In aforementioned blog posts we have spoken about different spots that can appear on the skin, either due to hypopigmentation or hyperpigmentation. Today is the turn of the skin spots that cause more alarm and are the reason for more visits to the dermatology office: dark or black spots .
The most common black spots:
Moles or nevus
The most common dark or black spots on the skin are moles or nevus . They
are very common benign lesions (present in most people), characterized by their
dark brown or black color and well-defined borders. They can be of
different sizes and appear isolated or grouped. They are normally located
in areas exposed to the sun (such as the face, neck, back or chest) and their
quantity depends on genetic predisposition and sun exposure .
There are different types of nevi. If the moment of
their appearance is taken into account, they are classified into congenital nevi (present
from birth or in the first 2 years of life, they are classified according to
their size and hairs can grow on their surface) and acquired nevi (they
normally appear during the first 10 years of life and they increase in number
until 35 - 40 years).
Another type is dysplastic
nevi . These are moles that have a somewhat different
appearance from the rest: they are usually larger than 5mm, they can have
irregular or poorly defined edges, various colors or be asymmetrical.
How are nevi diagnosed?
The clinical diagnosis of nevi is made from an ocular
inspection by the specialist, who usually uses a dermatoscope (a kind of
magnifying glass) to improve the vision of the lesion and to distinguish which
moles need to be removed for study and which ones are not.
To aid diagnosis, applications such as eDerma are being
developed, endorsed by the Spanish Academy of Dermatology and Venereology
(AEDV), which allows monitoring of the skin and suspicious lesions. The
user of the application can take photos of the different nevi and other skin
lesions to identify possible variations over time. The dermatologist will
be able to use the application to follow the evolution of the lesions of their
patients.

How do nevi evolve?
Although it is infrequent, some nevi can transform into malignant tumors called
melanomas, so it is advisable to carry out a periodic
control of them and consult a specialist if we detect any of the following
signs:
ABCDE rule:
To symmetry. Asymmetric
growth moles.
B ordes
irregular and / or poorly defined.
C oloración
different from one zone to another of the same mole.
D iámetro
greater than 6 mm.
E volution. Moles
that change in shape or size.
Moles that bleed
Itchy or painful moles.
It is recommended that this periodic control be carried
out by a specialist in dermatology in the following cases:
People with large congenital nevi (larger than 10 cm)
People with dysplastic nevi
People with many moles
People who have previously had melanoma or a family
history of melanoma
If the specialist suspects that the nevus may have transformed into a melanoma,
he or she may recommend performing a biopsy
and removing the mole for analysis.
Can black spots be avoided or
prevented?
You cannot avoid the appearance of nevus, what we can do
is prevent its transformation into a melanoma. To do this, we must avoid
excessive sun exposure and always use sunscreens with a high protection
factor , in addition to regular checks on our
moles. The AEDV recommends that these controls be carried out on a monthly
basis.
Can nevi be removed?
A nevus can be eliminated (by means of its removal) if the patient requests it (either
for cosmetic reasons or to cause friction or discomfort) or if the
specialist suspects that the nevus has
become malignant .
Some of the procedures used in these cases are:
Biopsy (by puncture) . Used
mainly in children. It consists of detaching the nevus from the skin and
cauterizing the area after doing so. To prevent possible infections, it is
treated with an antibiotic.
Removal by shaving . It
is the most widely used and fastest procedure (about 10 minutes per
nevus). The nevus is removed using a scalpel, previously applying local
anesthesia.
Laser . The
main advantage of using this procedure is that it does not leave a scar,
although it may not be sufficient for deeper nevi.