Melanocytic nevus
Encyclopedia
A melanocytic nevus is a type of lesion
that contains nevus cell
s (melanocytes).
Some sources equate the term mole with "melanocytic nevus". Other sources reserve the term "mole" for other purposes.
The majority of moles appear during the first two decades of a person’s life, while about one in every 100 babies is born with moles. Acquired moles are a form of benign
neoplasm, while congenital moles, or congenital nevi, are considered a minor malformation or hamartoma
and may be at a higher risk for melanoma. A mole can be either subdermal (under the skin) or a pigmented growth on the skin
, formed mostly of a type of cell
known as a melanocyte
. The high concentration of the body’s pigmenting agent, melanin
, is responsible for their dark color
. Moles are a member of the family of skin lesions known as nevi.
, the most common types of moles are skin tags, raised moles and flat moles. Benign
moles are usually circular or oval and not very large, though some can be larger than the size of a typical pencil eraser. Some moles typically produce dark, coarse hair
. Common mole hair removal procedures include plucking, cosmetic waxing, electrolysis
, threading
and cauterization.
The number of moles a person has correlates with telomere
length. One study found that people with over 100 moles had longer telomeres than those with under 25 moles. The length of telomeres may be of significance in the ageing
process. Shorter telomeres are thought to be associated with a greater risk of age-related diseases.
can have an influence on a person's moles.
Dysplastic nevi
and atypical mole syndrome are hereditary conditions which causes a person to have a large quantity of moles (often 100 or more) with some larger than normal or atypical. This often leads to a higher risk
of melanoma
, a serious skin cancer
. Dysplastic nevi are more likely than ordinary moles to become cancerous. Dysplastic nevi are common, and many people have a few of these abnormal moles. Having more than 50 ordinary moles increases the risk of developing melanoma.
In the overall population, a slight majority
of melanomas do not form in an existing mole, but rather create a new growth on the skin. Somewhat surprisingly, this also applies to those with dysplastic nevi. They are at a higher risk of melanoma occurring not only where there is an existing mole, but also where there are none. Such persons need to be checked regularly for any changes in their moles and to note any new ones.
that overexposure to UV, including excessive sunlight
, may play a role in the formation of acquired moles. However, more research
is needed to determine the complex interaction between genetic makeup and overall exposure to ultraviolet light. Some strong indications that this is so (but falling short of proof), are:
Studies have found that sunburns and too much time in the sun can increase the risk factors for melanoma. This is in addition to those who have dysplastic nevi being at higher risk of this cancer
. (The uncertainty is in regard to acquiring benign moles.) To prevent and reduce the risk of melanoma caused by UV radiation, the American Academy of Dermatology
and the National Cancer Institute
recommends staying out of the sun between 10 a.m. and 4 p.m. standard time (or whenever your shadow
is shorter than your height). The National Cancer Institute also recommends wearing long sleeves and trousers, hats with a wide brim, sunscreens, and sunglasses that have UV-deflecting lenses.
. An online-screening test
is also available to help screen out benign moles.
. Conversely, a junctional nevus, which develops at the junction of the dermis and epidermis, is potentially cancerous.
A basic reference chart used for consumers
to spot suspicious moles is found in the mnemonic
A-B-C-D, used by institutions such as the American Academy of Dermatology and the National Cancer Institute. The letters stand for Asymmetry, Border, Color, and Diameter. Sometimes, the letter E (for Elevation or Evolving) is added. According to the American Academy of Dermatology, if a mole starts changing in size, color, shape or, especially, if the border
of a mole develops ragged edges or becomes larger than a pencil
eraser
, it would be an appropriate time to consult with a physician. Other warning signs include a mole, even if smaller than a pencil eraser, that is different than the others and begins to crust over, bleed, itch
, or becomes inflamed. The changes may indicate developing melanomas. The matter can become clinically complicated because mole removal depends on which types of cancer, if any, come into suspicion.
A recent and novel method of melanoma detection is the "Ugly Duckling Sign" It is simple, easy to teach, and highly effective in detecting melanoma. Simply, correlation of common characteristics of a person's skin lesion is made. Lesions which greatly deviate from the common characteristics are labeled as an "Ugly Duckling", and further professional exam is required. The "Little Red Riding Hood" sign, suggests that individuals with fair skin and light colored hair might have difficult-to-diagnose melanomas. Extra care and caution should be rendered when examining such individuals as they might have multiple melanomas and severely dysplastic nevi. A dermatoscope must be used to detect "ugly ducklings", as many melanomas in these individuals resemble non-melanomas or are considered to be "wolves in sheep clothing". These fair skinned individuals often have lightly pigmented or amelanotic melanomas which will not present easy-to-observe color changes and variation in colors. The borders of these amelanotic melanomas are often indistinct, making visual identification without a dermatoscope very difficult.
People with a personal or family history of skin cancer or of dysplastic nevus syndrome
(multiple atypical moles) should see a dermatologist at least once a year to be sure they are not developing melanoma.
. Nonetheless, the U.S. National Cancer Institute
estimated that 62,480 new cases of melanoma
and 8,420 related deaths would appear in the United States in the year 2008.
, shave excision, electrodesiccation or cryosurgery may be performed, usually leaving very little if any scarring. If the lesion is suspected to be a skin cancer
, a skin biopsy
must be done first, before considering removal. This is unless an excisional biopsy is warranted. If the lesion is a melanocytic nevus, one has to decide if it is medically indicated or not.
