Blue nevus is the term that means the collection of skin lesions which are the growth of melanocytes stem cells forming bluish to black nodules in the head, extremities, or buttocks. Generally, these scars develop as solitary lesions available for distribution over several skin regions or they can be inherited and found to exist at the time of birth. There are two widely known histological subtypes: type I (commonly blue nevus) and type II (cellular blue nevus) nevus.
Epidemiology
Epidemiology varies among the two typical subtypes of the common divisions. Usually a birthmark-like appearance called common blue nevus is observed in young adults, while cellular blue nevus is mainly diagnosed in middle-aged patients and presents a more than two to one frequency in women in comparison to men.
Anatomy
Pathophysiology
The entity of bluish nevus is also unspecified. It is noteworthy that the components of blue nevus may be in fact part of melanocytes of neural crest which migrated as fetus developed. On the contrary, some believe that they develop from stem cells in the dermis layer. With a high concentration of melanocytes coming out from the dermis and lips of numerous melanophages with their dense melanin pigmentation another unique blue color is present. A pigment responsible for the specific blue color is represented by the reflection rather than absorption of shorter wavelengths of light corresponding to blue color by the dermal melanin.
Etiology
The common blue Nevi are usually an acquired feature; however, they can be congenital and associated with syndromes such as LAMB (lentigines, atrial myxomas, and blue Nevi) or NAME (nevi, atrial myxoma, myxoid neurofibromas, and ephelides). One variant, the epithelialoid type, is a main feature of the complex Carney, a multiple endocrine neoplasia distinguished by skin and mucous membrane pigmented spots and cardiac myxomas, a brain tumor of visceral neural tissue.
Genetics
Prognostic Factors
The blue nevus shows a positive prognosis as the injury in and of itself is not malignant. Similarly, though malignancy of the melanoma originating from blue nevus is a very rare phenomenon. Symmetrically retrospective analysis illustrates that BNLM poses a risk of metastasis and is similar prognosis to conventional melanoma and when comparing lesions at the same depth and stage.
Clinical History
In much younger age groups, the blue nevi often manifest as non-threatening pigmented lesions, which are usually solitary and have small dimensions. A patient may even be unaware of them until they are incidentally seen during a routine skin examination. Â It is often a common occurrence in those who have been exposed to the sun or had more time outdoors.
Physical Examination
Location: Blue nevi can be found around the body, but they are most common on the extremities, face, scalp or sacral area. Number and Distribution: Note that quantity and distribution of symptoms can indicate epidemical outbreaks. Multiple may be a symptom of syndromic conditions. Size and Shape: Analyse size and shape: small macules in contrast to large papules or plaques. Color: Mostly blue, dark blue, or violet blue; strong colour differences can happen. Texture: Assess the texture: usually dense yet slightly chewy and have a smooth or semi-rough surface.
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Blue nevi have a distinct appearance, but they are often misdiagnosed. One less common variant, the amelanocytic blue nevus, may resemble a dermatofibroma or scar due to the lack of melanin pigment and the presence of spindle cells, collagen, and/or sclerotic stroma in histology. It can also be confused with amelanocytic melanoma. Another variant, the desmoplastic blue nevus, shows exaggerated dermal fibrosis histologically and may be mistaken for desmoplastic melanoma. Additionally, blue nevus-like melanoma must be carefully distinguished from blue nevi, especially the cellular subtype, to avoid delayed diagnosis and treatment, as the two conditions are frequently confused with each other.
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
Observation: Most blue nevi are harmless and thus they don’t require any medical treatment. They may be checked from time to time for changes in size, shape, appearance, or color.
Surgical Excision: A blue nevus showing some characteristic signs, tending to be cosmetically bothersome can be removed through surgical excision under certain scenarios. Removal of the whole lesion and an appropriate margin of surrounding tissue is carried out (to provide adequacy).
Dermoscopic Evaluation: Dermoscopy, a non-invasive technique that optically magnifies the features of the lesion, which is applied to have closer look with the naked eye. This may result in diagnostic differentiation between harmless blue nevi and possibly malignant tumors, aiding in therapeutic decision-making.
Biopsy: The biopsy methods are performed in cases of an ambiguous diagnosis or suspicious features of malignancy to achieve histopathological diagnosis. In this process, a physician aspirates a small bit of the lesion for inspection by a pathologist under the microscope.
