Papillomatous nevus is a lumpy mole protruding above the surface of the skin, resembling a papilloma in its appearance. It is often located on the scalp, but may have a different location. The diagnosis of nevus is carried out using dermatoscopy, syascopy, in some cases a biopsy may be required. An indication for the removal of a papillomatous nevus is its frequent traumatization, inflammation or the patient’s desire to get rid of the nevus as a cosmetic defect. Removal is carried out by cryodestruction, surgical excision, electrocoagulation, with the use of a radio knife or a laser device.
Papillomatous nevus refers to benign neoplasms of the skin. It can be congenital and occur during life. Papillomatous nevus, as well as fibroepithelial nevus, Setton’s nevus, Mongolian spot, intradermal pigment nevus, is a melanomone-threatening formation and the probability of its transformation into melanoma is almost zero.
Papillomatous nevus has irregular outlines and a bumpy surface protruding above the general level of the skin. It can be the color of unchanged skin or pigmented with a brown or brown tint. Occasionally there are papillomatous nevi of black color. Papillomatous nevus is often permeated with pigmented hair, which makes it similar to fibroepithelial nevus. Papillomatous nevi can be multiple and single. Most often they are localized on the scalp, face and neck, but can be located on any part of the skin.
Characteristic of papillomatous nevus is a slow gradual increase in size. Appearing from birth or at any period of a person’s life, such a nevus is invisible at the beginning. But as it grows, it begins to cause inconvenience to its owner. Being located on the head, in the hair growth zone, the nevus is often injured when combing. As a result, its inflammation may occur, manifested by soreness and redness in the nevus area.
Typical localization on the head and neck, rather large size, growth of pigmented hair from the nevus make papillomatous nevus a serious cosmetic defect that causes significant psychological discomfort to the patient. In adolescents and people with a labile nervous system, this situation can cause the development of depression, sleep disorders, neurasthenia.
Even if the mole does not cause any unpleasant sensations in the patient, it should be shown to a dermatologist. Accurate diagnosis of the type of neoplasm is necessary to exclude melanoma and melanoma-threatening nevi, to determine adequate therapeutic tactics.
In most cases, an experienced dermatologist, based on an examination of the formation and dermatoscopy, will be able to diagnose papillomatous nevus and differentiate it from papilloma, verrucous nevus, melanoma, pigmented border nevus, fibroepithelial nevus, filamentous wart. In the diagnosis of pigmented nevus, a siascopic examination can additionally be used. In difficult cases, a biopsy of the formation is performed. The slightest doubt about the diagnosis is a reason to consult a dermatooncologist in order to exclude melanoma.
Permanent traumatization of the nevus, psychological discomfort and the appearance of inflammatory changes are indications for its removal. In cases where during the diagnosis it was not possible to exclude melanoma by 100%, dermatology recommends removal of the nevus with mandatory histological examination of the removed formation. Removal of papillomatous nevus can be carried out by laser, cryodestruction, radio wave method, electrocoagulation or by surgical excision. The use of any of these methods is usually carried out under local anesthesia.
In relation to papillomatous nevi located on the face and neck, laser mole removal is often used. This method, with proper care of the wound after removal, has the best cosmetic effect. However, it is not suitable for cases that are questionable in diagnostic terms, since it usually leaves no opportunity for histological examination of the removed tissues.
The use of cryodestruction of papillomatous nevus is justified when it is located on the scalp or parts of the body hidden by clothing. This method of removal can only be used by an experienced doctor, since too deep exposure to liquid nitrogen leads to cold burn of tissues and scar formation. Histological examination of remote education is not possible.
Removal of papillomatous nevus by radio wave method gives a good result. After surgery, the tissues heal by scarless epithelization, which guarantees an excellent cosmetic result. At the same time, the removed material can be sent for histology without any problems.
Electrocoagulation of the nevus, although it allows its accurate histological verification, is rarely used due to the formation of a noticeable scar at the site of removal. A large papillomatous nevus is an indication for surgical excision. The application of cosmetic sutures after surgery guarantees minimal cosmetic defect.