If a melanocytic nevus is suspected of being a melanoma
, it needs to be sampled or removed and sent for microscopic evaluation by a pathologist by a method called skin biopsy
. One can do a complete excisional skin biopsy
or a punch skin biopsy
, depending on the size and location of the original nevus. Other reasons for removal may be cosmetic, or because a raised mole interferes with daily life (e.g. shaving
). Removal can be by excisional biopsy or by shaving
. A shaved site leaves a red mark on the site which returns to the patient’s usual skin color
in about two weeks. However, there might still be a risk of spread of the melanoma, so the methods of Melanoma diagnosis, including excisional biopsy, are still recommended even in these instances. Additionally, moles can be removed by laser, surgery or electrocautery.
In properly trained hands, some medical lasers are used to remove flat moles level with the surface of the skin, as well as some raised moles. While laser treatment is commonly offered and may require several appointments, other dermatologists think lasers are not the best method for removing moles because the laser only cauterizes
or, in certain cases, removes very superficial levels of skin. Moles tend to go deeper into the skin than non-invasive lasers can penetrate. After a laser treatment a scab is formed, which falls off about seven days later, in contrast to surgery, where the wound has to be sutured. A second concern about the laser treatment is that if the lesion is a melanoma, and was misdiagnosed as a benign mole, the procedure might delay diagnosis. If the mole is incompletely removed by the laser, and the pigmented lesion regrows, it might form a recurrent nevus.
Electrocautery is available as an alternative to laser cautery. Electrocautery is a procedure that uses a light electrical current to burn moles, skin tags, and warts off the skin. Electric currents are set to a level such that they only reach the outermost layers of the skin, thus reducing the problem of scarring. Approximately 1-3 treatments may be needed to completely remove a mole. Typically, a local anesthetic is applied to the treated skin area before beginning the mole removal procedure.
For surgery, many dermatologic and plastic surgeons first use a freezing solution
, usually liquid nitrogen
, on a raised mole and then shave it away with a scalpel
. If the surgeon opts for the shaving method, he or she usually also cauterizes
the stump
. Because a circle
is difficult to close with stitches, the incision is usually elliptical or eye-shaped. However, freezing should not be done to a nevus suspected to be a melanoma, as the ice crystals can cause pathological changes called "freezing artifacts" which might interfere with the diagnosis of the melanoma.
or an anesthetic allergy or even nerve damage
. Lastly, the mole removal may imply an uncomfortable scar
depending on the mole size.
" when it appeared in certain spots on a woman’s face
. Examples include Marilyn Monroe
, model Cindy Crawford
, singer Madonna
, and the fictional Ms. Pac-Man
. Madonna's facial mole—below her right nostril—has been surgically removed. Almost everybody has at least one or two moles somewhere on his or her body
, while large numbers can be concentrated on the back
, chest
, and arm
s. Although they can be less noticeable because of the similar colors of the surrounding skin, darker skin shades have equivalent incidences of moles to lighter skin shades. Some folklore
about moles includes the notion that picking at a mole can cause it to become cancerous or grow back larger. While chronic picking or irritation
(by clothing) of a mole can be detrimental in many ways, it has not been associated with a higher incidence of cancer
. It is recommended by physicians that a dermatologist examines a mole to see if it should be removed. The dermatologist or plastic surgeon can perform the procedure with an eye toward preventing a larger scar
.
Throughout human history, individuals who have possessed facial moles have been subject to ridicule and attack based on superstition. Throughout most of history, facial moles were not considered objects of beauty
on lovely faces. Rather most moles were considered hideous growths that appeared mostly on the noses
, cheek
s, and chin
s of witches, frog
s and other low creatures
.
Both folklore
and modern popular culture
use physical traits to denote a character's either good or evil
tendencies. In contrast to the fine features and smooth skin of its heroes and heroines, characters who possess negative or evil characteristics have also been known to possess more rugged features and skin blemishes, including facial moles.
In Medieval Europe, among those accused of demonic possession, ecclesiastical edicts interpreted large warts and moles on the skin as physical signs of the entry point of the devil
into the soul.
In the 16th century, a popular pseudoscience
was invented that supposedly described how every facial mole had a corresponding birthmark
somewhere else on the body
. Once you knew where both moles were, the theory went, you had the inside track on what made the person tick. For instance, if a man had a mole on the bridge of his nose
, he supposedly had another on his right thigh
. Taken together, the moles meant the owners were persons of good moods
and would eventually receive healthy inheritance
s.
Moles that can be easily seen may be considered warnings or reminders, while hidden moles may symbolize good luck and fortune. Furthermore, traditional Chinese culture holds that each facial mole indicates the presence of a corresponding mole on another part of the body. For instance, if a mole is present around the mouth, a corresponding mole should be found in the pubic region.
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
that contains nevus cell
Nevus cell
Nevus cells are a variant of melanocytes. They are larger than typical melanocytes, do not have dendrites, and have more abundant cytoplasm with coarse granules. They are usually located at the dermoepidermal junction or in the dermis of the skin...
s (melanocytes).
Some sources equate the term mole with "melanocytic nevus". Other sources reserve the term "mole" for other purposes.
The majority of moles appear during the first two decades of a person’s life, while about one in every 100 babies is born with moles. Acquired moles are a form of benign
Benign
A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...
neoplasm, while congenital moles, or congenital nevi, are considered a minor malformation or hamartoma
Hamartoma
A hamartoma is a benign, focal malformation that resembles a neoplasm in the tissue of its origin. This is not a malignant tumor, and it grows at the same rate as the surrounding tissues. It is composed of tissue elements normally found at that site, but which are growing in a disorganized mass...
and may be at a higher risk for melanoma. A mole can be either subdermal (under the skin) or a pigmented growth on the skin
Skin
-Dermis:The dermis is the layer of skin beneath the epidermis that consists of connective tissue and cushions the body from stress and strain. The dermis is tightly connected to the epidermis by a basement membrane. It also harbors many Mechanoreceptors that provide the sense of touch and heat...
