Combined Nevus

Combined Nevus

Article
Skin Care
Diseases & Conditions
+1
Contributed byLester Fahrner, MD+1 moreJul 21, 2022

What are the other Names for this Condition? (Also known as/Synonyms)

  • Combined Naevus

What is Combined Nevus? (Definition/Background Information)

  • A nevus (plural nevi) is a mole on the skin that can occur on any part of the body. A melanocytic nevus is benign tumor of melanocytic (pigment-based) cells that occur on the skin
  • A Combined Nevus is a benign mole that shows histological components of two or more melanocytic moles. This pigmented skin lesion can be either acquired or congenital in nature
  • The components that may form a part of Combined Nevus may be from any of the following types:
    • Common mole (acquired); congenital common mole
    • Dysplastic mole
    • Blue nevus
    • Spitz nevus
    • Deep penetrating nevus
    • Any other type of melanocytic mole/nevus
  • The pigmented mole is usually well-defined and less than 1 cm in size. It can be present anywhere in the body, though often they are seen in the head and neck region or in the trunk
  • Combined Nevus is observed to occur spontaneously and the cause is largely unknown. There are also no identified risk factors for the development of a Combined Nevus
  • Generally, these moles do not present any significant complications, but may cause cosmetic concerns in some individuals. Occasionally, some moles are known to undergo malignant transformations
  • Treatment is generally not required for a Combined Nevus, unless it presents cosmetic issues. The prognosis is generally excellent, since these skin lesions are benign

Who gets Combined Nevus? (Age and Sex Distribution)

  • Combined Nevus is a benign skin tumor that can occur at any age; an age range between 3-85 years is observed (average age of presentation is around 30 years)
  • Both males and females are affected and there is no gender bias observed. Some study reports indicate a slight female predominance
  • All racial and ethnic groups are at risk
  • Combined Nevi constitute about 1% of all melanocytic nevi, per some study reports

What are the Risk Factors for Combined Nevus? (Predisposing Factors)

  • Currently, there are no clearly identified risk factors for Combined Nevus formation

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Combined Nevus? (Etiology)

  • The cause of Combined Nevus formation is unknown
  • Genetic mutations have been suspected by researchers in some cases, but these have not been well-characterized

What are the Signs and Symptoms of Combined Nevus?

The common signs and symptoms of Combined Nevus may include the following:

  • It is a benign tumor that occurs as a pigmented skin mole; the main clinical features may be based upon the predominant subtype or component noticed
  • The pigmented area is usually well-circumscribed; the nevus may be symmetric in appearance
  • The nodule is typically less than 1 cm in size (about 5-6 mm on an average)
  • The color of the nevus may vary from blue to black; some may take on shades of brown, or some are also flesh-colored
  • Some moles that are irregularly shaped may raise the concerns for a melanoma
  • Combined Nevus can occur anywhere on the body. The site of the nevus may reflect the locational preference of the greater component of the nevus
  • The most common site is the torso (around 35% of the cases) including the abdomen, chest, and back
  • Other common sites include - the head and neck region (in 24% of the cases); arms and legs (in 30% of the cases); and the pelvic region including the buttocks (in 5% of the cases)

How is Combined Nevus Diagnosed?

A Combined Nevus is diagnosed through the following tools:

  • Complete physical examination with evaluation of medical history
  • Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
  • Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
  • Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: In majority of the cases, no biopsy is necessary. But it may be performed, if the mole resembles a melanoma, which is a malignant skin tumor.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Combined Nevus?

There are frequently no complications that arise from a Combined Nevus.

  • Nevertheless, in some individuals, it may give rise to cosmetic concerns
  • Very rarely, some moles presenting atypical features are known to progress into a melanoma
  • Recurrence of the mole can occur on its incomplete excision and removal

How is Combined Nevus Treated?

The treatment measures for Combined Nevus include:

  • The healthcare provider may choose to regularly observe the benign tumor; a “wait and watch” approach may be followed. In such cases, no treatment is generally required
  • If required, a surgical excision and complete removal of the nodule, to address cosmetic issues or if its growth is worrisome
  • Follow-up care with regular screening and check-ups are important and encouraged

How can Combined Nevus be Prevented?

Current medical research has not established a method of preventing the formation of Combined Nevus.

What is the Prognosis of Combined Nevus? (Outcomes/Resolutions)

  • The prognosis of Combined Nevus is excellent on its complete excision and removal in most cases
  • Since, these are ‘essentially’ benign tumors, the prognosis is generally excellent even if no treatment is provided and only periodic observation maintained
  • In rare cases, some nevi presenting atypical cytological features are known to undergo malignant transformations. In such cases, the outcome is dictated by several factors including early diagnosis and appropriate treatment

Additional and Relevant Useful Information for Combined Nevus:

  • There is no evidence to prove that the tumor formation is influenced by one’s dietary choices
  • Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
  • The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse
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On the Article

Krish Tangella MD, MBA picture
Approved by

Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team
Lester Fahrner, MD picture
Reviewed by

Lester Fahrner, MD

Chief Medical Officer, DoveMed Team

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