Every person has moles or nevi on their body. light color skin. They can be both congenital and acquired. Melanocytic nevus is small speck on the skin, characterized by darker pigmentation.

There are several types of moles:

• intradermal;
• melanocytic;
• warty or papillomatous;
• congenital.

Melanocytic nevi are any pigmented moles on the body.

Intradermal pigmented nevus is a spot formed due to a disruption in the production or distribution of melanin. Such spots usually appear in early childhood and remain with the person for life. The following symptoms are characteristic of intradermal or intradermal melanocytic nevus:

• color uniformity throughout life;
• absence discomfort in the area of ​​the mole;
• clearly defined contour;
• absence of inflammatory processes in cells.

As a rule, such nevi are safe and do not transform into melanoma.

Papillomatous melanocytic nevus is one of the types of intradermal nevi. Such spots are characterized by the presence of a stalk or more light shade. Outwardly, they are easily confused with papilloma due to the fact that the mole looks like a growth. Typically, papillomatous intradermal melanocytic nevi are light pink in color and soft in texture. Such growths do not have a clearly defined contour and do not pose a danger, but they are often injured.

Congenital melanocytic nevi are rare. The development of such a formation on the skin begins in the prenatal period, so the child is born with a mole. Distinctive feature The reason for such spots is that they increase in size as the child grows. Small specks do not pose a danger, unlike large ones. If the surface of the mole is heterogeneous, any changes should be carefully monitored and observed by a dermatologist.

There is also a complex nevus of the skin, which is dark spot convex shape. Such benign neoplasms can develop into melanoma and therefore require careful monitoring. Doctors often suggest removing such spots.

Why do moles appear?

An intradermal melanocytic nevus is a cluster of specially pigmented cells. Factors leading to the appearance of moles on the skin:

• ultraviolet radiation;
• phototherapy;
• severe skin damage;
• burns;
• some dermatological diseases;
• hormonal disorders;
• immunodeficiency.

Many people have probably noticed how new spots appear on the skin after severe sunburn. Impact sun rays can lead to disruption of pigment production and the formation of spots of any size.

IN childhood new moles often appear after a course of phototherapy. There is also an increase in the number of spots with atopic dermatitis in newborns.

Disturbances in skin pigmentation and the appearance of new age spots and moles are often observed after burns. Household, chemical and sunburn, accompanied by the formation of large blisters on the skin, are one of the common causes of acquired melanocytic nevi.

Some inflammatory processes And skin infections can also cause the development of melanocytic spots. The appearance of moles after treatment for lichen is often noted.

The formation of new moles is observed in women during periods of hormonal changes in the body. So, spots can appear on the body during puberty, pregnancy and at the onset of menopause.

The appearance of congenital melanocytic nevus is due to the peculiarities of intrauterine development of the fetus.

Which nevi are dangerous?

In most cases, melanocytic moles do not pose a health risk. Their flat shape avoids injury and damage, so there is a risk of cell degeneration into malignant tumor minimal.

Papillomatous intradermal nevus and complex convex spots require observation. Development risk negative consequences for damage to such spots is quite high, so the patient is recommended to be checked annually by a dermatologist.

The following symptoms are reasons to visit a doctor:

• itching of the skin around the spot;
• inflammation of moles;
• increase in size or change in color of the spot;
• sudden bleeding;
• peeling of the skin.

If the nevus is located in places of contact with clothing or in skin folds, you should consult your doctor about the possibility of removing it.

Mole injuries

Often moles are damaged in everyday life. This often happens with spots located in depilated areas, skin folds or on the face in men. Accidentally cutting off a nevus while shaving is one of the most common causes of damage to these benign formations.

Raised spots can be accidentally damaged in everyday life, for example, while taking a shower. Any injury can cause bleeding.

Noticing that after a mole is damaged there's blood coming out, it is important to carry out antiseptic treatment in a timely manner and stop the bleeding. To do this, the wound is treated with hydrogen peroxide, and then pressed tightly with a swab made of sterile bandage. It should be remembered that damaged nevi should never be allowed to become infected in order to avoid the development of negative consequences.

Removal and diagnosis of nevi

Diagnosis of nevi is carried out by a dermatologist and oncologist. A dermatologist carefully studies the features of a benign formation using a special technique. If you suspect that the process of cell degeneration has begun, the doctor will recommend consulting with an oncologist.

It should be remembered that tissue scraping from moles is not carried out, as this leads to damage to the moles and is dangerous to health.

