Reconstructive Plastic Surgery

Nevi and melanoma

Moles are due to an increase in the number of melanocytes in the skin. Moles can be congenital, meaning present from birth, or acquired, meaning they develop later. They should not be confused with lentigo (sunspot or age spot) because the latter is due to an overactivity of melanocytes, stimulated by excessive sun exposure. Moles can vary in shape and color and can occur on both the skin and mucous membranes. There are benign moles and atypical moles.

Moles are ‘dangerous’ when atypical, meaning they can mimic melanoma. The clinical characteristics, in some cases, may not be clear even to the most experienced dermatologist, and sometimes the removal of the atypical mole with a histological examination is necessary for greater certainty.

Unlike a mole, even an atypical mole, melanoma is a malignant tumor that originates from melanocytes. It can arise as such or originate from a pre-existing mole. Sun exposure and family predisposition are very important factors in the genesis of melanoma. There are individuals at risk: those with fair skin (phototype I-II), with many moles on the body or with atypical moles, and with positive family history for melanoma. Of course, excessive and improper sun exposure also poses a risk.

If you have characteristics that put you at ‘risk,’ then good sun protection is indispensable to shield the skin from damage due to UV rays, and regular check-ups with a specialist are essential. The specialist will conduct a clinical examination and instrumental tests such as epiluminescence in Videodermatoscopy.

The moles that should typically be checked are the FLAT ones (not raised on the skin surface). An excellent rule for patients to follow is the ABCDE rule: A: Appearance of the lesion, changed over time? = consultation B: Borders: irregular, jagged = consultation C: Color: changed over time? presence of two or more colors over time? = consultation D: Dimensions: Is a flat mole enlarging > 6 mm? = consultation E: Evolution or elevation (raising and thickening) = consultation With these simple rules, it is possible to conduct an initial screening.

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