, formed mostly of a type of cell
Cell (biology)
The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....
known as a melanocyte
Melanocyte
-External links: - "Eye: fovea, RPE" - "Integument: pigmented skin"...
. The high concentration of the body’s pigmenting agent, melanin
Melanin
Melanin is a pigment that is ubiquitous in nature, being found in most organisms . In animals melanin pigments are derivatives of the amino acid tyrosine. The most common form of biological melanin is eumelanin, a brown-black polymer of dihydroxyindole carboxylic acids, and their reduced forms...
, is responsible for their dark color
Color
Color or colour is the visual perceptual property corresponding in humans to the categories called red, green, blue and others. Color derives from the spectrum of light interacting in the eye with the spectral sensitivities of the light receptors...
. Moles are a member of the family of skin lesions known as nevi.
Classification
Melanocytic nevi represent a family of lesions. The most common variants are:- Location:
- Junctional nevusJunctional nevusA junctional nevus is a mole found in the junction between the epidermis and dermis layers of the skin. These moles may be pigmented and slightly raised, and have a higher risk of developing into malignant melanoma.- External links :...
: the nevus cells are located along the junction of the epitheliumEpitheliumEpithelium is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. Epithelial tissues line the cavities and surfaces of structures throughout the body, and also form many glands. Functions of epithelial cells include secretion, selective...
and the underlying dermisDermisThe dermis is a layer of skin between the epidermis and subcutaneous tissues, and is composed of two layers, the papillary and reticular dermis...
. A junctional nevus is flat and brown to black. - Compound nevusCompound nevusA compound nevus is a type of mole formed by groups of nevus cells found in the epidermis and dermis .- External links :* entry in the public domain NCI Dictionary of Cancer Terms...
: a mixture of junctional and intradermal proliferation. Compound nevi are slightly raised and brown to black. Beauty markBeauty markA beauty mark or beauty spot is a euphemism for a type of dark facial mole, so named because such birthmarks are sometimes considered an attractive feature. Medically, such "beauty marks" are generally melanocytic nevus, more specifically the compound variant...
s are usually compound nevi of either the acquired variety or congenital variety. - Intradermal nevus: the nevus cells are located in the dermisDermisThe dermis is a layer of skin between the epidermis and subcutaneous tissues, and is composed of two layers, the papillary and reticular dermis...
only. Intradermal nevi are raised; most are flesh-colored (not pigmented).
- Junctional nevus
- Dysplastic nevusDysplastic nevusA dysplastic nevus is an atypical melanocytic nevus; a mole whose appearance is different from that of common moles. Dysplastic nevi are generally larger than ordinary moles and have irregular and indistinct borders...
(nevus of Clark): usually a compound nevus with cellular and architectural dysplasiaDysplasiaDysplasia , is a term used in pathology to refer to an abnormality of development. This generally consists of an expansion of immature cells, with a corresponding decrease in the number and location of mature cells. Dysplasia is often indicative of an early neoplastic process...
. Like typical moles, dysplastic nevi can be flat or raised. While they vary in size, dysplastic nevi are typically larger than normal moles and tend to have irregular borders and irregular coloration. Hence, they resemble melanomaMelanomaMelanoma is a malignant tumor of melanocytes. Melanocytes are cells that produce the dark pigment, melanin, which is responsible for the color of skin. They predominantly occur in skin, but are also found in other parts of the body, including the bowel and the eye...
, appear worrisome, and are often removed to clarify the diagnosis. Dysplastic nevi are markers of risk when they are numerous (atypical mole syndrome). According to the National Cancer Institute (NIH), doctors believe that dysplastic nevi are more likely than ordinary moles to develop into the most virulent type of skin cancer called melanoma. - Blue nevusBlue nevusBlue nevus is a type of melanocytic nevus.It is usually described as non-cancerous, but can be malignant.- Types :Blue nevi may be divided into the following types:...
: It is blue in color as its melanocytes are very deep in the skin. The nevus cells are spindle shaped and scattered in deep layers of the dermisDermisThe dermis is a layer of skin between the epidermis and subcutaneous tissues, and is composed of two layers, the papillary and reticular dermis...
. The covering epidermis is normal. - Spitz nevusSpitz nevusA Spitz nevus is a benign melanocytic nevus, a type of skin lesion, affecting the epidermis and dermis....
: a distinct variant of intradermal nevus, usually in a child. They are raised and reddish (non-pigmented). A pigmented variant, called the 'nevus of Reed, typically appears on the leg of young women. - Acquired nevus: Any melanocytic nevus that is not a congenital nevus or not present at birth or near birth. This includes junctional, compound and intradermal nevus.
- Congenital nevus: Small to large nevus present at or near time of birth. Small ones have low potential for forming melanomas, however the risk increases with size, as in the giant face pigmented nevus.
- Giant pigmented nevusGiant pigmented nevusGiant pigmented nevus is a cutaneous condition characterized by a large, darkly pigmented hairy patches....
: these large, pigmented, often hairy congenital nevi. They are important because [melanoma] may occasionally (10 to 15%) appear in them. - Intramucosal nevus: junctional nevus of the mucosa of the mouth or genital areas. In the mouth, they are found most frequently on the hard palate.
- Nevus of ItoNevus of ItoNevus of Ito is a cutaneous condition with similar features to the Nevus of Ota, but occurring in a different distribution....
and Nevus of OtaNevus of OtaNevus of Ota is a blue hyperpigmentation that occurs on the face. It was first reported by Dr. M. T. Ota of Japan in 1939.Nevus of Ota is caused by the entrapment of melanocytes in the upper third of the dermis...
