Generality
The mapping of the moles is a dermatological evaluation that allows constant monitoring of the pigmented lesions present on the whole body of the patient.
The snow mapping is performed with the aid of non-invasive precision optical instruments, which analyze not only the external morphological structure of the lesions, but also the characteristics of the layers placed immediately below the superficial dermis.
With this evaluation, the dermatologist has the opportunity to view and archive photos of suspected pigmented spots on a computer, to be able to compare them with the images recorded in the months or years and identify any signs of alteration .
For these reasons, the mapping of the moles represents an important diagnostic test to detect the presence of a skin cancer early and significantly improve the chances of treatment.
What is a neo (or nevus)?
The moles (or nevi) are pigmented spots caused by a proliferative process characterized by the accumulation of melanocytes (cells that produce melanin, a pigment responsible for the color of the skin and tanning).
These skin lesions can arouse suspicion when they present an "atypical" structure, both with the naked eye and following dermatoscopic examination.
What is the mapping of moles?
The term " mapping " is intended as a skin control program, implemented to periodically detect lesions on the patient's skin surface; in subsequent checks, comparison with the results of previous visits allows us to verify whether the skin lesions have undergone a change in shape and color.
The mapping of the moles uses non-invasive and painless technologies, such as manual dermatoscopic examination or digital videodermatoscopy.
- The dermatoscopic examination is a method that allows to examine the skin surface thanks to a strong enlargement, able to increase the dermatologist's diagnostic capacity. This survey also allows the vision of the structures placed immediately below the superficial epidermis (intermediate layer between epidermis and deep dermis), otherwise not visible to the naked eye.
The observation of these elements is relevant for the specialist doctor, who can assess the characteristics and the typical organization of each skin lesion.
The information relating to the moles is then cataloged and stored with appropriate computerized systems, to allow the control and comparison of suspicious new growths over time.
- Videodermatoscopy involves the use of a fiber optic camera, connected to a computer that transmits images of the highest quality and allows to save, with appropriate computerized systems, the photographs of the lesions. Thanks to this method, the dermatologist can carefully examine the pigmentary reticulum, the distribution of melanin and the vascularization of the stain, improving the ability to identify suspicious lesions, which will then be subjected to histological examination.
What is it for?
The purpose of the mapping is to record the presence of pigmentary neoformations all over the body and to carefully follow the nevi that show atypical clinical and dermatoscopic features.
During the mapping of the moles, the dermatologist can:
- Carefully observe the characteristic aspects of each mole;
- Have an indication about the nature of the skin spots;
- Distinguish neoplastic forms with a higher accuracy than with the naked eye or with a normal magnifying glass.
The mapping of the moles represents, therefore, a fundamental support for the early diagnosis of a melanoma, a malignant tumor from the epidermis that can arise on healthy skin or on a pre-existing nevus, transformed in a neoplastic sense.
Melanoma is not the most common skin cancer, but it is the most dangerous, since it can give metastases relatively quickly. If this is identified early and treated with surgery, however, the prognosis is favorable.
How to do it
The mapping of the moles is an investigation carried out during a dermatological examination, with the patient free from clothing, for a better evaluation of the skin and visible mucous membranes.
At first, the subject is examined on the table for global assessment with the naked eye, then the moles that appear irregular are marked.
The second part of the visit involves the use of the dermatoscope, which allows the dermatologist a direct view of the skin surface. This instrument is a kind of small microscope, equipped with a lens, which is placed in contact with the skin.
The area to be examined is illuminated with a polarized light incorporated in the device; the skin is translucent and the superficial dermis (the intermediate layer between the epidermis and the deep dermis) is also highlighted.
During the dermatoscopic examination, the dermatologist takes macro photographs of the marked moles and then analyzes them with a digital support.
Alternatively, the doctor can use a camera connected to an electronic system ( digital videodermatoscope ) for mapping the data, which allows the images to be viewed indirectly on a monitor.
In addition, the injury assessment program offers the possibility of creating folders for each patient, in which to store the skin images viewed. These personalized documents can be used to compare the data over time.