Histological analysis is carried out only after removal of the mole. The following methods are used for removal:

• surgical excision;
• radio knife;
• laser removal;
• cryodestruction.

All these methods are absolutely painless. Excision of a mole with a scalpel is carried out under local anesthesia. If the mole is located on the face, it is recommended to prefer radio wave or laser method removals that do not leave scars, unlike cryodestruction.

It is imperative to remove melanocytic stains that are subject to friction on clothing or are often damaged in everyday life.

Prevention measures

Despite the fact that transformation of melanocytic nevus cells is quite rare, it is important to avoid factors that injure this formation. To such negative impacts include intense tanning, rubbing with clothing and accidental damage.

If nevi are located on exposed areas of the skin, it is important to use sunscreen during periods of strong solar activity.

Protecting the spots with a patch will help prevent damage to skin growths. It is important to remember that if such a benign formation on the skin causes discomfort, you should definitely consult a doctor about the possibility of removing it.

Pigmented nevus is a skin disease. This condition is benign and occurs quite often. In the literature you can see the names “non-cellular”, “melanocytic” - these are synonyms, we're talking about about the same process.

Noncellular nevus – any congenital disease associated with the proliferation of nevocytes. These are skin cells in which the pigment melanin accumulates. They are very similar to melanocytes, but do not have processes and are less susceptible to the regulatory influences of hormones and other active substances. Nevus cells include round nuclei, their ability to divide is low. Externally, nevi may look like this:

• flat spots that blend into the skin;
• Maculae – spots raised above the surface of the skin;
• dome-shaped tumors or papillomas resembling a wart.

Many researchers believe that pigment formations do not arise during life, but only appear under the influence of certain factors, primarily sunlight. Infants have almost no moles, but in teenagers they are very common. U young man Up to 40 birthmarks can be found on the skin. With age they fade, disappear, and by old age they are practically absent.

These formations are found in most people. The number of their types is very large. According to WHO recommendations, there are:

• border;
• difficult;
• intradermal;
• spindle cell (epithelioid);
• nevus formed by balloon-shaped cells;
• halonevus;
• giant pigmented nevus;
• involutional (fibrous nasal papule);
• blue and checkered blue.

Types of pigmented nevus formations

Let us dwell in more detail on the features of the most common or most dangerous types.

Border

Borderline pigmented nevus, synonymous with functional nevus - initial stage development skin lesions. It is localized in the uppermost layer of the skin - the epidermis. The formation is congenital or acquired. It often develops in childhood and adolescence, localizing on the palms or soles. Microscopic analysis reveals well-defined clusters, called nests, of nevocytes in the lower epidermal layer at the border with the dermis, hence the name. This type is melanoma-dangerous because it can often degenerate into a malignant tumor.

It is a flat pigment formation. For a long time, pigmented nevi are small in size - up to 3 mm, which gives a person the impression that he has had these spots since birth. In some cases, borderline nevi begin to grow rapidly - 1 mm per year, growing in a few years to a size of 5-6 mm. With such a significant increase in the spot, it is necessary to show such a growing mole to an oncologist. It can transform into a dysplastic nevus, a precursor to skin cancer.

Intradermal

The most common form of pigment spots is intradermal pigmented nevus. It is otherwise called a “resting”, inactive, mole or birthmark. It is characterized by a variety of shapes and colors. A mole is the most common benign formation. It looks like a flat plaque up to half a centimeter in diameter, of any shade brown, evenly colored, with a dense texture, rounded shape and clearly visible boundaries. The outer layer of such a formation can be convex, in the form of a wart or a hemisphere. In this case, a papillomatous melanocytic pigmented nevus of the skin is formed.

Nevocytes are located deep in the dermis, its middle and lower layers, forming clusters there. Cells have different shapes and quite large sizes. If they have small nuclei arranged in the form of rosettes, this confirms the benign nature of the formation. Intradermal pigmented nevus may be visible at birth or appear at an early age.

Difficult

Such a nevus is localized both in the upper layer of the skin - the epidermis, and in the middle - the dermis. It is determined on the surface of the skin in the form of a protruding plaque or papilloma (wart). Nest accumulations of nevocytes are located at the point of contact of the upper and middle layers of the skin. If they begin to spread deeper into the thickness of the dermis, they say that the nevus is maturing. This is a benign process.

Neocytes lying in the upper layer of the skin are less mature, which increases their potential for malignancy. They are quite large, have a cubic shape, synthesize melanin and form clusters in the form of nests. Mature nevocytes lie in the deep layers; they are smaller and accumulate less melanin, so their cytoplasm is lighter. They grow with the formation of cords.

