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June 7, 2012 / molehunter

benign intradermal naevi-elevated moles on face

These lesions are common particularly past the age of 40, I have one on my right cheek. The key thing is very slow growth. If it grows faster, be suspicious. Benign intradermal naevi (or nevi)  tend to have been there for a decade or more, basal cell cancers (BCCs) will usually have grown over 2 years or less. In time they will ulcerate but may grow to 1cm or more before starting to break down. In that pre-ulcer phase they can look a lot like harmless naevi.

Dermoscopy can help distinguish benign intradermal naevi from papular or nodular basal cell cancers especially when small, say below 6mm.

Image

Image

Note the brown globules and comma (curvilinear) vessels. These short curved vessels tend to take the shape of letters C, S and J and are very different from the tapering, well focussed, curving and branching arborising vessels of a BCC. Study lots and the difference becomes very clear. Comma vessels appear less well defined as they are buried within the lesion, BCC vessels are usually very sharply focussed as they run over the top of the lesion. Study as many examples as possible and it becomes clear.

The surface texture is different too, BCCs feel waxy and blanch white if the skin is tensioned, benign intradermal naevi have a more ‘normal’ epidermal surface and tend to feel fleshy rather than waxy. I appreciate these terms are subjective, when you have examined several hundred it gets easier.

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