: congenital, flat brownish lesions on the face or shoulder. - Mongolian spotMongolian spotA Mongolian spot, also known as "Mongolian blue spot," "Congenital dermal melanocytosis," and "Dermal melanocytosis" is a benign, flat, congenital birthmark with wavy borders and irregular shape, discovered on and named after Mongolians by Erwin Bälz. It is also extremely prevalent among East...
: congenital large, deep, bluish discoloration on the back of Asian babies. - Recurrent nevus: Any incompletely removed nevus with residual melanocytes left in the surgical face wound. It creates a dilemma for the patient and physician, as these scars can not be distinguished from a melanoma.
Signs and symptoms
According to the American Academy of DermatologyAmerican Academy of Dermatology
The American Academy of Dermatology is the largest organization of dermatologists in the world. It was founded in 1938 and represents 17,000 dermatologists in the United States, Canada, and around the world. The Academy grants Fellowships and Associate Memberships, as well as Fellowships for...
, the most common types of moles are skin tags, raised moles and flat moles. Benign
Benignity
Benignity [from Latin benignus , from bonus + genus ] is a medical term used to describe a condition that is harmless...
moles are usually circular or oval and not very large, though some can be larger than the size of a typical pencil eraser. Some moles typically produce dark, coarse hair
Hair
Hair is a filamentous biomaterial, that grows from follicles found in the dermis. Found exclusively in mammals, hair is one of the defining characteristics of the mammalian class....
. Common mole hair removal procedures include plucking, cosmetic waxing, electrolysis
Electrolysis
In chemistry and manufacturing, electrolysis is a method of using a direct electric current to drive an otherwise non-spontaneous chemical reaction...
, threading
Threading (epilation)
Threading is an ancient method of hair removal originating in the Eastern world. In more recent times it has gained popularity in Western countries.-Technique:...
and cauterization.
Effect of age
Moles tend to appear during childhood and gradually disappear after middle age. People with white skin have an average of 30 moles, with some having up to 400 moles.The number of moles a person has correlates with telomere
Telomere
A telomere is a region of repetitive DNA sequences at the end of a chromosome, which protects the end of the chromosome from deterioration or from fusion with neighboring chromosomes. Its name is derived from the Greek nouns telos "end" and merοs "part"...
length. One study found that people with over 100 moles had longer telomeres than those with under 25 moles. The length of telomeres may be of significance in the ageing
Ageing
Ageing or aging is the accumulation of changes in a person over time. Ageing in humans refers to a multidimensional process of physical, psychological, and social change. Some dimensions of ageing grow and expand over time, while others decline...
process. Shorter telomeres are thought to be associated with a greater risk of age-related diseases.
Genetics
GenesGênes
Gênes is the name of a département of the First French Empire in present Italy, named after the city of Genoa. It was formed in 1805, when Napoleon Bonaparte occupied the Republic of Genoa. Its capital was Genoa, and it was divided in the arrondissements of Genoa, Bobbio, Novi Ligure, Tortona and...
can have an influence on a person's moles.
Dysplastic nevi
Dysplastic nevus
A dysplastic nevus is an atypical melanocytic nevus; a mole whose appearance is different from that of common moles. Dysplastic nevi are generally larger than ordinary moles and have irregular and indistinct borders...
and atypical mole syndrome are hereditary conditions which causes a person to have a large quantity of moles (often 100 or more) with some larger than normal or atypical. This often leads to a higher risk
Risk
Risk is the potential that a chosen action or activity will lead to a loss . The notion implies that a choice having an influence on the outcome exists . Potential losses themselves may also be called "risks"...
of melanoma
Melanoma
Melanoma is a malignant tumor of melanocytes. Melanocytes are cells that produce the dark pigment, melanin, which is responsible for the color of skin. They predominantly occur in skin, but are also found in other parts of the body, including the bowel and the eye...
, a serious skin cancer
Skin cancer
Skin neoplasms are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises...
. Dysplastic nevi are more likely than ordinary moles to become cancerous. Dysplastic nevi are common, and many people have a few of these abnormal moles. Having more than 50 ordinary moles increases the risk of developing melanoma.
In the overall population, a slight majority
Majority
A majority is a subset of a group consisting of more than half of its members. This can be compared to a plurality, which is a subset larger than any other subset; i.e. a plurality is not necessarily a majority as the largest subset may consist of less than half the group's population...
of melanomas do not form in an existing mole, but rather create a new growth on the skin. Somewhat surprisingly, this also applies to those with dysplastic nevi. They are at a higher risk of melanoma occurring not only where there is an existing mole, but also where there are none. Such persons need to be checked regularly for any changes in their moles and to note any new ones.
Sunlight
UV radiation from the sun causes premature aging of the skin and skin damage that can lead to melanoma. Some scientists hypothesizeHypothesis
A hypothesis is a proposed explanation for a phenomenon. The term derives from the Greek, ὑποτιθέναι – hypotithenai meaning "to put under" or "to suppose". For a hypothesis to be put forward as a scientific hypothesis, the scientific method requires that one can test it...
that overexposure to UV, including excessive sunlight
Sunlight
Sunlight, in the broad sense, is the total frequency spectrum of electromagnetic radiation given off by the Sun. On Earth, sunlight is filtered through the Earth's atmosphere, and solar radiation is obvious as daylight when the Sun is above the horizon.When the direct solar radiation is not blocked...