The most mature nevocytes are located in the middle of the neoplasm; they have a spindle-shaped, elongated shape. These cells form bundles that resemble peripheral nerve tissue.

Complex nevi in ​​the form of papillomas or polyps usually contain many vessels.

Pigmented nevi

Other types

Balloon nevus

Rarely encountered formation. It is characterized by huge cells with light cytoplasm compared to ordinary nevocytes. Under a microscope, they resemble inflated containers, or balloons, hence the name. They can be located intradermally, but sometimes this type is complex - the cells lie in two layers of skin.

Halonevus or Setton's nevus

It appears as a hyperpigmented (dark) area of ​​skin surrounded by a lighter (depigmented) surface. Sometimes it disappears without any external influence, after which a discolored spot remains on the skin. This formation is often localized on the back of young people and children. Clusters of nevocytes lie in two layers of the skin. A feature of this condition is the accumulation in the area of ​​nests of immunocompetent cells - lymphocytes and macrophages, as if infiltrating the nevus focus with the formation of an inflammatory infiltrate. Immune cells gradually destroy nevocytes - this explains the depigmentation zone around the spot. Over time, nevocytes are influenced immune cells disappear. This type of pigment formation is not melanoma-hazardous.

Often refers to giant form. A giant nevus is located on any part of the body, including the scalp. Its cells grow in the thickness of the dermis and form extensive clusters in it. Such education has high risk transformation into a malignant tumor (from 2 to 10%).

Spindle cell or epithelioid nevus

It is observed mainly on the face. Its other names are juvenile melanoma or Spitz nevus. The formation looks like one flat or hemispherical nodule. Sometimes it has a surface covered with papillae - papillomatosis. The color of the formation ranges from pink to dull yellow. Around the nodule, dilated small vessels are often visible -. Transformation into atypical form occurs rarely, although upon histological analysis (under a microscope) such a formation is similar to a malignant skin tumor at the beginning of its formation. Nevocytes occur in the form of rounded and elongated clusters. The cytoplasm of these cells is light because they usually do not contain melanin. In the underlying part of the formation, deep in the dermal layer, the cells become spindle-like. There are many around them blood vessels, from which red blood cells sweat, inflammatory infiltration.

Blue nevus

Otherwise called the Mongolian spot. The cells lie deep in the middle layer of the skin - the dermis. They have no connection with the epidermis. The deep location of nevocytes determines external effect– blue color of the spot. The lesion is located on the face, torso, skin of the lower back and hands in the form single spots pretty correct round shape blue or gray having a well-defined boundary. Such pigmented nevi are invisible above the surface of the skin or rise slightly above it. They become malignant in in rare cases. At microscopic examination in the deep layers of the skin, including subcutaneous fatty tissue, thin branching cells are found - a special type of nevocytes, which contain a lot of the coloring substance - melanin.

Cellular blue nevus is formed by large spindle-shaped cells and an infiltrate consisting of immunocompetent cells - lymphocytes. There is little melanin in it.

Halonevus or Setton's nevus;
Blue nevus

Dysplastic nevi

Any pigmented formation can degenerate into a tumor with signs of malignancy (uncontrolled growth, possibility of metastasis) -. The risk of such transformation is especially high if there is a dysplastic pigmented nevus.

The link between hyperpigmentation and skin cancer has been discovered for almost 200 years, but it wasn't until 1978 that the true precursor to melanoma was found. Such formations (dysplastic nevi) are otherwise called VK moles (after the letters with which the surnames of the very first families studied then began). They are larger than normal birthmarks, their diameter can exceed 12 mm. Outwardly, they look like flat plaques; their surface may be uneven and their shape may be irregular. They rise slightly above the surface of the skin and are unevenly colored in brown shades. Sometimes such structures do not contain melanin.

At histological examination the formation is similar to a complex or mixed pigmented nevus, but there are signs of infiltrative growth, that is, penetration into the surrounding layers of the skin. The shape of the cells also changes: they become angular, with uneven contours, with brightly colored (hyperchromed) cores. A condition that allows melanoma to be excluded is the absence of penetrating (infiltrative) growth towards the upper layer of the skin - the epidermis.

VK moles can appear at any age and on any part of the body. Sometimes their number exceeds several dozen. If there are already such cases in the family, the probability of such a nevus appearing over the age of 59 years exceeds 50%. In this case, the disease is transmitted in an autosomal dominant manner. In this case, they talk about FAMMM syndrome (familial atypical multiple mole melanoma syndrome). This is the main factor in the development of skin cancer.

