Rus Articles Journal

Birthmarks: a dangerous charm of

Nice marks on a body which all call birthmarks from time immemorial were considered as a secret of a ladies` charm. But it appears, this component of unique female charm can turn back serious problems with health for the owner.

Of course, existence of birthmarks in itself on a body - yet not a reason for disorders. Just to avoid possible unpleasant consequences, it is necessary to treat them more attentively. And that the nobility what it is necessary to be afraid of, it is useful to get acquainted with this phenomenon in more detail.

of the Birthmark is a household name of the congenital and acquired pigmented educations on skin, is more often in a look darkly - a brown spot or a pea. In medicine there is a term “nevus“ designating pigmentary formation of skin in general.

Why birthmarks

the Nevus appear (congenital or acquired) it is formed on skin at the expense of the pigmentary cages producing 1 melanin - melanotsit which normal are between two layers of skin: epidermis (the most top layer) and dermy (inside layer), and already exist there at the birth of the person.

the Congenital nevus

the Congenital nevus can conditionally be divided by the sizes into three categories:

In certain cases small a nevus can be exposed to malignant regeneration, but data on that, how often it occurs, no. Whereas the risk of transformation in a tumor of averages and huge a nevus is big and reaches 10 - 50% therefore their owners should be observed at the dermatologist or the oncologist 2 . Besides, such birthmarks need to be protected from influence of ultraviolet rays. In certain cases doctors offer removal of a large congenital nevus that they did not develop into a malignancy over time.

the Acquired nevus

is the Reasons of emergence of the acquired nevus

specific genetic features of the person. Similar educations in most cases appear on skin in the first years of life (pigmentary cages from depth of skin move closer to a surface where their congestions are formed) and, in turn, are also subdivided on:

  • of vnutridermalny a nevus (are characterized by a congestion of melanotsit deeply in skin, in its thermal layer);
  • epidermalny (are characterized by a congestion of melanotsit in the top layer of skin - in epidermis);
  • boundary , or mixed (congestions of cages are on border terms and epidermis).

Acquired epidermalny and vnutridermalny a nevus most often looks as a pea. As for boundary option, they, as a rule, appear in the form of the flat spot of brown shades which is not towering over skin.

the reason for alarm Is?

At birth each person can have on average about ten pigmentary marks. With age them can become more or less. It is important to pay attention to emergence of new birthmarks. In the beginning they look as microscopic spots, sometimes show a tendency to increase, but seldom reach the sizes more than 0,5 cm and, as a rule, remain flat or slightly raised over surrounding skin in the form of light-brown “small peas“, in certain cases - on a thin leg. The vast majority of similar pigmentary educations are absolutely harmless.

In life people usually pay more attention to convex “small peas“ than to flat spots. Meanwhile should pay special attention to flat boundary acquired nevus , especially if they increase in sizes or, on the contrary, decrease, that is - if such nevus has irregular shape and uneven pigmentation (color of education varies from light-brown to intensive black), then it should be considered as of displasticheskiya i.e. capable to regeneration in a melanoma - the malignant tumor developing from melanotsit (we will dwell upon this disease later). At the same time malignant transformation of a similar nevus on average takes from 5 to 10 years. And the owner of a similar birthmark loses vigilance just because long time happens nothing to it. However, at some displastichesky nevus the tendency to slow, but right increase can be traced: about 1 - 2 mm in 8 - 12 months, or even for bigger time. If the amount of similar education has 6 - 7 mm a diameter, it is necessary to consult at the dermatologist or the oncologist .

Timely removal of a similar birthmark is prevention of a melanoma.

Of course, it is impossible to claim that each displastichesky nevus surely gives rise to tumoral growth though the risk is rather big here. However a question of surgical intervention otherwise - the oncologist`s prerogative . In this regard the dermatologist who is engaged in cosmetic removal of birthmarks surely has to direct the patient to consultation to the oncologist in case of identification of suspicious pigmentary educations. cannot delete pigmentary educations independently or not at the dermatologist or the oncologist At all .