Cosmetic Treatments: If the lesion is a blue nevus, primarily, the cosmetic problem on the surface of the skin, laser therapy or cryotherapy will be required to reduce the pigmentation or flatten the lesion overall.
Surgical Excision: The treatment for blue nevus is surgery, that of particular importance, if the nevus is symptomatic, aesthetically annoying, or demonstrates certain features. In the course of excision the whole pervader as well as a margin of the adjacent healthy tissue are removed so that no remains can be left.
Laser Therapy: Q-switched lasers, for example, can be useful as they can be fired at the pigment in blue nevi and subsequently destroyed, causing the nevi to either fade away or eventually disappear. This being the case, this method is generally chosen for the cases with cosmetically sensitive traits or for the clients who opt for non-invasive treatments.
Cryotherapy: Stages include cryotherapy where the lesion is being frozen by using liquid nitrogen. However, therapy is not as common as in other lesions on the skin except for paget cells. Here, cryotherapy can be considered if there are small and superficial lesions, particularly on patients who cannot undergo surgical excision.
Electrosurgery: Electrosurgery is an operation that looks like a cutting and removal process due to the use of electrical currents that are of a high frequency. It could be a choice for smaller blue solar keratoses like hit warts, especially for stitches, on the lesions located where surgical excision is difficult.
Administration of Pharmaceutical Agents with Drugs
Blue nevi are usually harmless lesions that do not typically need medication, so pharmaceutical drugs are not the main treatment option.
Surgical Excision: Surgical excision is the main method of treating a blue nevus and if there is suspicion of melanoma, deeper and wider excision is important for confining the tumor. As such, nevus will be excised along with a little bit of normal tissue as a margin to confirm that the whole nevus is to be removed. This shading, due to the temperature difference between the healthy and the excised tissues, causes the lesions to appear more brownish leading in darker and deeper shades. Laser Therapy: Laser treatments e.g. Q- switched laser, focus on a pigment and cause it to breakdown gradually alleviating the appearance of blue nevi. This approach is chosen for less extensive cases or the sake of cosmetically sensitive regions, and for the sake of convenience of the patient who can choose their non-invasive treatment. Cryotherapy: Cryotherapy implies freezing the blue nevi with liquid nitrogen and thus causing the blistering and falling off of the lesion. This technique can be used to remove small, surface lesions and may be an alternative for patients who have an unfavourable condition to undergo surgical excision. Electrosurgery: In electrosurgery several high-frequency currents and an electrical system are used to remove a blue nevus. Macro-local ablation is often used for small lesions or lesions located in areas where surgical excision may be highly difficult. Dermabrasion: During dermabrasion treatment, deeper skin layers are removed with the help of equipment that leaves behind a smoother surface where the blue nevi are less noticeable due to their minimized size and prominence. This approach is less frequently used than the laser correction because of the risk of scarring and pigmentary changes. Punch Biopsy: If the blue nevi raise suspicion of malignancy or a definite diagnosis needed, excision of the lesion with a punch biopsy may be done. In this operation, a small cylindrical instrument which is known as a curette is employed to remove the specimen from a node by cutting off the lesion.
use-of-phases-in-managing-blue-nevi
Assessment Phase: This first stage comprises of the clinical examination and consequently dermoscopy to determine the exact nature of these lesions. Facets like size, location, color, shape, and limits are perceived so that the necessity of extra manipulation can be ascertained. Diagnosis Phase: During this phase, there is an actual determination of what disease someone has using histopathological examination, which is the process of looking at slides of the tissues. Usually a biopsy is performed to get the tissue. If pathological information is available it aids in confirming a diagnosis and ruling out malignancy or other concerning features. Treatment Planning Phase: According to the evaluation and diagnosis, the treatment plan is outlined which can be as follows: They could recommend either of expectant monitoring for benign lesion, or surgical excision, laser therapy or other procedures based upon symptomatic or cosmetically abnormal cases. Intervention Phase: The chosen interventions are implemented during this phase, as they should be executed in accordance with the treatment plan. This may include surgical removal, laser therapy, cryotherapy, or other treatments propose, depending on morphology of and location of the blue nevus. Monitoring Phase: Fulfilling the intervention, the doctor observes the patient success (healing), the possibility of recurrence or negative side effects. Essentially, regular follow-up appointments may be scheduled to assess the result of treatment and to reveal any lesion growth or changes that surfaced new around it.