Melanoma: who is most at risk?
Melanoma can develop at any age, with no difference between men and women.
However, some people have an average higher basic risk, as they have one of the following risk factors:
- Familiarity : presence of a first or second degree relative who developed melanoma.
- Phototype : individuals with fair skin and light eyes (blue or green), tendency to form freckles and burn themselves in the sun.
- Number of moles : more than 50 moles on the skin.
- Sun exposure : subjects who have developed sunburn (especially during childhood and adolescence) or who are exposed in the middle of the day and do not use creams with a sun protection factor (SPF) greater than 20.
- Previous personal history of melanoma : patients who have already developed this cancer in the past.
How long does it last
Generally, the time required to carry out a thorough mapping of the moles is 30 minutes. The patient is made to undress and lie on the couch, then the dermatologist will carry out an examination of the snows present on the skin, providing for their mapping.
At the end of the visit, a report is given to the patient to be shared with your general practitioner. In addition, indications are given on the correct sun exposure standards and on how to perform skin self-inspection (ie periodic checking of moles and lesions on the skin, performed in front of a mirror or with the help of a family member, which makes it possible to find rapid and suspicious changes).
How to control a mole
The presence of the moles must not be alarming, but it must be borne in mind that they can become dangerous when modifications occur which require a timely evaluation by a specialist doctor. For this reason, regular self-inspection of the skin is recommended.
When controlling a mole, it is necessary to remember the rule of the ABCDE, which takes into account the main characteristics of a lesion that should make one suspect the presence of a melanoma and induce to undergo a dermatological check.
- A as Asymmetry : neo formed by two different halves.
- B as Borders : presence of a mole with irregular and jagged edges.
- C as Color : very dark or non-uniform lesion, in which color variations have appeared (shades of brown or black, red, white and blue);
- D as Size : in sizes greater than 6 mm in diameter and rapid changes in width and thickness.
- And as Evolution : mole that has changed its initial appearance, by shape, size and color in a short period of time (6-8 months) or if it has bled spontaneously.
Is preparation necessary?
The mapping of the moles does not require any specific preparation.
However, to facilitate the vision of pigmented lesions and allow an accurate inspection of the whole body surface with dermatoscopy, some tricks can be useful:
- On the day of the visit, avoid making up eyelids, lips and face; if possible, thin out the beard or mustache; remove nail polish and do not wear watches or jewelry.
- Report any stains to the dermatologist in the genital area to prevent them from being inspected.
- If possible, do not book the appointment when you are tanned: after sun exposure, the nevi show signs of photo-activation that could hinder the instrumental examination.
Furthermore, it is good to remember to bring to the examination the clinical documentation deriving from previous dermatological evaluations and to report to the doctor if there have been cases of melanoma in the family.
Contraindications
The mapping of the moles has no contraindications. The examination does not cause pain and is not invasive; furthermore, it can also be carried out by pregnant women.
How often to take the exam
The frequency with which to submit to snow mapping depends on the assessment of the specialist, who takes into account various factors.
In general, if there are no particular situations, it is sufficient that the subject undergoes a dermatological examination every 2-3 years.
In case they were found in the "at risk", instead, it is advisable an annual check, through manual dermatoscopy or digital videodermatoscopy.
To remember
- Never expose yourself to the sun without adequate protection on the skin: use sunscreens with a protection factor appropriate to your skin type (between 20 and 50+), effective against UVB and UVA rays and without sensitizing ingredients. If necessary, consider taking a solar supplement.
- Avoid exposure to the sun in the central hours of the day.
- Avoid or minimize the use of tanning lamps and tanning beds.
- Keep skin blemishes and moles under control, according to the ABCDE rule: Asymmetry, Irregular Edges, Variable Color, Size and Rapid Evolution.
- Carry out a dermatological examination on a regular basis: the clinical examination of the skin and the mapping of the moles make it possible to diagnose melanoma as early as possible, identifying the appearance of new moles or changing existing ones.