If a dysplastic nevus occurs in isolation, without a hereditary predisposition, then it has a benign course.

Juvenile melanoma;
Dysplastic nevus

Pigmented nevus of the conjunctiva

This formation is practically not dangerous. It can be located on the conjunctiva (mucous membrane) and is then clearly visible. Also, a pigmented nevus of the eye may lie on choroid eyeball and can only be detected during a fundus examination by an ophthalmologist. This spot is formed by accumulations of melanocytes and looks like an ordinary mole.

Eye nevi can be stationary (not changing) or progressive (growing). If a lesion on the choroid grows, over time it can cause a narrowing of the visual field, reduce its acuity and cause other unpleasant symptoms. Therefore, it is removed using micro surgery or laser therapy.

Treatment of nevi

Treatment of pigmented nevus is carried out in cases where the formation is melanoma-dangerous, grows rapidly or is located in an area where it is constantly injured (for example, on the chin, temples, neck, lower back). If a person has age spots, he should regularly visit a dermatologist to have them examined and monitored.

Removal of a pigmented nevus is performed using surgery or minimally invasive intervention.

Removal of pigmented nevus surgically carried out when there is a risk of malignancy of the formation. Excision of the spot using a scalpel is carried out within healthy tissue, after which a scar may remain.

Minimally invasive methods are more often used on open areas of the skin, when the removal of age spots is primarily for aesthetic purposes. Applied, removal using the so-called.

Prevention of malignancy

The most likely malignant degeneration of large, unevenly colored, numerous formations. You should consult a doctor if a mole begins to grow, its surface or shape changes, redness appears around it, or skin itching, bleeding, peeling, sudden growth hair on the surface.

To prevent melanoma (skin cancer), you should follow simple rules:

• Avoid skin exposure to direct sunlight from 11 a.m. to 4 p.m.;
• refuse to visit the solarium;
• prefer light clothes with long sleeves, wear wide-brimmed hats in summer.

Using sunscreen does not reduce the risk of developing melanoma.

A complex pigmented nevus is a benign formation in the form of pigment spot brown in color, which is located simultaneously in two layers of the skin - epidermal and dermal. Externally, a nevus resembles a small wart (no more than a centimeter in diameter) or a papule rising above the skin. The nevus begins its growth in the upper layers of the skin, and then gradually grows into the dermis. Even though this type nevus is benign education skin, according to some data it can transform into melanoma (in 50-80% of cases).

Symptoms of complex pigmented nevus

A complex pigmented nevus is distinguished by a warty or smooth surface, on which the growth of bristly hair is often present. The nevus is located in two layers of the skin, therefore it combines the signs of intraepidermal and intradermal. The epidermal component causes its brown color, and the presence of the intradermal component contributes to its raised appearance above the skin level. A complex nevus will rarely reach large sizes.

Diagnosis of complex pigmented nevus

A dermatologist can diagnose a nevus based on a preliminary examination. Timely diagnosis of nevus is the key to quick and successful treatment. In order to determine the depth and extent of nevus growth into the dermis, the doctor may prescribe an ultrasound of the skin formation. During the examination, the doctor interviews the patient, finding out exactly when the formation occurred, whether its appearance, size, shape and color have changed, as well as the reasons for the changes themselves. It turns out whether there were attempts at treatment and what exactly the previous treatment was? If melanoma is suspected, immediate consultation with an oncologist is necessary. Carrying out a biopsy of a nevus is very dangerous; injury to the nevus can develop into malignancy. It is for this reason that histological examination is carried out after its removal.

Today there is new method diagnosing nevi - epiluminescence microscopy. This method diagnosis is carried out using a special optical device with artificial lighting. The study takes place directly on the surface of the skin. Apply a couple of drops to the nevus vegetable oil in order to create the effect of epiluminescence, then the device is placed on the neoplasm. This research method will not damage the nevus and is therefore the most accurate in determining the structure of the neoplasm. This study called dermatoscopy.

Way computer diagnostics are also widely used in such studies. Thanks to a digital video camera, the image of the pigment formation is recorded and stored in the computer memory. There is a special computer program, which processes the received information and compares it with the database, ultimately producing an accurate conclusion.