On reception at the expert

truly to establish the diagnosis, the expert, talking to the patient, finds out, or acquired this pigmentary education what appearance it had in the beginning what changes if they were and for what period happened to it what they are connected with, and also - whether treatment of a nevus was carried out already and what it had character is congenital. Besides, the doctor surely performs education inspection, specifying its color, a form, the sizes etc.

To standard methods of diagnostics of any pigmentary formations of skin including melanomas, carry histologic research - research of samples of the fabric taken from the patient under a microscope for the purpose of studying of a structure. Material for studying is received as follows: from a surface of pigmentary education (in the presence on it cracks and bleeding) do dab - a print and investigate it. Results are in that case usually ready next day.

Sometimes right after survey the suspicious new growth is exposed to full removal with the minimum spaces (3 - 5 mm) from its edges for further histologic research. Procedure is carried out under local anesthesia. Results can be received in several days. It is important to note that all listed events need to be held only in specialized oncological institutions.

Histologic research allows to distinguish a malignant tumor from good-quality, with high degree of reliability to establish the diagnosis, to define a disease stage, and also to make the further forecast of efficiency of treatment.

also other auxiliary physical methods of diagnostics Exist. For example, epilyuministsentny microscopy at which research of pigmentary education is made directly on a body surface, with increase by 10 - 40 times, using effect of an epilyuministsention which is reached by creation of the oil environment between object of research and dermatoskopy (the optical device with artificial highlighting). For this purpose several drops of vegetable oil apply on a surface of pigmentary education, then put to object dermatoskop. Dermoscopy allows to define pigmentary structure of a new growth of skin precisely.

One more auxiliary technology - a method of computer diagnostics . The image of a nevus recorded by means of a digital video camera remains in memory of the computer, and then on certain signs is compared to the available database.

epilyuministsentny and computer methods of diagnostics are convenient to

I in use not only for oncologists, but also for general practitioners. Therefore in the future they can be applied at mass inspections of the population.

Ways of removal of birthmarks

Exist two categories of indications for removal of birthmarks - cosmetic and oncological . Depending on it also the way of their elimination is defined. But the expert has to make a choice surely.

Cosmetic indications

If pigmentary education good-quality, for its removal can be used by any of the listed methods: is surgical, cryodestruction (by means of liquid nitrogen), electrocoagulation (by means of electric current of high frequency), and also removal of education by means of of the laser .

the Most traditional is surgical the method. It is irreplaceable when it is required to cope with deep or large skin education. The skin site with a birthmark which is exposed to removal has to make from 3 to 5 mm in the diameter. Histologic research of a remote nevus has to be conducted surely.

At of cryodestruction on skin remains a dry crust, protecting a wound from infection. The wound does not need special processing. Under a crust healthy fabric is gradually formed. The method of cryodestruction can use for removal of pigmentary spots on a face.

At of electrocoagulation current of high frequency causes thermal damage to fabric around the deleted zone. But after influence of current on skin there are small hems.

in One more way of removal of skin educations is the laser. Thanks to the small diameter and a certain depth of influence the laser beam “works“ very precisely, and surrounding fabrics are damaged minimum. And it is important during removal of birthmarks in the person and open parts of a body. On the place of operation there is a crust protecting a wound from penetration of an infection and formation of cicatricial fabric. The deleted birthmarks of the small size do not leave a mark, and here on the place of deeper educations there can be a colourless spot, at someone over time it will disappear, at someone is not present.

