Nevus


Nevus is a nonspecific medical term for a visible, circumscribed, chronic lesion of the skin or mucosa. The term originates from, which is Latin for "birthmark"; however, a nevus can be either congenital or acquired. Common terms are used to describe nevi, but these terms do not distinguish specific types of nevi from one another.

Classification

The term nevus is applied to a number of conditions caused by neoplasias and hyperplasias of melanocytes, as well as a number of pigmentation disorders, both hypermelanotic and hypomelanotic. Suspicious skin moles which are multi-colored or pink may be a finding in skin cancer.

Increased melanin

Usually acquired

Usually congenital

Decreased melanin

Acquired

Congenital

Additional types of nevi do not involve disorders of pigmentation or melanocytes. These additional nevi represent hamartomatous proliferations of the epithelium, connective tissue, and vascular malformations.

Epidermal nevi

These nevi represent excess growth of specific cells types found in the skin, including those that make up oil and sweat glands.

Connective tissue nevi

Connective tissue nevi represent abnormalities of collagen in the dermis, the deep layer of the skin.
  • Collagenoma
  • Elastoma

Vascular nevi

These nevi represent excess growth of blood vessels, including capillaries.Nevus simplex, also known as a stork bite or salmon patch.

Intramucosal nevi

An intramucosal nevus is a nevus within the mucosa as found in for example the mouth and genital areas. In the mouth, they are found most frequently on the hard palate. They are typically light brown and dome-shaped. Intramucosal nevi account for 64% of all reported case of oral nevi.

Diagnosis

Nevi are typically diagnosed clinically with the naked eye or using dermatoscopy. More advanced imaging tests are available for distinguishing melanocytic nevi from melanoma, including computerized dermoscopy and image analysis. The management of nevi depends on the type of nevus and the degree of diagnostic uncertainty. Some nevi are known to be benign, and may simply be monitored over time. Others may warrant more thorough examination and biopsy for histopathological examination. For example, a clinician may want to determine whether a pigmented nevus is a type of melanocytic nevus, dysplastic nevus, or melanoma as some of these skin lesions pose a risk for malignancy. The ABCDE criteria are often used to distinguish nevi from melanomas in adults, while modified criteria can be used when evaluating suspicious lesions in children. In addition to histopathological examination, some lesions may also warrant additional tests to aid in diagnosis, including special stains, immunohistochemistry, and electron microscopy. Typically, the nevi that exist since childhood are harmless.

Differential diagnoses

Hypermelanotic nevi must be differentiated from other types of pigmented skin lesions, including:

Management

The management of a nevus depends on the specific diagnosis, however, the options for treatment generally include the following modalities:

Destruction

Surgery

The decision to observe or treat a nevus may depend on a number of factors, including cosmetic concerns, irritative symptoms, ulceration, infection, and concern for potential malignancy.

Syndromes

The term nevus is included in the names of multiple dermatologic syndromes: