Congenital nevus
| Classification according to ICD-10 | |
|---|---|
| D22.L60 | Congenital nevus |
| ICD-10 online (WHO version 2019) | |
A congenital melanocytic nevus (also Riesennävus or congenital nevus cell nevus ) is a benign, usually very large and brownish / black colored skin lesion that is present at birth (in contrast to most other "so-called birthmarks " or " liver spots " which only arise during puberty). It is a specific subtype of benign, pigmented, limited malformations of the skin ( pigment nevi ).
Epidemiology
Congenital melanocytic nevi show no preference for gender or skin color. Smaller such congenital nevi occur with a frequency of 1% of all newborns , larger ones (from 10 cm in diameter) are found in one out of 20,000 newborns. So-called giant nevi , which cover entire body segments, are even rarer (1: 500,000).
clinic
Congenital melanocytic nevi are characterized by their light to dark brown / black color, their nodular to cobblestone-like surface and their usually very soft structure. The size can vary widely, from under 1.5 cm to well over 60 cm. The largest giant nevi affect up to 90% of the entire skin. Often these are accompanied by many small nevi, so-called 'satellites'. These are found all over the body, and the palms of the hands, soles of the feet and mucous membranes can also be affected. In some patients there are hundreds to thousands. Giant nevi, which are often found on the abdomen or back, usually also have increased dark and bristly hair. Hence the outdated term “animal fur nevus”.
Course and prognosis
There are special forms of congenital nevi that only show up in infancy, but otherwise correspond to the normal congenital nevus cell navi. They are called tardive congenital nevus cell nevi.
The risk of developing malignant melanoma increases with the size of the congenital nevus.
therapy
The standard therapy to achieve cosmetic improvement is surgical excision. There are some clinics in Germany that specialize in this area and have a lot of experience. There is a new network of nevus surgery. Various clinics and specialists are in constant contact there and work hand in hand. To prevent the potential development of melanoma, large congenital nevi are checked at regular intervals by an experienced dermatologist. Since the actual risk of malignant degeneration is much lower than previously assumed, this is no longer a reason for removing the nevus. High psychosocial stress from a nevus can be an indication for surgical excision. The decision should be made individually after consulting an experienced dermatologist, pediatrician and psychologist. Dermabrasion is an outdated treatment method in which the top layers of the skin are abraded. Since, in addition to the expected repigmentation, many patients also experience wound healing disorders and severe scarring, most doctors nowadays advise against this method.
literature
- Thomas B. Fitzpatrick, Klaus Wolff (ed.): Atlas and synopsis of clinical dermatology: common and threatening diseases . 3. Edition. McGraw-Hill, New York / Frankfurt a. M. 1998, ISBN 0-07-709988-5 .
- Ernst G. Jung, Ingrid Moll (Ed.): Dermatology . 5th edition. Thieme, Stuttgart, 2003, ISBN 3-13-126685-6
