▶ Previous Artlcle: #6-3. Dermal melanocytic lesions

 

Junctional nevus

 

Brown, dark brown, and black flat spots with a smooth and hairless surface. Histologically, nevus cells are localized to the basal layer. 

 

Compound nevus

 

Brown and black papular spots with elevated centers. The surface is smooth or rough, and hairy in some cases. Histologically, nevus cells are observed in epidermis and dermis.

 

Intradermal nevus

 

Hemispheric nevus raised in dome shape. It is observed as a black nevus in skin and also observed in wartshape, which is rough in some cases and often hairy. Histologically, nevus cells are localized in the dermis.

 

Giant hairy nevus

 

Giant hairy nevus is a nevus with coarse hair, which is 20 cm or more in size. The prevalence of melanoma in giant congenital melanocytic nevusis roughly 5-15%, although it varies from center to center.

 

Therefore, if it grows locally or if bleeding, pain, ulcers, and itching are observedduring the treatment of congenital melanocytic nevus, it must be approached considering malignant transformation.

 

The principle of treatment is to remove the entire nevus if possible. The nevus can be removed sequentially, orin case of removing all at once, skin graft should be done if necessary.

 

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Small & medium sized congenital melanocytic nevus

 

The nevus smaller than 1.5cm is classified into the small sized congenital melanocytic nevus, and the nevus of 1.5–20cm is into the medium sized congenital melanocytic nevus.

 

As these nevi are also likely to develop melanoma, persistent follow-up is necessary. From a cosmetic point of view, it can be treated with CO2 laser, Er:YAG laser, long pulsed Alexandrite laser, and Q-switched Ruby laser. However, the lesion is deep, which may cause frequent recurrences.

 

- To be continued