Blue nevus is the term that means the collection of skin lesions which are the growth of melanocytes stem cells forming bluish to black nodules in the head, extremities, or buttocks. Generally, these scars develop as solitary lesions available for distribution over several skin regions or they can be inherited and found to exist at the time of birth. There are two widely known histological subtypes: type I (commonly blue nevus) and type II (cellular blue nevus) nevus.
Epidemiology varies among the two typical subtypes of the common divisions. Usually a birthmark-like appearance called common blue nevus is observed in young adults, while cellular blue nevus is mainly diagnosed in middle-aged patients and presents a more than two to one frequency in women in comparison to men.
The entity of bluish nevus is also unspecified. It is noteworthy that the components of blue nevus may be in fact part of melanocytes of neural crest which migrated as fetus developed. On the contrary, some believe that they develop from stem cells in the dermis layer. With a high concentration of melanocytes coming out from the dermis and lips of numerous melanophages with their dense melanin pigmentation another unique blue color is present. A pigment responsible for the specific blue color is represented by the reflection rather than absorption of shorter wavelengths of light corresponding to blue color by the dermal melanin.
The common blue Nevi are usually an acquired feature; however, they can be congenital and associated with syndromes such as LAMB (lentigines, atrial myxomas, and blue Nevi) or NAME (nevi, atrial myxoma, myxoid neurofibromas, and ephelides). One variant, the epithelialoid type, is a main feature of the complex Carney, a multiple endocrine neoplasia distinguished by skin and mucous membrane pigmented spots and cardiac myxomas, a brain tumor of visceral neural tissue.
The blue nevus shows a positive prognosis as the injury in and of itself is not malignant. Similarly, though malignancy of the melanoma originating from blue nevus is a very rare phenomenon. Symmetrically retrospective analysis illustrates that BNLM poses a risk of metastasis and is similar prognosis to conventional melanoma and when comparing lesions at the same depth and stage.
In much younger age groups, the blue nevi often manifest as non-threatening pigmented lesions, which are usually solitary and have small dimensions. A patient may even be unaware of them until they are incidentally seen during a routine skin examination. Â It is often a common occurrence in those who have been exposed to the sun or had more time outdoors.
Location: Blue nevi can be found around the body, but they are most common on the extremities, face, scalp or sacral area. Number and Distribution: Note that quantity and distribution of symptoms can indicate epidemical outbreaks. Multiple may be a symptom of syndromic conditions. Size and Shape: Analyse size and shape: small macules in contrast to large papules or plaques. Color: Mostly blue, dark blue, or violet blue; strong colour differences can happen. Texture: Assess the texture: usually dense yet slightly chewy and have a smooth or semi-rough surface.
Blue nevi have a distinct appearance, but they are often misdiagnosed. One less common variant, the amelanocytic blue nevus, may resemble a dermatofibroma or scar due to the lack of melanin pigment and the presence of spindle cells, collagen, and/or sclerotic stroma in histology. It can also be confused with amelanocytic melanoma. Another variant, the desmoplastic blue nevus, shows exaggerated dermal fibrosis histologically and may be mistaken for desmoplastic melanoma. Additionally, blue nevus-like melanoma must be carefully distinguished from blue nevi, especially the cellular subtype, to avoid delayed diagnosis and treatment, as the two conditions are frequently confused with each other.
Observation: Most blue nevi are harmless and thus they don’t require any medical treatment. They may be checked from time to time for changes in size, shape, appearance, or color.
Surgical Excision: A blue nevus showing some characteristic signs, tending to be cosmetically bothersome can be removed through surgical excision under certain scenarios. Removal of the whole lesion and an appropriate margin of surrounding tissue is carried out (to provide adequacy).
Dermoscopic Evaluation: Dermoscopy, a non-invasive technique that optically magnifies the features of the lesion, which is applied to have closer look with the naked eye. This may result in diagnostic differentiation between harmless blue nevi and possibly malignant tumors, aiding in therapeutic decision-making.
Biopsy: The biopsy methods are performed in cases of an ambiguous diagnosis or suspicious features of malignancy to achieve histopathological diagnosis. In this process, a physician aspirates a small bit of the lesion for inspection by a pathologist under the microscope.
