What's the difference between a red mole and a black mole?

Nevus are localized skin pigment abnormalities, which can occur at birth or the day after tomorrow. Healthy people can usually find 15 ~ 20 moles on the skin. Most of these moles are benign and do not need treatment. But there are some moles on the face, which affect the appearance and can be removed in different ways. There are several commonly used methods to remove moles: laser method, freezing method, electrocautery method, spot scanning method and chemical agent method.

Black spot nevus is a kind of pigmented nevus, which often attracts special attention because of its local blackening, rough skin and long hard and short hair. Attention should be paid to moles that occur in parts of the body that are vulnerable to friction or injury, such as rapid growth and increase of the body, fading or deepening of the color, shedding of short hairs on the mole, redness around the mole, faintly visible bloodshot, festering and scabbing on the surface, and even forming lasting ulcers. Nearby lymph node enlargement, or some small satellite-like nevus around the big nevus, all indicate that the nevus has a tendency to malignant transformation. You should go to the hospital to ask a dermatologist and a surgeon for diagnosis, so as to deal with it in time. For the treatment of black spot nevus, small nevus with a diameter less than 0.5 cm can be cauterized by laser or high frequency electrotome. Its advantages are simple operation, less damage to normal tissues and less scar after healing. The disadvantage is that it is difficult to take the nevus tissue for pathological examination and it is not easy to remove it. There are also freezing and chemical etching to remove moles, because the impurities left behind stimulate the malignant transformation of nevus cells, which is not suitable. Resection of pigmented nevus by trephine can make up for the above shortcomings. After local skin anesthesia, the whole pigmented nevus is drilled with a trephine 0.2 cm larger than the diameter of the nevus, and the incision can be sutured with fine thread. Because the long axis of the incision is consistent with the skin lines or expression lines, the postoperative scar is not obvious and the cosmetic effect is good.

What kind of mole should be removed?

Dr. Li pointed out that in addition to aesthetic factors, in order to avoid becoming malignant melanoma, the following kinds of moles should be removed:

1. moles that will be stimulated by long-term friction, such as those on bras and waist.

2. Nevus with atypical changes. Nevus with atypical appearance may become malignant, such as very dark nevus, uneven (mottled) pigment, uneven or irregular edge, unclear boundary, asymmetric left and right, and statistically larger than 5 mm in diameter.

3. A mole will change suddenly and rapidly. If the mole of the whole body changes at the same time because of the change of the black door, there is no doubt about it. If a single mole changes suddenly and rapidly, it is worth noting.

4. moles that grow in special parts. For example, moles growing on limbs (hands and feet) must be observed, because moles in these places are more likely to become malignant melanoma than moles in other places.

5. Mucosal nevus. Moles appeared in oral mucosa, conjunctiva, vagina and foreskin.

6. Nail groove nevus. The nail groove is connected with the skin under the nail, which may grow under the nail and be blocked by the nail, so it is not easy to see the change, and it grows at the end and is more likely to become malignant in the future.

7. Some moles are high-risk moles. The moles that babies can see at birth are called congenital moles, and there are not many congenital moles. According to statistics, 1% of newborns have moles. Not all congenital moles are inherently dangerous, and size is an important factor. Generally speaking, the bigger the mole, the greater the possibility of malignant transformation in the future, so the doctor suggested to remove it as soon as possible.

Some people have the physique of swollen crab feet, and scar tissue will proliferate abnormally, resulting in hypertrophic scars. Crab foot swelling is common in earlobe, shoulder, upper arm, chest and back, but not in face. If people with this physique want to get rid of moles for beauty, they should first inform the doctor of their physique so as not to get rid of moles for big scars.

Dangerous malignant melanoma

Ou, a plastic surgeon at MacKay Hospital in Taipei, said that benign nevus can turn into malignant melanoma: protrusion, excessive melanin, itching, pain, bleeding and ulcers.

Skin cancer mainly includes three types: malignant melanoma, basal cell carcinoma and squamous cell carcinoma.

Malignant melanoma accounts for 4% of all skin cancers, but it leads to nearly 80% of skin cancer mortality, which is one of the worst prognosis of all cancers. 10 ~ 15% patients with malignant melanoma have a family genetic history. The incidence of malignant melanoma in yellow race is lower than that in white race.

It is pointed out that 70 ~ 80% of malignant melanoma in China is acromegaly nevus, which is characterized by its predilection in palm, sole and other parts that may not be exposed to sunlight, as well as in body mucosa. Malignant melanoma of acromegaly often invades the skin basement membrane vertically and invades subcutaneous blood vessels or lymphatic vessels when the tumor is still very young, and then metastasizes. Once metastasized, the prognosis is extremely poor, and the three-year survival rate is only about 10%.

Nevus may change, some changes are warning signals, they will become malignant, and some changes are benign. Whether the nevus is malignant or not can be determined by biopsy.

Most western customs do not equate moles with fate. Elizabeth Taylor, a veteran Hollywood actress, and Marilyn Monroe, a sexy goddess, have been described as "beauty moles".

