis, can often say what we are dealing with and how much a birthmark is dangerous. But to make sure of the correctness of the initial diagnosis, doctors prefer to conduct instrumental diagnostics.

The methods of instrumental diagnosis, relevant for the study of moles on the body include:

• Dermatoscopy is the most popular method of studying moles with the use of a special strong microscope, which displays an image on the computer screen (dermatoscope). Helps to see the smallest changes on the surface of the tumor.
• SIAScopy is a non-invasive study that is a spectrophotometric scan of pigmented tumors using an apparatus called a siascaner. This method is sometimes called deep dermatoscopy, because it allows you to obtain a three-dimensional image of the result of dermatoscopy, melanin and skin collagen, blood. The accuracy of the study on the detection of melanoma and skin cancer reaches 90%.

Laboratory diagnosis is usually required if instrumental studies indicate changes in neoplastic cells or are controversial. The general analysis of blood and blood on oncomarkers are preliminary studies. More precisely, whether the mole is a melanoma, can only histological examination after a biopsy.

And since melanoma after it is disturbed, begins to develop more rapidly, a biopsy of such neoplasms is usually done after their removal. In principle, when it comes to papillomatous nevi, it is even desirable to remove them, because a certain discomfort is associated with these ugly build-ups: they are often traumatized, they significantly damage the appearance of a person, and cause strong psycho-emotional experiences.

[37], [38], [39], [40], [41], [42], [43]

Differential diagnosis

A major role in the study of moles of the patient is assigned to differential diagnosis. Still, the papillomatous nevus has some similarities with many other neoplasms, and if traumatized, it can strongly resemble melanoma.

The greatest similarity of the warty nevus is with the papilloma (hence one of the names of the birthmark). Papilloma is  also a benign neoplasm, but the cause of the appearance of growths on the skin is the papilloma virus, which for a long time may be in the body incognito.

Appearance of neoplasms in papillomatosis of the skin differs little from the papillomatous nevus. These are the same tubercles on a thick base (sometimes on a thin stem), which can have a color from beige to light brown. They can be localized in the groove and perineum, on the mucous membranes, on the neck and eyelids, in the axillary region. The size can range from tiny pointed warts to outgrowths of about 2 cm in diameter.

What is the difference between papilloma and papillomatous nevus? To begin with, papillomatosis is an acquired disease that develops as a result of the virus entering the human body and its subsequent activation. Papillomatous nevus is an innate neoplasm that can become visible a little later as it grows.

The color of the papilloma usually does not differ from the color of the human skin, while the warty nevus can have different shades: flesh, pink, red, brown, purple, black.

The papillomatous nevus, though often irregular in shape, is a symmetrical neoplasm with clear boundaries. There are no such limitations for the papilloma.

Inside the nevus, a certain amount of melanocytes are accumulating, making the new growth more dense than the rest of the skin. Papilloma, on the contrary, is very soft with a gentle surface.

For papillomas on the skin soreness, itching or burning is considered normal. Such a symptomatology on moles can indicate tissue damage, nevus cell degeneration, and infection.

The pigmented type of the papillomatous nevus has a certain similarity with the borderline pigment nevus. It is a birthmark up to 1 cm in size with a bright shade (gray, brown or black) and a smooth surface. It is characterized by an intensification of the intensity of the color closer to the edge of the mole, the absence of hairs, slow growth. It is also an innate neoplasm, which, unlike the papillomatous nevus, is considered melanoma-dangerous.

Galoneuvus (or Nevton Settona ) also externally can be similar to a papillomatous birthmark of a pigmented type. But this neoplasm has a distinctive feature - around it a rather wide border of a skin of a lighter shade is formed. This rim is much lighter than the mole itself, but also the rest of the human skin. It can be either single or multiple growths with predominant localization in the back area.

Halonovus as well as papillomatous nevus rarely develops into melanoma, but if such neoplasms are much likely that the patient will have other pathologies, such as inflammatory thyroid disease (thyroiditis), which often causes hypothyroidism (organ failure), a violation of skin pigmentation , called "vitiligo", or secretly leaking skin cancer.

Papillomatous nevus pigmented type can be quite large and then it becomes like a giant pigment nevus. Giant nevus is also considered a benign congenital neoplasm, but due to its size (from 20 cm in diameter), it is highly prone to traumatization, which is why it is considered melanomo dangerous. For example, in infants, in 5% of cases, the birthmark degenerates into melanoma.

Another convex neoplasm, which may have a thin or fairly thick stem, is called fibroepithelial nevus or fibropapilloma. Such neoplasms can often be found on the face and body (especially the armpits), but sometimes they are also found on the skin of the upper and lower extremities. This is a benign form of nevi, which can be both congenital and acquired, appearing at different ages.

The size of the neoplasm can range from 2 mm to 2 cm, although there are also larger growths. They have a spherical shape, a fairly smooth surface and soft to the touch. It is possible to grow hairs on the surface of the build-up. The color of fibropapilloma can also be different, but in general it is usually lighter than pigmented nevi. Most often, fibropapillomas are found on the face and body of the weaker sex.

Papillomatous nevus, which may have an irregular shape, somewhat heterogeneous color and different sizes, must be differentiated from the rare form of moles, called dysplastic nevus. And although this form of neoplasm is diagnosed only in 4-5% of cases, it is considered quite dangerous and is close to the precancerous state.

If the disease has a rare hereditary nature, then there can be several such neoplasms on the body. And even if some members of the family do not show this kind of moles, they should still be examined regularly by a dermatologist and, if necessary, by an oncologist.

Acquired disease usually manifests itself as single neoplasms (sporadic type). With papillomatous nevus may be similar in appearance:

• a typical form (a new growth with an elevation in the center of various shades of brown of different shapes),
• keratolic form (excrescence, having a hilly surface, light brown hue and large dimensions),
• erythematous form (large pink mole).

In contrast to the papillomatous nevus, the dysplastic form of moles, which is characterized by bizarre forms and uneven coloration, is very prone to malignant cells and must be constantly monitored by a physician. Ideally, such moles are best removed immediately, without waiting for their degeneration into a cancerous tumor.

Papillomatous nevus in some cases may have a bluish or violet hue, which resembles a  blue nevus  (the blue birthmark of Jadasson-Tiche). Sometimes such neoplasms from blue to almost black can rise above the skin in the form of a nodule up to 1 cm in diameter (although there are instances 2-3 times larger). The favorite places of the blue nevus are the lower leg and forearm, the hands and feet (on the back), buttocks, but similar specimens of moles can also be found on the face, neck, trunk or in the lips.

The blue nevus is quite dense to the touch, but its tissues remain elastic, and the surface is smooth. Hair on such birthmarks do not usually grow. The papillomatous pigment nevus is more similar to the cellular form of the blue birthmark with a dark color, rather large size and often uneven surface.

Despite the fact that in melanoma such tumors rarely pass, they are considered melanomopods and require regular monitoring.

We listed only some of the neoplasms on the skin with which it is worthwhile to differentiate the papillomatous birthmark. In fact, there are a lot more of them, and everyone can conceal a certain danger in themselves.

As you can see, the papillomatous nevus is far from the only new type of this type that can appear on the human body. And unlike the warty birthmark, some of them have a rather high risk of degeneration into a cancerous tumor. The similarity of the examined neoplasm with others causes certain difficulties in conducting self-diagnosis, so it is very difficult for a person who is far from dermatology to accurately diagnose. Such responsible work should be entrusted to professionals.

[44], [45], [46], [47]

Treatment of the papillomatous nevus

By themselves, papillomatous nevi are completely harmless neoplasms, if not for the discomfort caused by them and a great risk of traumatizing the birthmark, which will lead to a change in the properties of the cells or the infection of tissues. If the birthmark is located on the head of a person will constantly worry about what can damage it while combing your hair, washing your head or haircuts. The nevus in the form of an ugly wart on the face will constantly evoke complexes from its master about its external unattractiveness. Birthmarks on the neck and underarms are prone to rubbing and irritation with clothing. Whatever it was, but the inconvenience is obvious.