Cosmetic Treatments: If the lesion is a blue nevus, primarily, the cosmetic problem on the surface of the skin, laser therapy or cryotherapy will be required to reduce the pigmentation or flatten the lesion overall.
Dermatology, General
Surgical Excision: The treatment for blue nevus is surgery, that of particular importance, if the nevus is symptomatic, aesthetically annoying, or demonstrates certain features. In the course of excision the whole pervader as well as a margin of the adjacent healthy tissue are removed so that no remains can be left.
Laser Therapy: Q-switched lasers, for example, can be useful as they can be fired at the pigment in blue nevi and subsequently destroyed, causing the nevi to either fade away or eventually disappear. This being the case, this method is generally chosen for the cases with cosmetically sensitive traits or for the clients who opt for non-invasive treatments.
Cryotherapy: Stages include cryotherapy where the lesion is being frozen by using liquid nitrogen. However, therapy is not as common as in other lesions on the skin except for paget cells. Here, cryotherapy can be considered if there are small and superficial lesions, particularly on patients who cannot undergo surgical excision.
Electrosurgery: Electrosurgery is an operation that looks like a cutting and removal process due to the use of electrical currents that are of a high frequency. It could be a choice for smaller blue solar keratoses like hit warts, especially for stitches, on the lesions located where surgical excision is difficult.
Blue nevi are usually harmless lesions that do not typically need medication, so pharmaceutical drugs are not the main treatment option.
Surgical Excision: Surgical excision is the main method of treating a blue nevus and if there is suspicion of melanoma, deeper and wider excision is important for confining the tumor. As such, nevus will be excised along with a little bit of normal tissue as a margin to confirm that the whole nevus is to be removed. This shading, due to the temperature difference between the healthy and the excised tissues, causes the lesions to appear more brownish leading in darker and deeper shades. Laser Therapy: Laser treatments e.g. Q- switched laser, focus on a pigment and cause it to breakdown gradually alleviating the appearance of blue nevi. This approach is chosen for less extensive cases or the sake of cosmetically sensitive regions, and for the sake of convenience of the patient who can choose their non-invasive treatment. Cryotherapy: Cryotherapy implies freezing the blue nevi with liquid nitrogen and thus causing the blistering and falling off of the lesion. This technique can be used to remove small, surface lesions and may be an alternative for patients who have an unfavourable condition to undergo surgical excision. Electrosurgery: In electrosurgery several high-frequency currents and an electrical system are used to remove a blue nevus. Macro-local ablation is often used for small lesions or lesions located in areas where surgical excision may be highly difficult. Dermabrasion: During dermabrasion treatment, deeper skin layers are removed with the help of equipment that leaves behind a smoother surface where the blue nevi are less noticeable due to their minimized size and prominence. This approach is less frequently used than the laser correction because of the risk of scarring and pigmentary changes. Punch Biopsy: If the blue nevi raise suspicion of malignancy or a definite diagnosis needed, excision of the lesion with a punch biopsy may be done. In this operation, a small cylindrical instrument which is known as a curette is employed to remove the specimen from a node by cutting off the lesion.
Assessment Phase: This first stage comprises of the clinical examination and consequently dermoscopy to determine the exact nature of these lesions. Facets like size, location, color, shape, and limits are perceived so that the necessity of extra manipulation can be ascertained. Diagnosis Phase: During this phase, there is an actual determination of what disease someone has using histopathological examination, which is the process of looking at slides of the tissues. Usually a biopsy is performed to get the tissue. If pathological information is available it aids in confirming a diagnosis and ruling out malignancy or other concerning features. Treatment Planning Phase: According to the evaluation and diagnosis, the treatment plan is outlined which can be as follows: They could recommend either of expectant monitoring for benign lesion, or surgical excision, laser therapy or other procedures based upon symptomatic or cosmetically abnormal cases. Intervention Phase: The chosen interventions are implemented during this phase, as they should be executed in accordance with the treatment plan. This may include surgical removal, laser therapy, cryotherapy, or other treatments propose, depending on morphology of and location of the blue nevus. Monitoring Phase: Fulfilling the intervention, the doctor observes the patient success (healing), the possibility of recurrence or negative side effects. Essentially, regular follow-up appointments may be scheduled to assess the result of treatment and to reveal any lesion growth or changes that surfaced new around it.