, may play a role in the formation of acquired moles. However, more research
Research
Research can be defined as the scientific search for knowledge, or as any systematic investigation, to establish novel facts, solve new or existing problems, prove new ideas, or develop new theories, usually using a scientific method...
is needed to determine the complex interaction between genetic makeup and overall exposure to ultraviolet light. Some strong indications that this is so (but falling short of proof), are:
- The relative lack of moles on the buttocksButtocksThe buttocks are two rounded portions of the anatomy, located on the posterior of the pelvic region of apes and humans, and many other bipeds or quadrupeds, and comprise a layer of fat superimposed on the gluteus maximus and gluteus medius muscles. Physiologically, the buttocks enable weight to...
of people with dysplastic nevi. - FreckleFreckleFor other uses of the word, see Freckles .Freckles are clusters of concentrated melanin which are most often visible on people with a fair complexion. A freckle is also called an "ephelis". Freckles do not have an increased number of melanin producing cells...
s (spots of melanin on the skin, and distinct from moles) are known to be influenced by sunlight.
Studies have found that sunburns and too much time in the sun can increase the risk factors for melanoma. This is in addition to those who have dysplastic nevi being at higher risk of this cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
. (The uncertainty is in regard to acquiring benign moles.) To prevent and reduce the risk of melanoma caused by UV radiation, the American Academy of Dermatology
American Academy of Dermatology
The American Academy of Dermatology is the largest organization of dermatologists in the world. It was founded in 1938 and represents 17,000 dermatologists in the United States, Canada, and around the world. The Academy grants Fellowships and Associate Memberships, as well as Fellowships for...
and the National Cancer Institute
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...
recommends staying out of the sun between 10 a.m. and 4 p.m. standard time (or whenever your shadow
Shadow
A shadow is an area where direct light from a light source cannot reach due to obstruction by an object. It occupies all of the space behind an opaque object with light in front of it. The cross section of a shadow is a two-dimensional silhouette, or reverse projection of the object blocking the...
is shorter than your height). The National Cancer Institute also recommends wearing long sleeves and trousers, hats with a wide brim, sunscreens, and sunglasses that have UV-deflecting lenses.
Diagnosis
Clinical diagnosis can be made with the naked eye using the ABCD guideline or by using dermatoscopyDermatoscopy
Dermatoscopy is the examination of skin lesions with a dermatoscope...
. An online-screening test
Moletest
Moletest is a UK based company and the World’s first online remote mole screening service for the detection of non-melanoma and melanoma skin cancers in moles...
is also available to help screen out benign moles.
Differentiation from melanoma
It often requires a dermatologist to fully evaluate moles. For instance, a small blue or bluish black spot, often called a blue nevus, is usually benign but often mistaken for melanomaMelanoma
Melanoma is a malignant tumor of melanocytes. Melanocytes are cells that produce the dark pigment, melanin, which is responsible for the color of skin. They predominantly occur in skin, but are also found in other parts of the body, including the bowel and the eye...
. Conversely, a junctional nevus, which develops at the junction of the dermis and epidermis, is potentially cancerous.
A basic reference chart used for consumers
Consumer
Consumer is a broad label for any individuals or households that use goods generated within the economy. The concept of a consumer occurs in different contexts, so that the usage and significance of the term may vary.-Economics and marketing:...
to spot suspicious moles is found in the mnemonic
Mnemonic
A mnemonic , or mnemonic device, is any learning technique that aids memory. To improve long term memory, mnemonic systems are used to make memorization easier. Commonly encountered mnemonics are often verbal, such as a very short poem or a special word used to help a person remember something,...
A-B-C-D, used by institutions such as the American Academy of Dermatology and the National Cancer Institute. The letters stand for Asymmetry, Border, Color, and Diameter. Sometimes, the letter E (for Elevation or Evolving) is added. According to the American Academy of Dermatology, if a mole starts changing in size, color, shape or, especially, if the border
Border
Borders define geographic boundaries of political entities or legal jurisdictions, such as governments, sovereign states, federated states and other subnational entities. Some borders—such as a state's internal administrative borders, or inter-state borders within the Schengen Area—are open and...
of a mole develops ragged edges or becomes larger than a pencil
Pencil
A pencil is a writing implement or art medium usually constructed of a narrow, solid pigment core inside a protective casing. The case prevents the core from breaking, and also from marking the user’s hand during use....
eraser
Eraser
An eraser or rubber is an article of stationery that is used for rubbing out pencil markings. Erasers have a rubbery consistency and are often white or pink, although modern materials allow them to be made in any color. Many pencils are equipped with an eraser on one end...
, it would be an appropriate time to consult with a physician. Other warning signs include a mole, even if smaller than a pencil eraser, that is different than the others and begins to crust over, bleed, itch
Itch
Itch is a sensation that causes the desire or reflex to scratch. Itch has resisted many attempts to classify it as any one type of sensory experience. Modern science has shown that itch has many similarities to pain, and while both are unpleasant sensory experiences, their behavioral response...
, or becomes inflamed. The changes may indicate developing melanomas. The matter can become clinically complicated because mole removal depends on which types of cancer, if any, come into suspicion.
A recent and novel method of melanoma detection is the "Ugly Duckling Sign" It is simple, easy to teach, and highly effective in detecting melanoma. Simply, correlation of common characteristics of a person's skin lesion is made. Lesions which greatly deviate from the common characteristics are labeled as an "Ugly Duckling", and further professional exam is required. The "Little Red Riding Hood" sign, suggests that individuals with fair skin and light colored hair might have difficult-to-diagnose melanomas. Extra care and caution should be rendered when examining such individuals as they might have multiple melanomas and severely dysplastic nevi. A dermatoscope must be used to detect "ugly ducklings", as many melanomas in these individuals resemble non-melanomas or are considered to be "wolves in sheep clothing". These fair skinned individuals often have lightly pigmented or amelanotic melanomas which will not present easy-to-observe color changes and variation in colors. The borders of these amelanotic melanomas are often indistinct, making visual identification without a dermatoscope very difficult.
