Borderline pigmented nevus is a congenital neoplasm. In rare cases, it appears after the birth of a person, at any age. Together with such types of nevus as blue nevus, Dubreuil melanosis, Ota nevus, giant pigmented nevus undergoes malignant degeneration in 1.8% to 10% of cases. Therefore, experts classify it as a melanoma-threatening species.
The content of the article:
Symptoms of borderline pigmented nevus
Borderline pigmented nevus and its diagnosis
Treatment of borderline pigmented nevus
Borderline pigmented nevus
Symptoms of borderline pigmented nevus
Borderline pigment nevus is a flattened black, gray, dark or light brown nodule with a diameter of several millimeters and up to 4-5 cm, but, as a rule, most often it does not exceed 1 cm. The surface of the nevus may be smooth, dry and slightly uneven. Borderline pigmented nevus differs from other species in that there is no hair on its surface (even fluffy).
Borderline nevus can occur on different parts of the body, as well as on the soles and palms. As a rule, a borderline nevus is a single formation, but there are also foci of multiple nevi.
Cockade nevus is a kind of borderline nevus, the feature of which is a gradual increase in pigmentation, due to which after a while the nevus acquires the shape of rings and has a different degree of color.
The malignant transformation of the borderline pigment nevus is indicated by a change in color, a sharp increase in size, the appearance of erosion, cracks and bumps on its surface, redness around the formation or its vague boundaries. If such changes are detected, an urgent consultation with a dermatologist is required.
Pigmented borderline nevus should also be distinguished from cavernous hemangiomas, the consistency of which is softer, and from “senile” (seborrheic) keratoma, which is characterized by a “rough” sebaceous and less smooth surface. In the differential diagnosis between early melanoma and borderline pigmented nevus, increased attention is paid to anamnesis. Most patients who were diagnosed with melanoma indicate that the tumor developed for a long time in place of the existing pigment nevus, which did not cause any inconvenience. Nevus grows slowly according to the weight of the human body. During puberty, patients note that the nevus grows faster due to an increase in the level of metabolic and pigment processes, as well as hormonal restructuring of the body. Mechanical injury is often one of the main factors that accompanies the malignancy of nevi, which previously did not bring discomfort.
Borderline pigmented nevus and its diagnosis
Borderline pigmented nevus in the patient is diagnosed during dermatoscopy and dermatological examination. An additional method is also used — siascopy. If there is a suspicion of malignancy, a consultation with a dermatooncologist is required.
A biopsy is usually not performed from a borderline pigmented nevus, since its injury can push it to degenerate into a malignant formation. Histological studies are carried out after the nevus is removed by radio wave or surgical method.
Borderline pigment nevus is distinguished from such pigment formations as freckles, pigment spots, Setton nevi, Dubrey melanosis and blue nevi.
Treatment of borderline pigmented nevus
Those patients who have been diagnosed with borderline pigmented nevus should be regularly monitored by a dermatologist. If the neoplasm is benign, then such a nevus is not removed. But we should not forget that borderline pigmented nevus is also classified as melanoma—threatening, so the best way to prevent melanoma is to remove the nevus. Permanent traumatization of the nevus is an indication for its surgical treatment, especially if it is located on the surface of the palms or soles.
The borderline pigment nevus is removed using a surgical scalpel, as well as a radio wave or laser device. Electrocoagulation and cryodestruction of the nevus are undesirable, because according to experts, such removal methods can cause severe tissue injury, which can cause the development of melanoma.
As a rule, a cosmetic defect does not remain after removing moles with a laser. However, laser treatment can be used only when the remote formation does not require histological examination. Removal of nevi using a radiosurgical knife is most often carried out when the size of the formation does not exceed 5 mm. Such methods of removal with small sizes of formations do not require suturing.
If signs of malignant transformation are detected in the nevus, it should be immediately surgically removed and a histological analysis of the removed material should be performed.
