S82 Naevus/mole (ICD-10:D22.9)

Introduction

Naevus, commonly known as a mole, is a common skin growth that occurs when pigment cells (melanocytes) grow in clusters. Moles can appear anywhere on the skin and vary in size, shape, and color^[1]. While most moles are harmless, some may develop into melanoma, a type of skin cancer^[2]. The aim of this guide is to provide healthcare professionals with a comprehensive overview of the diagnosis and management of naevus/mole.

Codes

• ICPC-2 Code: S82 Naevus/mole^[3]
• ICD-10 Code: D22.9 Melanocytic naevi, unspecified^[4]

Symptoms

• Appearance of a pigmented spot on the skin
• Irregular shape or border of the spot
• Variation in color within the spot
• Increase in size or change in shape over time
• Itching, bleeding, or crusting of the spot^[5]

Causes

• Genetic predisposition
• Exposure to ultraviolet (UV) radiation from the sun or tanning beds
• Hormonal changes during puberty or pregnancy^[6]

Diagnostic Steps

Medical History

• Gather information about the patient’s personal and family history of skin cancer
• Inquire about any changes in the mole’s appearance, size, or symptoms
• Assess the patient’s history of sun exposure and use of tanning beds
• Determine if the patient has any risk factors for melanoma, such as fair skin, freckles, or a large number of moles^[7]

Physical Examination

• Conduct a thorough examination of the skin, including all moles and pigmented spots
• Use a dermatoscope to magnify and examine the mole in detail
• Assess the mole’s size, shape, color, and border characteristics
• Look for any signs of asymmetry, irregularity, or changes in the mole’s appearance^[8]

Determine Severity

• Classify the mole based on severity and depth, if applicable
• Superficial moles: Limited to the top layers of the skin
• Compound moles: Extend into the deeper layers of the skin
• Congenital moles: Present at birth and may be larger in size
• Dysplastic nevi: Atypical moles that have a higher risk of developing into melanoma^[9]

Laboratory Tests

• No specific laboratory tests are required for the diagnosis of naevus/mole
• If there is suspicion of melanoma, a skin biopsy may be performed to confirm the diagnosis^[10]

Diagnostic Imaging

• No diagnostic imaging is necessary for the diagnosis of naevus/mole

Other Tests

• No other diagnostic tests are necessary for the diagnosis of naevus/mole

Follow-up and Patient Education

• Advise the patient to perform regular self-examinations of their skin to monitor for any changes in moles
• Educate the patient about the ABCDE rule for melanoma detection:
  • A: Asymmetry – one half of the mole does not match the other half
  • B: Border irregularity – the edges of the mole are not smooth or well-defined
  • C: Color variation – the mole has different colors or shades within it
  • D: Diameter – the mole is larger than 6 millimeters in diameter
  • E: Evolution – the mole is changing in size, shape, or color
• Encourage the patient to seek medical attention if they notice any concerning changes in their moles

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Naevus/Mole:

1. Topical retinoids (e.g., Tretinoin, Adapalene):
   • Cost: $10-$100 per tube.
   • Contraindications: Hypersensitivity to retinoids.
   • Side effects: Skin irritation, redness, dryness.
   • Severe side effects: Severe skin reactions, blistering.
   • Drug interactions: None reported.
   • Warning: Avoid sun exposure while using topical retinoids.
2. Cryotherapy (liquid nitrogen):
   • Cost: $100-$500 per session.
   • Contraindications: None reported.
   • Side effects: Pain, blistering, scarring.
   • Severe side effects: Infection, pigment changes.
   • Drug interactions: None reported.
   • Warning: Multiple sessions may be required for complete removal.
3. Surgical excision:
   • Cost: $500-$2000 per procedure.
   • Contraindications: None reported.
   • Side effects: Pain, bleeding, scarring.
   • Severe side effects: Infection, wound healing complications.
   • Drug interactions: None reported.
   • Warning: Requires local anesthesia and sutures.
4. Laser therapy (e.g., CO2 laser, Q-switched laser):
   • Cost: $500-$2000 per session.
   • Contraindications: None reported.
   • Side effects: Pain, redness, swelling.
   • Severe side effects: Scarring, pigment changes.
   • Drug interactions: None reported.
   • Warning: Multiple sessions may be required for complete removal.
5. Electrosurgery (electrocautery):
   • Cost: $500-$2000 per session.
   • Contraindications: None reported.
   • Side effects: Pain, scarring.
   • Severe side effects: Infection, wound healing complications.
   • Drug interactions: None reported.
   • Warning: Requires local anesthesia.