People with a personal or family history of skin cancer or of dysplastic nevus syndrome
Dysplastic nevus syndrome
Dysplastic nevus syndrome is a cutaneous condition described in certain families, and characterized by unusual nevi and multiple inherited melanomas.-Historical background:In 1820 Norris reported the first case of what is now recognized as FAMMM...
(multiple atypical moles) should see a dermatologist at least once a year to be sure they are not developing melanoma.
Complications
Experts, such as the American Academy of Dermatology, say that vast majority of moles are benignBenign
A benign tumor is a tumor that lacks the ability to metastasize. Common examples of benign tumors include moles and uterine fibroids.The term "benign" implies a mild and nonprogressive disease. Indeed, many kinds of benign tumors are harmless to human health...
. Nonetheless, the U.S. National Cancer Institute
National Cancer Institute
The National Cancer Institute is part of the National Institutes of Health , which is one of 11 agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the U.S...
estimated that 62,480 new cases of melanoma
Melanoma
Melanoma is a malignant tumor of melanocytes. Melanocytes are cells that produce the dark pigment, melanin, which is responsible for the color of skin. They predominantly occur in skin, but are also found in other parts of the body, including the bowel and the eye...
and 8,420 related deaths would appear in the United States in the year 2008.
Management
First, a diagnosis must be made. If the lesion is a seborrheic keratosisSeborrheic keratosis
A seborrheic keratosis is a noncancerous benign skin growth that originates in keratinocytes. Like liver spots, seborrheic keratoses are seen more often as people age. In fact they are sometimes humorously referred to as the "barnacles of old age". They appear in various colors, from light tan to...
, shave excision, electrodesiccation or cryosurgery may be performed, usually leaving very little if any scarring. If the lesion is suspected to be a skin cancer
Skin cancer
Skin neoplasms are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises...
, a skin biopsy
Skin biopsy
Skin biopsy is a biopsy technique in which a skin lesion is removed and sent to the pathologist to render a microscopic diagnosis. It is usually done under local anesthetic in a physician's office, and results are often available in 4 to 10 days. It is commonly performed by dermatologists. Skin...
must be done first, before considering removal. This is unless an excisional biopsy is warranted. If the lesion is a melanocytic nevus, one has to decide if it is medically indicated or not.
If a melanocytic nevus is suspected of being a melanoma
Melanoma
Melanoma is a malignant tumor of melanocytes. Melanocytes are cells that produce the dark pigment, melanin, which is responsible for the color of skin. They predominantly occur in skin, but are also found in other parts of the body, including the bowel and the eye...
, it needs to be sampled or removed and sent for microscopic evaluation by a pathologist by a method called skin biopsy
Skin biopsy
Skin biopsy is a biopsy technique in which a skin lesion is removed and sent to the pathologist to render a microscopic diagnosis. It is usually done under local anesthetic in a physician's office, and results are often available in 4 to 10 days. It is commonly performed by dermatologists. Skin...
. One can do a complete excisional skin biopsy
Skin biopsy
Skin biopsy is a biopsy technique in which a skin lesion is removed and sent to the pathologist to render a microscopic diagnosis. It is usually done under local anesthetic in a physician's office, and results are often available in 4 to 10 days. It is commonly performed by dermatologists. Skin...
or a punch skin biopsy
Skin biopsy
Skin biopsy is a biopsy technique in which a skin lesion is removed and sent to the pathologist to render a microscopic diagnosis. It is usually done under local anesthetic in a physician's office, and results are often available in 4 to 10 days. It is commonly performed by dermatologists. Skin...
, depending on the size and location of the original nevus. Other reasons for removal may be cosmetic, or because a raised mole interferes with daily life (e.g. shaving
Shaving
Shaving is the removal of hair, by using a razor or any other kind of bladed implement, to slice it down to the level of the skin. Shaving is most commonly practiced by men to remove their facial hair and by women to remove their leg and underarm hair...
). Removal can be by excisional biopsy or by shaving
Shaving
Shaving is the removal of hair, by using a razor or any other kind of bladed implement, to slice it down to the level of the skin. Shaving is most commonly practiced by men to remove their facial hair and by women to remove their leg and underarm hair...
. A shaved site leaves a red mark on the site which returns to the patient’s usual skin color
Color
Color or colour is the visual perceptual property corresponding in humans to the categories called red, green, blue and others. Color derives from the spectrum of light interacting in the eye with the spectral sensitivities of the light receptors...
in about two weeks. However, there might still be a risk of spread of the melanoma, so the methods of Melanoma diagnosis, including excisional biopsy, are still recommended even in these instances. Additionally, moles can be removed by laser, surgery or electrocautery.
In properly trained hands, some medical lasers are used to remove flat moles level with the surface of the skin, as well as some raised moles. While laser treatment is commonly offered and may require several appointments, other dermatologists think lasers are not the best method for removing moles because the laser only cauterizes
Cauterization
The medical practice or technique of cauterization is the burning of part of a body to remove or close off a part of it in a process called cautery, which destroys some tissue, in an attempt to mitigate damage, remove an undesired growth, or minimize other potential medical harmful possibilities...
or, in certain cases, removes very superficial levels of skin. Moles tend to go deeper into the skin than non-invasive lasers can penetrate. After a laser treatment a scab is formed, which falls off about seven days later, in contrast to surgery, where the wound has to be sutured. A second concern about the laser treatment is that if the lesion is a melanoma, and was misdiagnosed as a benign mole, the procedure might delay diagnosis. If the mole is incompletely removed by the laser, and the pigmented lesion regrows, it might form a recurrent nevus.