Blue nevus is the term that means the collection of skin lesions which are the growth of melanocytes stem cells forming bluish to black nodules in the head, extremities, or buttocks. Generally, these scars develop as solitary lesions available for distribution over several skin regions or they can be inherited and found to exist at the time of birth. There are two widely known histological subtypes: type I (commonly blue nevus) and type II (cellular blue nevus) nevus.
Epidemiology varies among the two typical subtypes of the common divisions. Usually a birthmark-like appearance called common blue nevus is observed in young adults, while cellular blue nevus is mainly diagnosed in middle-aged patients and presents a more than two to one frequency in women in comparison to men.
The entity of bluish nevus is also unspecified. It is noteworthy that the components of blue nevus may be in fact part of melanocytes of neural crest which migrated as fetus developed. On the contrary, some believe that they develop from stem cells in the dermis layer. With a high concentration of melanocytes coming out from the dermis and lips of numerous melanophages with their dense melanin pigmentation another unique blue color is present. A pigment responsible for the specific blue color is represented by the reflection rather than absorption of shorter wavelengths of light corresponding to blue color by the dermal melanin.
The common blue Nevi are usually an acquired feature; however, they can be congenital and associated with syndromes such as LAMB (lentigines, atrial myxomas, and blue Nevi) or NAME (nevi, atrial myxoma, myxoid neurofibromas, and ephelides). One variant, the epithelialoid type, is a main feature of the complex Carney, a multiple endocrine neoplasia distinguished by skin and mucous membrane pigmented spots and cardiac myxomas, a brain tumor of visceral neural tissue.
The blue nevus shows a positive prognosis as the injury in and of itself is not malignant. Similarly, though malignancy of the melanoma originating from blue nevus is a very rare phenomenon. Symmetrically retrospective analysis illustrates that BNLM poses a risk of metastasis and is similar prognosis to conventional melanoma and when comparing lesions at the same depth and stage.
In much younger age groups, the blue nevi often manifest as non-threatening pigmented lesions, which are usually solitary and have small dimensions. A patient may even be unaware of them until they are incidentally seen during a routine skin examination. Â It is often a common occurrence in those who have been exposed to the sun or had more time outdoors.
Location: Blue nevi can be found around the body, but they are most common on the extremities, face, scalp or sacral area. Number and Distribution: Note that quantity and distribution of symptoms can indicate epidemical outbreaks. Multiple may be a symptom of syndromic conditions. Size and Shape: Analyse size and shape: small macules in contrast to large papules or plaques. Color: Mostly blue, dark blue, or violet blue; strong colour differences can happen. Texture: Assess the texture: usually dense yet slightly chewy and have a smooth or semi-rough surface.
Blue nevi have a distinct appearance, but they are often misdiagnosed. One less common variant, the amelanocytic blue nevus, may resemble a dermatofibroma or scar due to the lack of melanin pigment and the presence of spindle cells, collagen, and/or sclerotic stroma in histology. It can also be confused with amelanocytic melanoma. Another variant, the desmoplastic blue nevus, shows exaggerated dermal fibrosis histologically and may be mistaken for desmoplastic melanoma. Additionally, blue nevus-like melanoma must be carefully distinguished from blue nevi, especially the cellular subtype, to avoid delayed diagnosis and treatment, as the two conditions are frequently confused with each other.
Observation: Most blue nevi are harmless and thus they don’t require any medical treatment. They may be checked from time to time for changes in size, shape, appearance, or color.
Surgical Excision: A blue nevus showing some characteristic signs, tending to be cosmetically bothersome can be removed through surgical excision under certain scenarios. Removal of the whole lesion and an appropriate margin of surrounding tissue is carried out (to provide adequacy).
Dermoscopic Evaluation: Dermoscopy, a non-invasive technique that optically magnifies the features of the lesion, which is applied to have closer look with the naked eye. This may result in diagnostic differentiation between harmless blue nevi and possibly malignant tumors, aiding in therapeutic decision-making.
Biopsy: The biopsy methods are performed in cases of an ambiguous diagnosis or suspicious features of malignancy to achieve histopathological diagnosis. In this process, a physician aspirates a small bit of the lesion for inspection by a pathologist under the microscope.
