What are intradermal nevi and compound nevi?

Both are a type of mole (technically called a “melanocytic nevus”) that are usually not present at birth. They are lumpy, soft, brown or flesh-colored moles that usually appear on the face, neck, and back starting in adolescence. Sometimes they have some hair inside. They can easily be confused with warts or fibroids, but they are not the same.

Intradermal nevi are frequently on the face, neck and trunk.

Why do compound nevi and intradermal nevi appear?

Moles usually originate in the lower zone of the epidermis (the most superficial layer of the skin) and are technically called “junctional nevi” (because they are located at the junction between the epidermis and the dermis). As the years go by, they gain volume and go deeper into the dermis (which is underneath the epidermis), first becoming “compound nevi” (when they are both in the junction and in the dermis) and later becoming “intradermal” (when they are only in the dermis).

As they become larger, they also lose their ability to produce pigment (called melanin) and therefore become lighter over the years, becoming flesh-colored in many cases. Hence they are easily confused with warts or skin tags.

How are intradermal nevi diagnosed?

A simple clinical examination by a dermatologist is usually sufficient. A dermoscope is often used to confirm the diagnosis. In very rare cases, it may be necessary to analyze the lesion to confirm that it is a nevus and not something else (e.g., basal cell carcinoma).

Should compound or intradermal nevi be treated?

It is not necessary to treat compound or intradermal nevi, as they are benign lesions by definition and do not pose a health risk. It is not better to leave them or to remove them; depending on the circumstances, one or the other may be chosen. For example, they can sometimes be uncomfortable or unsightly, and one may prefer to remove them for these reasons.

It is not necessary to remove compound or intradermal nevi as they are benign.

How can compound or intradermal nevi be removed?

The removal of compound or intradermal nevi is performed under local anesthesia in a simple procedure that we usually perform in the same office. Sometimes sutures may be necessary, and in other cases (most) we use techniques such as electrocoagulation or CO2 laser to heal the wound, with great aesthetic results.

The post Is it a mole or a wart: compound and intradermal nevus? first appeared on Dra. LOREA BAGAZGOITIA.

What is a pyogenic granuloma?

These are bright red, wart-like bumps that can range in size from a few millimeters to a little more than a centimeter. They are most common in children or young adults, but can occur at any age. It is usually not painful, but it is uncomfortable because it bleeds easily, which makes it a bit of a nuisance. It is characteristic that around the lump we observe a “collarette” of skin that surrounds it at its base.

In children they can appear on the face and in adults we usually see them on the extremities.

More pictures of pyogenic granuloma

Why do pyogenic granulomas appear?

As with so many other diseases in dermatology, the cause of pyogenic granulomas is not clear, but in many cases their appearance is related to a small abrasion or wound that for some reason, instead of healing normally, heals in a way that we can call “peculiar”, forming the red and bleeding lump in the wound area.

They can occur as a result of minor trauma or be caused by certain medications.

On the other hand, they are known to occur more frequently in people taking certain medications such as retinoids, epidermal growth factor inhibitors, cyclosporine, HIV protease inhibitors, and some chemotherapy drugs (capecitabine, etoposide, 5-fluorouracil, docetaxel).

How are pyogenic granulmas diagnosed?

A pyogenic granuloma can be diagnosed with the naked eye by a dermatologist. Its appearance is very characteristic, and if we also know that it has grown rapidly in a short time, the diagnosis is quite clear.

However, sometimes it is necessary to differentiate it from other skin lesions such as infantile hemangioma, Spitz nevus or even melanoma, in addition to conventional warts, of course.

How are pyogenic granulomas treated?

They are usually removed by a very simple procedure under local anesthesia, which consists of curettage (a kind of scraping) of the lesion and coagulation of the area to stop bleeding. There is usually a blackish scab for a while, which heals in a few weeks, leaving the skin smooth.

In small cases, we can significantly reduce its volume by placing a small pile of salt covered with a bandage over the lesion. This will gradually dry it out.

Pyogenic granulomas are usually treated by simple surgery.

Occasionally, laser, topical timolol or slightly deeper surgical techniques requiring stitches may be used.

Do you think you have a pyogenic granuloma?

As an online dermatologist I can help you with diagnosis and treatment assessment.

The post A wart that bleeds: pyogenic granuloma first appeared on Dra. LOREA BAGAZGOITIA.