Electrocautery is available as an alternative to laser cautery. Electrocautery is a procedure that uses a light electrical current to burn moles, skin tags, and warts off the skin. Electric currents are set to a level such that they only reach the outermost layers of the skin, thus reducing the problem of scarring. Approximately 1-3 treatments may be needed to completely remove a mole. Typically, a local anesthetic is applied to the treated skin area before beginning the mole removal procedure.
For surgery, many dermatologic and plastic surgeons first use a freezing solution
Solution
In chemistry, a solution is a homogeneous mixture composed of only one phase. In such a mixture, a solute is dissolved in another substance, known as a solvent. The solvent does the dissolving.- Types of solutions :...
, usually liquid nitrogen
Liquid nitrogen
Liquid nitrogen is nitrogen in a liquid state at a very low temperature. It is produced industrially by fractional distillation of liquid air. Liquid nitrogen is a colourless clear liquid with density of 0.807 g/mL at its boiling point and a dielectric constant of 1.4...
, on a raised mole and then shave it away with a scalpel
Scalpel
A scalpel, or lancet, is a small and extremely sharp bladed instrument used for surgery, anatomical dissection, and various arts and crafts . Scalpels may be single-use disposable or re-usable. Re-usable scalpels can have attached, resharpenable blades or, more commonly, non-attached, replaceable...
. If the surgeon opts for the shaving method, he or she usually also cauterizes
Cauterization
The medical practice or technique of cauterization is the burning of part of a body to remove or close off a part of it in a process called cautery, which destroys some tissue, in an attempt to mitigate damage, remove an undesired growth, or minimize other potential medical harmful possibilities...
the stump
Amputation
Amputation is the removal of a body extremity by trauma, prolonged constriction, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for...
. Because a circle
Circle
A circle is a simple shape of Euclidean geometry consisting of those points in a plane that are a given distance from a given point, the centre. The distance between any of the points and the centre is called the radius....
is difficult to close with stitches, the incision is usually elliptical or eye-shaped. However, freezing should not be done to a nevus suspected to be a melanoma, as the ice crystals can cause pathological changes called "freezing artifacts" which might interfere with the diagnosis of the melanoma.
Mole removal risks
Mole removal risks mainly depend on the type of mole removal method the patient undergoes. First, mole removal may be followed by some discomfort that can be relieved with pain medication. Second, there is a risk that a scab will form or that redness will occur. However, such scabs and redness usually heal within one or two weeks. Third, as in other surgeries, there is also risk of infectionInfection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
or an anesthetic allergy or even nerve damage
Nerve Damage
Nerve Damage is a compilation album by Groove Metal band Skinlab, released in 2004. It is a 2CD collection of rare and unreleased material, including a live set, demos, remixes, alternate mixes, and two new tracks.-Disc 1:# "Losing All" – 4:04...
. Lastly, the mole removal may imply an uncomfortable scar
Scar
Scars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in...
depending on the mole size.
History
In the 1950s and 60s (and, to lesser extent, currently) a facial mole was known as a "beauty markBeauty mark
A beauty mark or beauty spot is a euphemism for a type of dark facial mole, so named because such birthmarks are sometimes considered an attractive feature. Medically, such "beauty marks" are generally melanocytic nevus, more specifically the compound variant...
" when it appeared in certain spots on a woman’s face
Face
The face is a central sense organ complex, for those animals that have one, normally on the ventral surface of the head, and can, depending on the definition in the human case, include the hair, forehead, eyebrow, eyelashes, eyes, nose, ears, cheeks, mouth, lips, philtrum, temple, teeth, skin, and...
. Examples include Marilyn Monroe
Marilyn Monroe
Marilyn Monroe was an American actress, singer, model and showgirl who became a major sex symbol, starring in a number of commercially successful motion pictures during the 1950s....
, model Cindy Crawford
Cindy Crawford
Cynthia Ann "Cindy" Crawford is an American model. Known for her trademark mole just above her lip, Crawford has adorned hundreds of magazine covers throughout her career. She was named #3 on VH1's 40 Hottest Hotties of the 90s...
, singer Madonna
Madonna (entertainer)
Madonna is an American singer-songwriter, actress and entrepreneur. Born in Bay City, Michigan, she moved to New York City in 1977 to pursue a career in modern dance. After performing in the music groups Breakfast Club and Emmy, she released her debut album in 1983...
, and the fictional Ms. Pac-Man
Ms. Pac-Man
Ms. Pac-Man is an arcade video game produced by Midway as an unauthorized sequel to Pac-Man. It was released in North America in 1981 and became one of the most popular video games of all time, leading to its adoption by Pac-Man licensor Namco as an official title...
. Madonna's facial mole—below her right nostril—has been surgically removed. Almost everybody has at least one or two moles somewhere on his or her body
Body
With regard to living things, a body is the physical body of an individual. "Body" often is used in connection with appearance, health issues and death...
, while large numbers can be concentrated on the back
Back
- People :* Adam Back, British cryptographer* Charles Back, South African winemaker* Chris Back , Australian politician* Ernst Emil Alexander Back , German physicist* Frédéric Back , Canadian animator...
, chest
Chest
The chest is a part of the anatomy of humans and various other animals. It is sometimes referred to as the thorax or the bosom.-Chest anatomy - Humans and other hominids:...
, and arm
Arm
In human anatomy, the arm is the part of the upper limb between the shoulder and the elbow joints. In other animals, the term arm can also be used for analogous structures, such as one of the paired forelimbs of a four-legged animal or the arms of cephalopods...
s. Although they can be less noticeable because of the similar colors of the surrounding skin, darker skin shades have equivalent incidences of moles to lighter skin shades. Some folklore
Folklore
Folklore consists of legends, music, oral history, proverbs, jokes, popular beliefs, fairy tales and customs that are the traditions of a culture, subculture, or group. It is also the set of practices through which those expressive genres are shared. The study of folklore is sometimes called...
about moles includes the notion that picking at a mole can cause it to become cancerous or grow back larger. While chronic picking or irritation
Irritation
Irritation or exacerbation, in biology and physiology, is a state of inflammation or painful reaction to allergy or cell-lining damage. A stimulus or agent which induces the state of irritation is an irritant...