However, many people in China believe that moles are related to fate, and some patients even ask for or refuse to remove moles based on the viewpoint of life, which bothers doctors. There are also fortune tellers who claim on TV that the mole on the sole of the foot is a good mole and the mole on the foot is brave and fearless.

Doctors' regrets and dilemmas

Ou, who has been a doctor for 32 years, stressed that the mole on the foot should actually be closely observed, because the probability of long-term friction becoming malignant melanoma is very high, and he has seen 10 cases of this. Not long ago, he removed a mole on the soles of the feet for an 85-year-old man and turned it into malignant melanoma. That mole should have been with the old gentleman for decades, and it has recently become malignant.

"Once a mole becomes malignant melanoma, it will deteriorate rapidly," O 'Yun Sheng said. He's seen this before. The youngest is a 40-year-old mother with a mole of 0.5 cm on the knuckle side of her little toe, which has become malignant melanoma by biopsy. He advised her to have an operation at once and cut off the whole little toe, but the patient hesitated and dragged on for a month before coming back to the hospital to cut off the little toe. Half a year later, her cancer cells metastasized to the groin, spread to the whole body about a year, and died. Obviously, in the short period of one month that she hesitated, the cancer cells had metastasized.

"It made me sad all my life and regretted it all my life. Seven or eight years later, I still often think, sometimes, if the whole sole was removed at that time, would it be saved? Doctors are not gods, and their hearts will be soft. As soon as the patient hears that he is going to cut off his little toe, he will scare away. If they persuade her to cut off the soles of her feet, will she be more afraid of coming back? " The Yun Sheng bowed his head and said slowly.

Dr. Ou stressed: "The mole on the foot often rubs the shoes, which makes it easier to turn from benign to malignant. If there are moles on the toes and soles of the feet, it is better to remove them as soon as possible. 」

Another example also impressed European doctors. A female patient's upper arm nevus, about 1 cm in diameter, became malignant melanoma. In order to avoid residual cancer cells, he cut off the mole with a diameter of 5 cm. Unexpectedly, three years later, the patient came back unscathed and angrily accused him, which led to a big scar on her arm and made him feel embarrassed to be a doctor.

Dr. Ou pointed out that the degree of resection is based on medical experience. Considering that the smaller incision may be unclean and may recur in the future, he would rather cut it larger, but it is sometimes difficult to say whether the cancer cells have metastasized. Some patients said violently when they heard that they were going to cut off their fingers. "If I want to cut off my fingers, I would rather die." 」

How to remove moles?

The way to remove moles usually depends on the type, size and location of moles. Generally speaking, more than 3 mm must be removed.

1. If it is suspected to be malignant, it should be removed, and biopsy should be done, so the laser may not be clean. Compound nevus and dermal nevus are too deep and protruding. If they want to be cleared, they should be cleared. Larger nevus should be sutured after excision, and even skin grafting (transferring a piece of skin from other places) and skin flap transfer (taking the meat next to it) are needed.

2. Laser laser is a therapeutic method to convert electric energy into light, which is suitable for small and shallow moles, such as flat-seam moles.

3. High-frequency electrocautery destroys cells with heat energy.

4. Liquid nitrogen freezing is destroyed at the low temperature of-196 degrees Celsius, but it is rarely used.

5. The disadvantage of chemical cauterization is that it is difficult to control the depth and range of cauterization. When burned, there will be concave holes, some of which are deep, so the medical profession does not use this method, but some beauty salons and night market stalls in Dot mole like to use it.

Ou said that almost all moles can be removed, but if they are not handled properly, most will leave obvious scars. It is difficult to remove moles on eyelids and nose; Eyelids are difficult to sew, nasal nevus is difficult to repair, and skin grafting or skin flap transfer is needed; It is easier to do nevus removal surgery with decree lines because there are many surrounding tissues.

Precautions before and after operation

Do not use any maintenance or cosmetics before removing moles and laser surgery. These operations require anesthesia, laser surface anesthesia and injection anesthesia, both of which require informed consent. After laser surgery, we should do a good job of sun protection, and apply antibiotic ointment or artificial skin according to the doctor's advice before the wound scabs off to ensure the best effect. Apply beauty patch 3 ~ 6 months after stitches are removed.

Who should I ask for help?

Ou pointed out that nevus resection, laser, plastic surgery and dermatology can be done, and some patients go directly to plastic surgery.

Beirong Li Dingda suggested that for moles with malignant suspicion, you should see a dermatologist first, and you can judge them with the naked eye according to clinical data. If you can't judge with the naked eye, you should let a dermatologist biopsy and interpret it to determine whether it is malignant.

Dermatologists in big hospitals can do skin biopsy and interpret the results themselves. It is no problem to use laser to remove moles for cosmetic purposes. But large-scale excision, even skin grafting, or facial beauty and function are more suitable for reference plastic surgery. However, every hospital has it.

Ordinary people should pay attention to observe whether the moles on their bodies have changed. If they feel suspicious, they should see a doctor as soon as possible. Dr. Li said that people with moles can take photos of moles every once in a while, or take the photos to the hospital for doctors to see.