Alternative Drugs:

• Imiquimod (topical cream): Stimulates the immune system to treat certain types of skin growths. Cost: $100-$500 per box.
• 5-fluorouracil (topical cream): Inhibits the growth of abnormal skin cells. Cost: $100-$500 per tube.
• Photodynamic therapy (PDT): Uses a photosensitizing agent and light to destroy abnormal cells. Cost: $1000-$3000 per session.
• Intralesional corticosteroids: Injected directly into the mole to reduce inflammation and shrink the growth. Cost: $100-$500 per injection.
• Chemical peels: Application of a chemical solution to remove the top layers of the skin. Cost: $100-$500 per session.

Surgical Procedures:

• Excisional biopsy: Surgical removal of the entire mole for further examination. Cost: $500-$2000 per procedure.
• Shave biopsy: Shaving off the mole using a scalpel or razor blade. Cost: $500-$2000 per procedure.
• Punch biopsy: Using a circular blade to remove a small, cylindrical piece of the mole. Cost: $500-$2000 per procedure.

Alternative Interventions

• Acupuncture: May help improve blood flow and reduce pain. Cost: $60-$120 per session.
• Chelation therapy: Controversial treatment involving the administration of chelating agents to remove heavy metals from the body. Cost: $75-$150 per session.
• Hyperbaric oxygen therapy: Involves breathing pure oxygen in a pressurized chamber to increase oxygen delivery to tissues. Cost: $200-$300 per session.
• Herbal supplements: Some herbs, such as garlic and ginkgo biloba, may have potential benefits for improving skin health. Cost: Varies depending on the specific supplement.

Lifestyle Interventions

• Sun protection: Encourage the patient to use sunscreen with a high SPF, wear protective clothing, and seek shade during peak sun hours. Cost: $10-$30 per bottle of sunscreen.
• Avoid tanning beds: Educate the patient about the risks of using tanning beds and encourage them to avoid them altogether. Cost: Varies depending on the tanning salon.
• Regular skin checks: Advise the patient to perform regular self-examinations of their skin to monitor for any changes in moles. Cost: None.
• Healthy diet: Promote a balanced diet rich in fruits, vegetables, and antioxidants to support overall skin health. Cost: Varies depending on food choices.
• Stress management: Encourage stress-reducing activities, such as exercise, meditation, or yoga, to support skin health. Cost: Varies depending on the chosen activity.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – S82 Naevus/mole (ICD-10:D22.9)

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Naevus/mole effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Naevus/mole. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. Mayo Clinic. (2022). Moles – Symptoms and causes. Retrieved from https://www.mayoclinic.org/diseases-conditions/moles/symptoms-causes/syc-20375200
2. American Academy of Dermatology. (2023). Moles: Overview. Retrieved from https://www.aad.org/public/diseases/a-z/moles-overview
3. World Organization of Family Doctors. (2020). ICPC-2 – English. Retrieved from https://www.gesy.org.cy/el-gr/annualreport/icpc-2-english1-10.pdf
4. ICD10Data.com. (2024). 2024 ICD-10-CM Diagnosis Code D22.9: Melanocytic nevi, unspecified. Retrieved from https://www.icd10data.com/ICD10CM/Codes/C00-D49/D10-D36/D22-/D22.9
5. Skin Cancer Foundation. (2023). Moles. Retrieved from https://www.skincancer.org/skin-cancer-information/moles/
6. National Cancer Institute. (2023). Common Moles, Dysplastic Nevi, and Risk of Melanoma. Retrieved from https://www.cancer.gov/types/skin/moles-fact-sheet
7. American Cancer Society. (2023). Skin Cancer Prevention and Early Detection. Retrieved from https://www.cancer.org/cancer/skin-cancer/prevention-and-early-detection.html
8. DermNet NZ. (2024). Melanocytic naevi. Retrieved from https://dermnetnz.org/topics/melanocytic-naevi
9. Melanoma Research Alliance. (2023). Moles and Melanoma. Retrieved from https://www.curemelanoma.org/about-melanoma/melanoma-101/moles-and-melanoma/
10. National Health Service. (2023). Moles. Retrieved from https://www.nhs.uk/conditions/moles/