(by clothing) of a mole can be detrimental in many ways, it has not been associated with a higher incidence of cancer
Skin cancer
Skin neoplasms are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises...
. It is recommended by physicians that a dermatologist examines a mole to see if it should be removed. The dermatologist or plastic surgeon can perform the procedure with an eye toward preventing a larger scar
Scar
Scars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in...
.
Society and culture
Beauty
Beauty is a characteristic of a person, animal, place, object, or idea that provides a perceptual experience of pleasure, meaning, or satisfaction. Beauty is studied as part of aesthetics, sociology, social psychology, and culture...
on lovely faces. Rather most moles were considered hideous growths that appeared mostly on the noses
Human nose
The visible part of the human nose is the protruding part of the face that bears the nostrils. The shape of the nose is determined by the ethmoid bone and the nasal septum, which consists mostly of cartilage and which separates the nostrils...
, cheek
Cheek
Cheeks constitute the area of the face below the eyes and between the nose and the left or right ear. They may also be referred to as jowls. "Buccal" means relating to the cheek. In humans, the region is innervated by the buccal nerve...
s, and chin
Chin
In the human anatomy, the chin is the lowermost part of the face.It is formed by the lower front of the mandible.People show a wide variety of chin structures. See Cleft chin....
s of witches, frog
Frog
Frogs are amphibians in the order Anura , formerly referred to as Salientia . Most frogs are characterized by a short body, webbed digits , protruding eyes and the absence of a tail...
s and other low creatures
Animal
Animals are a major group of multicellular, eukaryotic organisms of the kingdom Animalia or Metazoa. Their body plan eventually becomes fixed as they develop, although some undergo a process of metamorphosis later on in their life. Most animals are motile, meaning they can move spontaneously and...
.
Both folklore
Folklore
Folklore consists of legends, music, oral history, proverbs, jokes, popular beliefs, fairy tales and customs that are the traditions of a culture, subculture, or group. It is also the set of practices through which those expressive genres are shared. The study of folklore is sometimes called...
and modern popular culture
Popular culture
Popular culture is the totality of ideas, perspectives, attitudes, memes, images and other phenomena that are deemed preferred per an informal consensus within the mainstream of a given culture, especially Western culture of the early to mid 20th century and the emerging global mainstream of the...
use physical traits to denote a character's either good or evil
Evil
Evil is the violation of, or intent to violate, some moral code. Evil is usually seen as the dualistic opposite of good. Definitions of evil vary along with analysis of its root motive causes, however general actions commonly considered evil include: conscious and deliberate wrongdoing,...
tendencies. In contrast to the fine features and smooth skin of its heroes and heroines, characters who possess negative or evil characteristics have also been known to possess more rugged features and skin blemishes, including facial moles.
In Medieval Europe, among those accused of demonic possession, ecclesiastical edicts interpreted large warts and moles on the skin as physical signs of the entry point of the devil
Devil
The Devil is believed in many religions and cultures to be a powerful, supernatural entity that is the personification of evil and the enemy of God and humankind. The nature of the role varies greatly...
into the soul.
In the 16th century, a popular pseudoscience
Pseudoscience
Pseudoscience is a claim, belief, or practice which is presented as scientific, but which does not adhere to a valid scientific method, lacks supporting evidence or plausibility, cannot be reliably tested, or otherwise lacks scientific status...
was invented that supposedly described how every facial mole had a corresponding birthmark
Birthmark
A birthmark is a benign irregularity on the skin which is present at birth or appears shortly after birth, usually in the first month. They can occur anywhere on the skin. Birthmarks are caused by overgrowth of blood vessels, melanocytes, smooth muscle, fat, fibroblasts, or...
somewhere else on the body
Body
With regard to living things, a body is the physical body of an individual. "Body" often is used in connection with appearance, health issues and death...
. Once you knew where both moles were, the theory went, you had the inside track on what made the person tick. For instance, if a man had a mole on the bridge of his nose
Human nose
The visible part of the human nose is the protruding part of the face that bears the nostrils. The shape of the nose is determined by the ethmoid bone and the nasal septum, which consists mostly of cartilage and which separates the nostrils...
, he supposedly had another on his right thigh
Thigh
In humans the thigh is the area between the pelvis and the knee. Anatomically, it is part of the lower limb.The single bone in the thigh is called the femur...
. Taken together, the moles meant the owners were persons of good moods
Mood (psychology)
A mood is a relatively long lasting emotional state. Moods differ from emotions in that they are less specific, less intense, and less likely to be triggered by a particular stimulus or event....
and would eventually receive healthy inheritance
Inheritance
Inheritance is the practice of passing on property, titles, debts, rights and obligations upon the death of an individual. It has long played an important role in human societies...
s.
Face mole reading
In traditional Chinese culture, facial moles are respected and they are used in moleomancy, or face mole reading. The moles' meaning varies according to which of the nine "wealth spots" of the face they are located in. Depending on their position and color, a person's facial moles may render their face "lucky" or "unlucky."Moles that can be easily seen may be considered warnings or reminders, while hidden moles may symbolize good luck and fortune. Furthermore, traditional Chinese culture holds that each facial mole indicates the presence of a corresponding mole on another part of the body. For instance, if a mole is present around the mouth, a corresponding mole should be found in the pubic region.