Treatment of papillomatous moles is to remove them by an experienced specialist in a clinic. There are no other safe ways to solve the problem. Attempts to get rid of "warts" at home by burning or bandaging can lead to deplorable results, nevertheless moles respond to injuries differently than normal warts or papillomas. In addition, there is always the risk of infection of the wound at the site of the former mole.

Removal of papillomatous nevus can be prescribed for several reasons. It is mandatory if the rapid growth of the neoplasm has been observed, cracks and festering sores appeared on it, the place around the mole inflamed and blushed. Itching, peeling, soreness of the build-up can also indicate unhealthy changes in nevus cells, so the mole will be better removed.

But even if the mole does not hurt and does not itch, but there is a big risk of its regular damage, a person can consult a doctor about the treatment of a neoplasm, and the specialist will definitely meet him. As well as in the event that the birthmark spoils the appearance of the patient, located in the visible places: on the face, neck, head. The possibilities of plastic surgery are such that even after removing large neoplasms on the body there remains an almost unnoticeable scar that looks much more aesthetic than some moles of a strange kind.

Moles, the presence of which can cause depression and neuroses in their owner, are also subject to disposal, even if they are considered safe.

Ways to remove the birthmark safely and almost painlessly great variety. This can be done with a surgical scalpel, laser, electricity, radio waves, cold. It is clear that the patient has the right to choose which method is better to remove the tumor, but still it is worth to listen to the opinion of the doctor who will choose the best option based on the studies and diagnosis.

For example, if the papillomatous nevus undergoes changes resulting from trauma associated with cancer, the best method is traditional surgical treatment, when the mole is removed promptly with a scalpel. Such treatment will help stop the spread of a cancerous tumor, since not only patients, but also a part of healthy tissues, where separate malingering cells can be removed, are subject to removal.

Surgical removal of moles can be prescribed for those patients for whom other more modern methods of treatment are contraindicated because of existing diseases, peculiarities of the organism, the presence of metal implants, etc. The operation does not require the introduction of general anesthesia and local anesthesia is applied.

The plus of this treatment is the complete absence of absolute contraindications and carrying it out in a hospital by a qualified surgeon, and not in a cosmetology room or clinic where other ways of removing moles are practiced. There are several relative contraindications to surgery, such as acute infectious and inflammatory processes, herpetic eruptions on the body. The possibility of surgery during pregnancy and lactation will need to be discussed with the doctor.

A surgical scar is considered a scar on the site of an ex-birthmark, especially if the neoplasm was large or the melanoma developing on the site of the nevus was to be removed. Ugly scars help to correct a small plastic surgery.

One of the most popular innovative methods of removing various neoplasms on the skin and mucous membranes is laser treatment. It can take place under both local anesthesia and without it, since the patient does not experience any significant pain sensations. The laser sequentially removes the expanded nevus cells.

Positive aspects of such treatment are: imperceptible scars and absence of scars formed if the wound is long healing, bloodlessness (the laser removes the tumor and immediately coagulates the vessels and disinfects the wound), a small risk of inflammation at the site of surgery, a short recovery period with proper care wounded. Laser treatment shows the best cosmetic effect (there remains practically unnoticeable scarf), therefore it is recommended if the mole is located on the face or neck. But if there is no certainty that the neoplasm is benign, such treatment is not carried out, because it does not leave material for carrying out histology, although only the tissues of the birthmark are to be removed.

Disadvantages of treatment can be considered a higher cost compared with a surgical operation. True, the result is worth it. And even if the skin remains a scar, it can be corrected again with a laser.

Electrocoagulation is actually burning out a birthmark with an electric current. Such treatment will be effective at small moles. Unlike laser treatment, after it there are tissues that can be taken for histology, and this can be considered a plus.