Cosmetic Treatments: If the lesion is a blue nevus, primarily, the cosmetic problem on the surface of the skin, laser therapy or cryotherapy will be required to reduce the pigmentation or flatten the lesion overall.
Dermatology, General
Surgical Excision: The treatment for blue nevus is surgery, that of particular importance, if the nevus is symptomatic, aesthetically annoying, or demonstrates certain features. In the course of excision the whole pervader as well as a margin of the adjacent healthy tissue are removed so that no remains can be left.
Laser Therapy: Q-switched lasers, for example, can be useful as they can be fired at the pigment in blue nevi and subsequently destroyed, causing the nevi to either fade away or eventually disappear. This being the case, this method is generally chosen for the cases with cosmetically sensitive traits or for the clients who opt for non-invasive treatments.
Cryotherapy: Stages include cryotherapy where the lesion is being frozen by using liquid nitrogen. However, therapy is not as common as in other lesions on the skin except for paget cells. Here, cryotherapy can be considered if there are small and superficial lesions, particularly on patients who cannot undergo surgical excision.
Electrosurgery: Electrosurgery is an operation that looks like a cutting and removal process due to the use of electrical currents that are of a high frequency. It could be a choice for smaller blue solar keratoses like hit warts, especially for stitches, on the lesions located where surgical excision is difficult.
Blue nevi are usually harmless lesions that do not typically need medication, so pharmaceutical drugs are not the main treatment option.
Surgical Excision: Surgical excision is the main method of treating a blue nevus and if there is suspicion of melanoma, deeper and wider excision is important for confining the tumor. As such, nevus will be excised along with a little bit of normal tissue as a margin to confirm that the whole nevus is to be removed. This shading, due to the temperature difference between the healthy and the excised tissues, causes the lesions to appear more brownish leading in darker and deeper shades. Laser Therapy: Laser treatments e.g. Q- switched laser, focus on a pigment and cause it to breakdown gradually alleviating the appearance of blue nevi. This approach is chosen for less extensive cases or the sake of cosmetically sensitive regions, and for the sake of convenience of the patient who can choose their non-invasive treatment. Cryotherapy: Cryotherapy implies freezing the blue nevi with liquid nitrogen and thus causing the blistering and falling off of the lesion. This technique can be used to remove small, surface lesions and may be an alternative for patients who have an unfavourable condition to undergo surgical excision. Electrosurgery: In electrosurgery several high-frequency currents and an electrical system are used to remove a blue nevus. Macro-local ablation is often used for small lesions or lesions located in areas where surgical excision may be highly difficult. Dermabrasion: During dermabrasion treatment, deeper skin layers are removed with the help of equipment that leaves behind a smoother surface where the blue nevi are less noticeable due to their minimized size and prominence. This approach is less frequently used than the laser correction because of the risk of scarring and pigmentary changes. Punch Biopsy: If the blue nevi raise suspicion of malignancy or a definite diagnosis needed, excision of the lesion with a punch biopsy may be done. In this operation, a small cylindrical instrument which is known as a curette is employed to remove the specimen from a node by cutting off the lesion.
Assessment Phase: This first stage comprises of the clinical examination and consequently dermoscopy to determine the exact nature of these lesions. Facets like size, location, color, shape, and limits are perceived so that the necessity of extra manipulation can be ascertained. Diagnosis Phase: During this phase, there is an actual determination of what disease someone has using histopathological examination, which is the process of looking at slides of the tissues. Usually a biopsy is performed to get the tissue. If pathological information is available it aids in confirming a diagnosis and ruling out malignancy or other concerning features. Treatment Planning Phase: According to the evaluation and diagnosis, the treatment plan is outlined which can be as follows: They could recommend either of expectant monitoring for benign lesion, or surgical excision, laser therapy or other procedures based upon symptomatic or cosmetically abnormal cases. Intervention Phase: The chosen interventions are implemented during this phase, as they should be executed in accordance with the treatment plan. This may include surgical removal, laser therapy, cryotherapy, or other treatments propose, depending on morphology of and location of the blue nevus. Monitoring Phase: Fulfilling the intervention, the doctor observes the patient success (healing), the possibility of recurrence or negative side effects. Essentially, regular follow-up appointments may be scheduled to assess the result of treatment and to reveal any lesion growth or changes that surfaced new around it.
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