Nevocellular nevi (Moles)

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Moles are small, dark spots, in the skin. They are produced by some cells in the skin that produce pigment (colour). Moles are usually brown, although some may be of a darker colour or of skin colour. Moles can be flat or with denivelations, smooth or rough, some have hairs on their surface. Moles are round or oval, with regular edges.
Some moles are present at birth. These are called congenital nevi. However, most moles develop during the first 20 years of life (and sometimes also in the third and fourth decades). They usually occur in the case of excessive exposure to sun, tending to occur on areas which were most exposed to sunlight, for example on the face. Moles can change their aspect in time, sometimes respond to hormonal changes, such as those during pregnancy, adolescence and menopause. Some may disappear with the passage of time or remove, without the person realizing it. Seborrheic keratoses are some benign formations, common among older people who have long exposed to the sun. The surface of this formation is soft, usually with denivelations. The colour varies from yellow to black. Most moles are normal and harmless, but some may develop into melanoma, a type of skin cancer. Malignant melanoma is the most severe type of skin cancer and it is usually caused by short periods with excessive exposure to sunlight, such as a two weeks holiday. Malignant melanoma can appear anywhere on the body. It may be a dark, fast-growing spot, on an area where there is no mole, or a pre-existing mole that changes its shape, size or colour, bleeds, it is itchy or inflamed.
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It is important to perform a regular monitoring of moles, for any type of change in shape, size or color. Most changes are benign, as determined by a normal, benign (non-cancerous) growth of the pigment at the level of the skin cells. However, you should see your doctor if you notice any abnormal changes of a nevus. The doctor will ask the patient about the recent changes of the formations and about the time when they occurred. He will also ask about the heredocolateral antecedents in order to assess the risk of developing melanoma.
If minor changes occur, your doctor will make photos of the nevus, which may be used for further evaluation. If signs of malignant transformation occur, the doctor might recommend taking a biopsy (a portion of the formation) or the total excision of the formation. These can be done in a surgery clinic. The portion of skin will be sent to a histopathology laboratory for the examination under a microscope of signs of malignant transformation.
If there is suspicion of malignant transformation of the nevus, it is recommended to consult a plastic surgeon or dermatologist (skin disease specialist) in order to conduct a proper treatment. You may also consult a specialist in pigmented lesions, which can identify and diagnose malignant melanoma. There will probably be two appointments, one for the examination of the formation by a specialist, the second for its surgical excision.


If the biopsy shows abnormal cell changes of the nevus, excision is recommended. If cell changes are recent, the formation will be excised by a simple surgical technique. This is possible because the melanoma has not exceeded the superficial layers of skin and has not spread to neighboring organs. If melanoma is diagnosed in late stages, there may be metastases at distance ( the spread of tumor cells along the blood flow, with the formation of new tumors in other organs). If your doctor is worried about a mole, the excision of the formation can be made before receiving the results of the biopsy or the nevus can be completely excised and then sent to a histopathological examination. If abnormal cells are found, periodic medical examination is recommended in order to complete the treatment if necessary and to examine all moles.
Moles are surgically excised by using the following methods:
- Excision (incision and removal of the formation), sometimes with suture, or
- Excision with electrocautery (a tool is used to burn the formation).
The surgical suture is performed or not depending on the size and depth of the tumor formation, and depending on the scar that might occur after. Before the surgical excision, the skin is disinfected and numbed with a local anesthetic. For the removal of the formation without suture, the surgeon uses a scalpel to scrape the formation so that the superficial layer of skin is not exceeded very much. Then an electric instrument is used to coagulate the remaining region. The wound will be covered with a sterile dressing, and the doctor will explain to the patient how to care of it.
Moles that need suture after excision, are larger, darker and / or flat. The surgeon removes the formation fully and a part of healthy tissue, according to the risk of cancer and if there are cells scattered away. Absorbable threads or unabsorbable threads applied to the skin surface in order to be removed later may be used inside the surgical wound.
Sometimes moles are excised for cosmetic reasons, although they have no pathological significance. For example, a person who has a big, ugly mole which can affect his confidence and self esteem. Usually, this type of surgery will be paid by the patient (it is not included in the interventions covered by medical insurance) and it is typically performed in a private clinic. It is recommended to consult your doctor for more information about them.


Skin cancer is the most common cancer in the United Kingdom, and the reported cases are increasing. The numbers have doubled compared to 1980 and there are over 69,000 new cases diagnosed each year in the United Kingdom. It is therefore important to perform regular checkups of both new and congenital moles.
Regular monitoring is recommended every few months for any type of changes. The following things will be observed:
- Moles that grow very much (most moles are no bigger than a pencil width)
- Unevenly coloured moles (most moles have one, maximum two colours, but melanomas have many colors on their surface)
- Moles with irregular edges or surface (moles are usually round or oval, with regular edges)
- Bleeding, local itching, redness, swelling or crusting on the surface (if the mole has never been traumatized), which does not heal in a few weeks
- Emergence of a new mole that is irregular or with an odd appearance (it is normal that new nevi appear during the life course, but their periodic monitoring is recommended, if the edges are irregular or unevenly coloured)
- Inflammation, swelling or patch with no apparent reason, which lasts more than a few weeks
- Portions of skin that are itchy, tough, scaly, dirty, bleeding or red, without an obvious cause (e.g. eczema).
Safe exposure to sunlight
The most efficient way to prevent skin cancer consists of cautious exposure to sunlight and limiting long exposure to sun.
Do not cheat yourself by saying that you will burnonly if you sunbathe; activities such as traveling by car with the windows open or practising outdoor sports are also a type of exposure to sun. The sun can also burn among us, this is why it is better to use sunscreen all year.
Ultraviolet radiation from the sun (which burns the skin) is more intense at midday (between April and September), at high altitudes (e.g. skiing holidays), and as we are closer to the equator.
The following tips are useful in order to protect ourselves against the sun:
- Stay in the shade when the sun is very powerful (between 11 am and 3 pm)
- Avoid the exposure of newborns and infants to the sun, use a sunscreen with high sun protection factor, dress them with loose clothing to protect their delicate skin
- Wear loose clothing, wide-brimmed hats and sunglasses
- Use a sunscreen with high protection factor (minimum SPF 15) and apply it regularly, especially after bathing
- Avoid using the solarium or the ultraviolet lamps because they emit ultraviolet radiation.


Most skin cancers are caused by sun exposure. However, only one in ten people have a mole (nevus) which is abnormal (dysplastic nevus), and which has a higher risk of transformation into melanoma compared with a normal mole. The moles with problems are usually flat and large. Dysplastic nevi are sometimes diagnosed as malignant melanoma because they can have similar aspects.
Solar keratoses or sun spots are small, red formations, with a scaly surface, giving the feeling of rough if they are touched. They are more common in people over 40 years, exposed to the sun, and represent another sign of predisposition to melanoma.
The risk of melanoma is increased also in the case of people with many moles, usually more than 25 moles. In this case we recommend caution about sun exposure and periodic examination of the moles for any type of change. This is very important especially if family history of melanoma exists.
Other risk factors for melanoma are:
- People who have freckles
- People with light skin
- Females (melanoma is more common in women than in men)
- Frequent episodes of sunburn in the past
- Frequent exposure to sunlight.



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