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. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. alled vascularnaevi (Figs. 75 and 76), while those formed of lymph-atics are known as lymphangiectasis. A special form of nsevus is the pigmentary to the presence of lymphatics this is called byV071 Recklinghausen lymphangio-fibroma, by Borstfibroma melanodes. These are often covered withhairs and are also known as pigmented hairy nsevi(Fig. 67). In pigmentary nsevi there is proliferationof fibrous cells in the dermis, dilatation of lymphaticvessels, and pigment within th
. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. alled vascularnaevi (Figs. 75 and 76), while those formed of lymph-atics are known as lymphangiectasis. A special form of nsevus is the pigmentary to the presence of lymphatics this is called byV071 Recklinghausen lymphangio-fibroma, by Borstfibroma melanodes. These are often covered withhairs and are also known as pigmented hairy nsevi(Fig. 67). In pigmentary nsevi there is proliferationof fibrous cells in the dermis, dilatation of lymphaticvessels, and pigment within the cells of the dermisand epidermis. These naevi are round, oval, or irregular in shape,with a sharply defined margin, and brown, yellowish-brown, blackish-brown or black color. Clinicallythey are divided into two forms, flat nsevi, on a levelwith the skin, and projecting nsevi. Flat nsevi occur on one side or over the wholebody. Their distribution sometimes corresponds tothat of the cutaneous nerves, and on this accounttheir origin has been attributed to trophic changes 134 Bockenheimer, Atlas. Tab. Fig. 67. Naevus pijj;mentosus pilosus. in the spinal ganglia, also to fibromas of the smallestcutaneous nerves. In elephantiasis of nerves flatnsevi are generally found on the body. Projectingnsevi, especially pigmentary, often have a surfaceresembling that of a wart, and may assume a villousappearance. Lastly, papillomas, carcinomas andsarcomas may arise from nievi. As a rule, nsevi cause no trouble, but occasionallythey may become ulcerated. Differential Diagnosis. Nsevi may have someresemblance to warts, fibromas and pityriasis versi-color, but the diagnosis is usually easy. Treatment. On exposed parts of the body nsevishould be excised, for cosmetic reasons. Removal isalso indicated in rapidly growing naevi, and wheninflammation occurs. Ephelides may be removed by the application ofstrong resorcin paste. Fig. 67 shows a very extensive pigmentary hairynaevus which was pres
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