Treatment of complex pigmented nevus

This disease requires mandatory observation by a dermatologist. Treatment of pigmented nevus is a strictly individual procedure. The treatment method is selected by the doctor for each specific case. Before consulting a doctor, do not use ointments. There is no point in delaying treatment or going to the doctor, as there is a high probability that the spot will increase in size every year. The indication for its removal is permanent injury or the appearance characteristic features malignancy. Removal may also be done for cosmetic reasons. There are several ways to remove a nevus:

• using a laser;
• radio wave method;
• surgical excision;
• electrocoagulation;
• cryodestruction.

Cryodestruction and electrocoegulation are used very rarely due to the fact that during the removal process the nevus may not be completely eliminated, and also because of the risk of traumatizing it, which can later develop into malignant growth.

Removing a nevus with a laser does not make it possible to study the nevus in a histological examination after elimination. It is most advisable to use the radio wave method or surgical excision for removal, since they guarantee complete removal nevus cells, which has great importance to prevent the development of melanoma.

The surgical method is most suitable when the nevus is deep in the skin. The disadvantage of this method of elimination is the postoperative scar, since the nevus is removed along with the adjacent skin. According to oncological requirements, the diameter of the removed surface should be 3-5 cm.

If a nevus is detected, you should immediately consult a doctor for advice. Under no circumstances should you excise a nevus yourself, since injury to it leads to the development of a malignant tumor. According to statistics, in men melanoma more often develops on the back, and in women on lower limbs. To prevent the appearance of melanoma, you need to stay under the sun as little as possible, avoid solariums, and also carefully monitor existing moles. The first time their shape or size changes, you should immediately consult a doctor. There are many known cases that ended fatal due to self-medication and the reluctance of patients to seek medical help in a timely manner.

Most white-skinned people have brown spots or dots on their bodies, which are colloquially called moles. These are places of increased skin pigmentation, accumulations of so-called melanocytes - cells that produce the dark pigment melanin, the amount of which determines the light, dark or completely black color of people's skin. Darkening of the skin in a fair-skinned person is scientifically called pigmented nevus. On the contrary, a dark-skinned person may have a non-pigmented, light area of ​​skin. There are modifications to the skin that do not change its color. Let's look at what cases happen and what actions should be taken if skin in one place or another differs from the skin on the rest of the body in density, color or structure.

If at the birth of a child there are dark spots on his body - moles or nevi, according to medical terminology, this is normal. Almost everyone has them. It is not advisable to injure them and overheat them in the sun. Removal is not always required. People sometimes live with them long and calmly.

If the pigmented nevus is quite large, pedunculated or oddly shaped, it makes sense to show it to the doctor. Particularly important timely treatment child. The doctor will determine whether removal is necessary. If the doctor says that the treatment is ineffective and removal is necessary, do not delay it. If a suspicious tumor is not destroyed surgically, a malignant tumor may develop from it. Think about the child's future and hurry to carry out treatment.

It happens that there are a lot of moles, although they are small, this should also prompt you to be careful with your health. This means the body is predisposed to neoplasms. It is better for such a person not to sunbathe at all and, if possible, to healthy image life, you shouldn’t do physiotherapy.

Sometimes large moles, popularly called birthmarks, are discovered on a child at birth. In this case, he must be examined by a doctor and done necessary tests. Follow-up of the spot throughout life is mandatory. It may darken and disappear. Sometimes birthmarks appear and disappear temporarily in adults. For example, in a woman during pregnancy. If birthmark, increases in size and begins to bother, itch, this is very bad sign. Need to urgent treatment, sometimes surgically.

It is the pigmented nevus that most often provokes the development cancerous tumor. The non-pigmented, modified area of ​​skin usually remains benign neoplasm. Therefore, some surgeons define skin nevus as just a pigmented growth on the body. Other surgeons believe that non-pigmented formations can also be considered nevi. But they also secrete pigmented or melanocytic from general group nevi, considering them the most dangerous.

The non-pigmented growth can be a hygroma, hemangioma, teratoma and other benign tumors. If they bother you, it is necessary to remove them, mainly for the purpose of plastic surgery, and not for the sake of saving lives. Only in rare cases do they degenerate into a malignant tumor. But still, this variant of skin tumors cannot be completely discounted; you need to see a doctor.

There is also a vascular nevus, which is often found in a newborn baby; it is also called “strawberry nevus”. It is red, but not pigmented, but from the convexity of blood vessels in a certain place. In a child it is formed as a result of severe birth process and dissolves over time. In adults - less often.

There is also a pigmented modified area around which there is a halo white. This is the so-called nevus of Seton. Also a pigmented nevus.

