Nevus: Therapy

General measures

  • Review of permanent medication due topossible effect on the existing diseaseImmunosuppressive therapy (here: anti-TNF-alpha antibodies, azathioprine, methotrexate) → increases the number of melanocytic nevi and alters their dermatoscopic picture.

Therapeutic measures

Dermal melanocytic nevi

  • There is no need for therapy

Epidermal melanocytic nevi

  • There is no need for therapy

Nevus cell nevus (NZN)

  • If there are signs of dysplasia, the changes should be checked regularly and, if necessary, prophylactically excised (cut out)!
  • Benign juvenile melanoma (spindle cell nevus; Spitz tumor) – there is no need for therapy; if necessary, excision if the diagnosis is unclear.
  • Dysplastic nevus (atypical nevus, active nevus) – should be excised.
  • Halo nevus (Sutton nevus) – there is no need for therapy.
  • Nevus pigmentosus et pilosus (giant pigmented nevus) – the changes should be regularly checked, if necessary abraded or excised.

Vascular nevi, hemangiomas.

  • Nevus flammeus (ICD-10 Q82.5; port-wine stain; nevus teleangiectaticus; planar hemangioma) – electrocoagulation, laser therapy (using pulsed dye laser; as early as possible laser therapy without anesthesia – for example, as an infant under one year; with early therapy, the nevi are still without thicker plaques, ie, without hypertrophy).
  • Hemangioma (ICD-10 D18.0) – usually regress on their own; if a function/organ is impaired by the hemangioma, cortisone therapy or laser therapy may be indicated; for “infantile hemangioma,” first-line therapy is treatment with an oral propranolol (3 mg/kg bw propranolol) until 12 to 16 months of age; see.
  • Granuloma pyogenicum (ICD-10 L98.0; granuloma teleangiectaticum, botryomycoma) – the change should be excised

Epidermal nevi

  • Can be excised if they are disturbing

Sebaceous nevi (nevus sebaceus).

  • In most cases, there is spontaneous regression.
  • If exophytes occur, the changes should be excised immediately.
  • Since the development of various tumors (basal cell carcinoma (BZK; basal cell carcinoma), squamous cell carcinoma of the skin, spiradenoma, trichoblastoma) has been described, the excision should be aimed until younger adulthood