Clinical Dermatology
Moles (Veni)
Veni, commonly called "moles", are cells of dermal origin and are the most benign skin tumor. Benign tumors are all skin lesions, which have no evidence of malignancy and do not pose a health problem. Almost all people, men and women, have moles either from their birth or acquired in the course of their lives. New moles may occur until the age of 40, and there are some that disappear with age.

Moles may appear at any part of the body in various shapes and sizes and, under the influence of certain factors, may constitute a danger to the health of the individual as they can degenerate into malignant lesions, migrate elsewhere if neglected or and bleed.
 
The dermatologist and plastic surgeon are the only doctors who can assess whether a mole is benign or can cause a problem. After examining each case individually, they can decide whether the mole has to be removed or simply be followed up. According to the ABCDE international dermatological rule, moles are suspected when presenting:
  • A → Asymmetry: If the parts of the mole, if separated by line, are symmetrical, then the mole is considered normal. If it is asymmetric, further consideration should be given.
  • B → Limits: Smooth boundaries of the mole are benign. If the limits are irregular, then further consideration should be given.
  • C → Color: If the mole shows a multicolour or a change in colour, then there is a possibility of malignancy. If the mole is not stable, then further examination should be performed.
  • D → Diameter: Generally speaking, the small diameter of the mole indicates being benign, while the malignant moles are larger. The only certainty is that if the mole has a diameter of more than 6 millimeters, it needs further examination.
  • E → Evolution: The benign moles remain stable in colour and size over time. Any change suggests a risk and needs further examination.
For proper prevention and diagnosis, mole mapping is now considered the respective Pap-test for skin. Dermatologists recommend performing mapping every year, especially in cases of:
  • People with multiple or dysplastic neoplasms
  • People with family history and especially with a history of melanoma
  • Individuals of low immune system
It is the most effective method for detecting skin cancer, particularly melanoma, at a very early stage. With special digital imaging equipment and the use of polarized light, it draws up accurate and detailed "map" of the body with photographs of the patient's moles. Then, using electronic technology, individual images of carefully selected whips are taken and stored for diagnosis by the physician and for future digital comparison. Having the option of revocation, there is the possibility of re-checking images and digital comparisons with new images resulting from a review.

Mapping moles is a painless and enjoyable process. Practically, moles are photographed with the help of a special digital dermatoscopic camera, which is called a digital video dermatoscope. The method is absolutely safe from the neonatal period of life to any age and, of course, totally safe for pregnant women. It is an examination that can be done at any time, because it does not require any preparation by the patient. The examination may take from a few minutes to half an hour, which, of course, depends on the extent of the damage to be treated. During that time, moles are not only captured, but also a first diagnosis is made, and the doctor may need to intervene in the immediate removal of a mole.

The philosophy of mapping is based not only on accurately recording the position of moles on the classical anatomical surfaces of the body, but also on frequent and regular monitoring. That is why each patient should often visit the dermatologist for a repetitive examination of the moles after mapping and this should happen at least once a year, depending of course on the incident.

After mapping the moles and assessing their condition, you may need to remove the ones appearing worrying signs.

How Are Moles Treated? 
At Dermatology & Cosmetics Lab, we use all the modern and classic ways to remove the moles with the best results.
  • Segmental resection: Applied primarily to large-sized moles, it is performed after a biopsy has occurred because the skin defect is large. After the biopsy is done and the removal is decided, the mole is removed after being cut into small pieces and followed by plastic surgery to restore the skin.
  • Shave Excision: It is done in benign moles that show little or no overcoat and do not reach the dermis. First, local anesthesia with xylocaine is applied, and then the dermatologist cuts the mole with a fine blade just on the surface of the skin. The mole, of course, will be sent for biopsy. This technique leaves no marks and the person can immediately return to his everyday life.
  • Surgical removal: This is the method used when malignant or large moles are detected. The surgeon who removes the mole at the same time takes skin tissue from the surrounding area, which is also sent for biopsy to exclude any possibility of malignancy. Surgical removal is performed by local anesthesia, sutures are made at the point of abdomen and tissue removal and may remain a small scar after healing.
  • Cavitation: This method that uses low-intensity electric current to destroy the mole is one of the classic methods of removing small moles and epithelia. Following this method, although it is not necessary to suture the wound, it may take a long time for the wound to return because the area is burning. Therefore, it is recommended to avoid it on skins that tend to scar. 
  • Fractional Laser: One of the most modern methods of mole removal. After dermatoscopy or mapping of mole, Dermatology & Cosmetics Lab's specialised doctors indicate the lasers that are suitable for laser removal. A focused beam of light destroys the mole by sublimation without affecting the surrounding healthy tissue. Sutures are not required and no scars remain. The method is suitable for young, small or flat moles, depending on the case, while all the moles are sent for histological examination.
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