Melanocytic moles

Pigmented nevus or melanocytic, different in color from the rest of the skin on the body, can be: light and dark brown, sometimes almost black, bluish and even blue. Darker nevi have the poorest prognosis for cancer development. Therefore, if suddenly a previously light mole has darkened, swollen, and a red halo has formed around it, you need to urgently go to the doctor for removal.

Moles that are larger in size often also have an atypical composition of cells (that is, different from the typical one). If a pigmented melanocytic nevus does not exceed 0.5-1.5 cm, then it is considered small. If its size is 1.5-10 cm, then it is classified as medium. A nevus larger than 10 cm in size is considered large, more than 20 cm is considered gigantic. A giant nevus most often develops into a malignant tumor.

Based on the depth of their occurrence, moles are divided into the following types:

• epidermal nevus (located in the epidermis - the upper layer of the skin, consisting of five rows of cells, usually a small mole-dot);
• intradermal nevus (modifies the main part of the skin, the dermis, usually a medium-sized intradermal nevus and is defined by non-specialists as a birthmark);
• border nevus (located on the border between the epidermis and dermis, it is usually medium in size, like an intradermal nevus);
• mixed nevus (covers both the epidermis and the entire dermis, sometimes a borderline nevus is mistaken for it, but a nevus mixed type usually larger size and often still protrudes in the form of a tubercle above the skin).

The usual shape of a mole is a circle or oval. More complex forms have much worse oncological prognosis.

If a mole is located above the skin on a stalk and has a wrinkled structure, it is called a verrucous nevus. Typically, such a nevus on the skin is unpleasant in appearance and interferes with active life, clings to clothes. And a verrucous nevus is still easy to damage, pick off and not be noticed, which is very dangerous. Therefore, for such a nevus, surgical removal is preferable.

What to do if there are a lot of pigmented moles on the body?

Nevi can be located anywhere on the human body. Even on the head. Very often they are found in places where a person sweats or rubs from uncomfortable clothing. Sometimes they line up in this place, forming a linear nevus.

If nevi cover large areas of the skin surface, this means serious illness body - skin nevus. If moles are large in size, have uneven edges and uneven pigmentation, this is called a dysplastic nevus and is the initial stage of development of melanoma, that is, a cancerous tumor.
Dysplastic nevus is a signal that urgent care is needed serious treatment body, most often surgical removal. It is best to see a doctor and start treatment earlier, without waiting until you are diagnosed or identify yourself as having a dysplastic nevus.

A nevus is a serious statement from your body and should not be joked with. Especially for a person in adulthood. For a child, this is only a warning about a possible malfunction in the body in the event of an incorrect lifestyle. For an elderly person, the presence of nevi that have not manifested themselves in any way during a long life is also not dangerous.

The pigment growth should not be injured unnecessarily. Hair can grow on moles; you should not pull them out, as this can injure the pigmented nevus and push it to grow. Under no circumstances should you remove nevi yourself. Only by medical means. In special clinics you will undergo electrocoagulation and cryodestruction, only then will your problem be removed without consequences.

Synonyms of complex nevus: mixed nevus.

Definition. Acquired pigmented nevus, the nevus cells of which are located both in the epidermis and in the dermis. It has the clinical features of borderline and intradermal nevi.

Age and gender. Occurs in adolescence. Gender doesn't matter.

Elements of the rash of a complex nevus. A tumor-like formation in the form of a papule or node, usually less than 1 cm in size. The surface is smooth, less often warty, keratinized, often with the growth of bristly hair. In shape, complex nevomelanocytic nevi are predominantly uniformly elevated formations. Various clinical variants of complex nevi are discussed in detail in the third chapter of this atlas.

The color is usually uniform: dark brown, sometimes almost black. In the presence of an intraepidermal component, the nevus is usually dark in color. During the transformation of a complex nevus into intradermal color may be uneven.

Localization any.

Histology. Combines the histological features of borderline and intradermal nevi. Nests of nevus cells are located both in the epidermis and in the skin itself. Nevomelanocytes, which migrated into the dermis more or less evenly over the entire area of ​​the nevus, are determined in the form of nests mainly in the papillary layer of the dermis.

Differential clinical diagnosis complex nevus carried out together with intradermal melanocytic nevus, since these two neoplasms are almost impossible to distinguish from each other. However, some clinical signs allow you to do this. Firstly, a complex nevus is more characterized by the preservation of a pronounced skin pattern on the surface, secondly, it is darker and, thirdly, it is less elevated than an intradermal nevus.

Forecast. Complex nevi rarely transform into melanoma.

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