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Nevus

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A nevus is a medical term for a visible, permanent lesion on the skin or mucosa. The mucosa is the soft, moist lining found in areas like the mouth or genital regions.

Pie chart of incidence and malignancy of pigmented skin lesions
Pie chart of incidence and malignancy of pigmented skin lesions

The word comes from the Latin word for "birthmark." However, a nevus is not always present at birth. Some are congenital, meaning they are there from birth, while others are acquired later in life. People often use common names like "mole," "beauty mark," or "birthmark" to describe them. These common names are helpful, but they do not distinguish between the many specific types of nevi.

Many nevi are caused by changes in melanocytes. These are the cells that produce melanin, the pigment responsible for skin color. Some nevi are hypermelanotic, meaning they contain increased amounts of melanin. These often appear dark or colorful. Other nevi are hypomelanotic, which means they have decreased melanin and appear lighter.

Pie chart of incidence and malignancy of pigmented skin lesions
Pie chart of incidence and malignancy of pigmented skin lesions

Beyond pigment cells, some nevi involve the growth of other tissues. Epidermal nevi involve excess growth of cells like those in sweat or oil glands. Connective tissue nevi involve abnormalities in collagen within the dermis, the deep layer of the skin. Vascular nevi involve the excess growth of blood vessels, such as capillaries. One example is the nevus simplex, often called a stork bite.

Doctors classify melanocytic nevi by where the cells are located in the skin layers. A junctional nevus is found in the epidermis, the outermost layer. An intradermal nevus is located in the dermis, the deeper layer. A compound nevus involves both the epidermis and the dermis. There are also many specific types of pigmented nevi. A blue nevus is typically flat, smaller than 1 cm, and blue-black in color. A nevus spilus features dark speckles on a tan-brown background. Atypical or dysplastic nevi are characterized by irregular borders and variable pigmentation. These require a histological examination, which means looking at the tissue under a microscope, to diagnose.

Congenital melanocytic nevi are often categorized by their size at birth. These lesions usually grow in proportion to the body as a person ages. Small nevi are less than 1.5 cm. Medium nevi are between 1.5 cm and 19.9 cm. Large nevi are 20 cm or greater. This size categorization is very important for medical safety. Large congenital melanocytic nevi are associated with an increased risk of melanoma. Melanoma is a serious type of skin cancer. Because of this risk, doctors monitor these growths very closely.

Diagnosing a nevus involves looking at the lesion's physical features. Clinicians often use the naked eye or a tool called a dermatoscope. For more detail, they may use computerized dermoscopy and image analysis. If a lesion looks suspicious, a doctor might perform a biopsy. This involves taking a sample of the skin for histopathological examination. This process allows experts to detect unique cellular features under a microscope. In adults, doctors use the ABCDE criteria to check for melanoma. This stands for asymmetry, border irregularity, color variegation, diameter greater than 6 mm, and evolution. For children, doctors use modified criteria, such as looking for bleeding, bumps, or uniform color.

Managing a nevus depends on its specific type and any diagnostic uncertainty. Some nevi are known to be benign, or harmless, and only require observation over time. Other nevi might be treated if they cause irritation, such as itching, or if they ulcerate.

Cryogun
Cryogun

Doctors have several ways to treat or destroy a nevus. They may use cryotherapy, which uses extreme cold to freeze the tissue. Other methods include chemical peels, dermabrasion, or laser ablation. In some cases, a doctor may perform surgery to remove the lesion. The choice of treatment often depends on cosmetic concerns or the risk of malignancy.

Nevi are also linked to several dermatologic syndromes. These are groups of medical signs and symptoms that occur together. Examples include Basal cell nevus syndrome and Dysplastic nevus syndrome. Other examples are Blue rubber bleb nevus syndrome and Epidermal nevus syndrome. Understanding these connections helps doctors see the bigger picture of a patient's health. By studying the specific cells and patterns of a nevus, medical professionals can distinguish between a simple birthmark and a more serious condition.

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