Positive aspects of the procedure can be considered the absence of bleeding, the possibility of carrying out under local anesthesia, the short duration of the operation and the recovery period, the absence of damage to healthy tissues. But the method also has one big drawback: after the operation, appreciable scars can remain, so the electrocoagulation method is not used to remove moles on the face.

Cryodestruction or the removal of a mole by freezing it also belongs to the category of innovative technologies. With the aid of a special apparatus with liquid nitrogen, only the tissues of the mole are frozen. A low temperature leads to necrosis and death of nevus cells.

For all the effectiveness of the operation, doctors do not recommend conducting it on open areas of the skin (on the face and neck), except that the operation is conducted by a highly qualified specialist, who can be entrusted with such a scrupulous business. The doctor should calculate everything to a millimeter, because too deep exposure to liquid nitrogen is fraught with the development of a cold burn of tissues, which can cause the formation of a non-esthetic postoperative scar.

Cryodestruction is not used if there is a need for sampling for further tissue research.

Radio wave removal of the papillomatous nevus is a very effective method of solving a problem with many advantages. Among them we can distinguish:

• almost complete absence of pain, which rejects the need for even local anesthesia,
• the minimum duration of the procedure (usually less than 5 minutes),
• minimum risk of scarring and scarring,
• the absence of such consequences as swelling of the tissues, inflammation, suppuration of the wound due to infection.
• very rapid regeneration of tissues after surgery, which gives the best cosmetic effect.

The radio wave method can remove papillomatous nevi on any part of the body. The method does not lead to the destruction or death of cells, which means that the biomaterial can always be taken for histology.

As we see, the removal of papillomatous pigmented neoplasms does not cause special difficulties and is available in virtually any hospital (surgical method). But a person always has a sufficient choice of treatment options, which it is a sin not to use, if the birthmark interferes with normal living and feels confident in yourself and your attractiveness.

And the removal of moles is a universal method of treatment, regardless of the reason that led to such cardinal methods: the inconvenience and unethical nature of the tumor or its transformation into a malignant tumor.

Prevention

Papillomatous nevus is a harmless formation on the skin, which has an innate character, which means that a person can not prevent his appearance from himself. It's another matter if the expectant mother will take care that her baby does not show any new growth after birth, which will cause psychoemotional disorders, bullying in the children's team, painful injuries and possibly degeneration into a malignant tumor.

The preventive measures that must be followed by a pregnant woman, in this case will be:

• refusal from the use of alcohol and other toxic products,
• the use of natural products that do not contain nitrates, preservatives, dyes and other harmful additives,
• caution in the choice of medicines,
• choosing a place of residence with a normal radiation background,
• minimizing direct skin contact with strong household chemicals,
• refusal to work with toxic and toxic substances,
• use of relatively safe detergents and cleaners,
• timely treatment of emerging urogenital and other infections in the body of a woman,
• prevention of all kinds of diseases both during pregnancy and on the eve of conception of the child.

If you avoid the appearance of papillomatous pigmented formations on the face, head and body could not be avoided, you need to closely monitor such birthmarks, trying not to allow their injury and prolonged exposure to ultraviolet radiation. To examine birthmarks, even if they do not bother, it is recommended that once a week, before the mirror.

The slow growth of papillomatous nevi is not a cause for particular concern, except from a cosmetic point of view. But if the mole begins to grow very quickly, changes color and shape, starts to bleed or fester, you need not postponing for a later consultation in this regard with a dermatologist, and if necessary, an oncologist.

The papillomatous nevus is not the most attractive adornment on the body, so do not be afraid to part with it if the neoplasm brings physical and psychological discomfort. Such operations are not new to doctors, so the prognosis of treatment is overwhelmingly positive. It is clear that the treatment of malignant neoplasms no longer gives one hundred percent guarantee of recovery, so it is very important to turn to specialists for help in a timely manner, without waiting until unusual changes are recorded on the birthmark.

[48], [49], [50], [51], [52], [53], [54]