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Melanocytic naevi (moles) (Pathophysiology (Stages Junctional: flat…
Melanocytic naevi
(moles)
Pathophysiology
Stages
Junctional: flat dermis (melanocytes at base of epidermis)
Compound (melanocytes in epidermis and dermis)
Intradermal: dermis only
Natural history
Initially small and flat, melanocytes located at base of the epidermis
Naevi proliferate over time forming dome shaped masses and lose colour
Over time becomes unable to progress (old naevi rarely become melanomas)
Atypical naevi
Dont mature typically; fail to mature (sensence)
Persistent junctional proliferation and inflammation
Most mature eventually, some become melanoma
Clinical presentation
Mole
Diagnosis
Examination
Derm exam
ABCD (appearance, border, colours, diameter)
Ugly duckling test (different to other moles?)
Invesitgations
Biopsy
If atypical/unclear diagnosis
History
DH
Meds, allergies
FH
Moles, cancers of the skin
PMH
Previous skin conditions e.g. cancers
Other medical conditions
SH
Living arrangements, occupation,
holidays, sun exposure, smoking, alcohol
PC/HPC
Site, character, changes over, time, any itch/bleeding
Other moles
Management
Conservative
Information, advice, support
Surgical
Removal
Indication: atypical mole, suspected melanoma
MOA: incision with border for
histology and diagnosis
Definition
Benign skin growth
Epidemiology
Very common
Caucasians particularly