Oncological indications

If are serious reasons to suspect malignant regeneration of a pigmentary nevus, then in such cases surgical removal of all pathological center with obligatory subsequent its histologic research has to be always made by .

by

the Melanoma

in the different countries noted Recently the prompt growth of incidence of a skin melanoma. Unfortunately, it became one of often found pathologies at young women. Besides, it is known that at the fair sex this malignancy meets on skin of the lower extremities more often, and men - on skin have backs. In Russia four of 100 thousand people get sick with a melanoma. The melanoma can sprout in several layers of skin, extend on lymphatic and blood vessels in other bodies and fabrics (lungs, a brain, a liver) and to form the new centers of growth (metastasises). This disease mortality in case of an untimely initiation of treatment can reach 50%.

of the Reason of emergence of a melanoma

the Artful ultraviolet

Occurs opinion that the sunlight leading to damage of genetic material of melanotsit and defiant decrease in immunity that increases risk of uncontrolled reproduction of pigmentary cages and development of a tumor is the main reason of formation of a melanoma. Really, in the countries with hot climate where the year-round level of ultra-violet radiation is rather high, indicators of incidence of the mentioned illness are high. Besides researches of the last years demonstrate that each solar burn got in the childhood considerably increases risk of development of a melanoma at mature age. However cases of developing of a melanoma and at people, the northern latitudes never leaving and not acquiring a tan are known.

a heredity Role

Lack of genetic ability of skin to adapt to aggressive influence of environment plays an important role in development of a disease.

Also the rare congenital pathology called by a syndrome of a multiple displastichesky nevus in total with a family melanoma of skin which results from specific genetic disorders exists. It is shown that among close relatives predisposition not only to emergence of a multiple displastichesky nevus, but also their malignant regeneration in a melanoma passes from father to son. Such people need special attention of experts. They need carrying out the physician - genetic consultation and the main thing - continuous, careful medical supervision over all pigmentary objects on skin. Nevertheless, according to data of medical statistics, 2/3 cases of developing of a melanoma carry acquired, but not congenital character.

the Trauma is guilty

? whether

the trauma Can provoke development of a melanoma? There are no convincing data demonstrating that the travmatization (any character) can stimulate malignant regeneration of a pigmentary nevus today.

Risk factors

Should note

that people with low intensity of pigmentation of skin in response to ultra-violet radiation are subject to the greatest risk of developing of a melanoma and, therefore, having the low level of natural protection of skin against the sun. These are white, red-haired and blue-eyed. Under the influence of the sun they instead of suntan get solar burn. Also those at whom treat “risk group“:

  • a lot of good-quality nevus on skin is available;
  • three and more displastichesky nevus is;
  • by
  • noted three and more episodes of heavy solar burns of skin during life;
  • by
  • revealed melanoma cases at close relatives.

Traditional treatment

with

Primary melanoma of skin, that is a tumor at a stage of local manifestations, has to be removed surgically. Secondary displays of a disease, namely the metastasises striking lymph nodes and internals need to be removed too if it is possible. Depending on a stage of a disease surgical the method of treatment can be combined with preventive chemotherapy (adyyuvantny) , slowing down growth and reproduction of microscopic congestions of tumor cells (micrometastasises) which could remain in an organism. And also with medical chemotherapy 2 , influencing larger tumoral centers which cannot be removed.

So, diagnosis of a melanoma of skin at an early stage and the subsequent surgical intervention practically in all cases assumes an absolute recovery of the patient, but in due time to begin treatment, it is necessary to make the diagnosis as soon as possible.

the Prevention and precautionary measures preventing development of a melanoma:

  1. is not recommended to be long on the sun during the period from 11 to 17 o`clock when sunshine are especially active. If the sun is closed by clouds, it does not mean that it does not radiate an ultraviolet (85 its % get on skin at cloudy weather at the sea).
  2. Should consider
  3. that reflection of the sun from water and sand, and also from snow doubles quantity of ultraviolet rays which are absorbed by skin.
  4. of Means from suntan protect skin from a solar burn, but convincing data that these ointments, sprays and lotions really prevent development of a melanoma, no.
  5. Should not abuse artificial suntan in a sunbed. And people till 28 years, according to WHO recommendations, it is better not to use the equipment for artificial suntan as it can lead to development of cancer of skin.
  6. needs to study regularly “card“ of the body, attentively monitoring all changes of its “landscape“. And at emergence of the suspicious birthmarks causing concern - it is urgent to address the expert.

have some attention to itself, reasonable discretion - and charming birthmarks will give them to the owner only pleasure from awareness of own appeal.