Are Moles that Stick Up More Likely to Become Melanoma?
Intradermal nevus. Credit: Dr P. Marazzi/Science Source
Do you have a mole that sticks up more than the others, or maybe it’s the ONLY one that’s raised, and melanoma has barged into your mind?
There are a few things to consider if you’ve come to notice that a mole sticks up more (elevation) than the others.
“Moles that stick out are not more likely to become melanoma; they are simply a type of mole known as an intradermal nevus,” says Emily de Golian, MD, a board certified dermatologist with Forefront Dermatology in Atlanta, GA.
“The raised appearance of these moles is simply due to the architecture of the mole cells in the skin, and this architecture is unrelated to the potential of those cells to become atypical.
“In fact, scientific research indicates that nearly three-fourths of melanomas arise in previously normal skin, not from pre-existing moles.
“Of course, all moles should still be examined regularly for changes.
“However, new brown, black, asymmetrical or growing spots on the skin should be evaluated as well.”
This is a nodular melanoma. Note how similar it looks to the benign mole at the top of this article. This is why any new or “What is that?” growth needs to be examined by a dermatologist.
The Mole Sticks Up – When It Used to Be Flat
This is the second consideration.
A mole that has always been raised, as Dr. de Golian pointed out, is normal and not more likely than any common flat mole to undergo a malignant transformation.
Plus, if you’ve only begun inspecting your skin for just the past few years, and thus, your discovery of that raised mole is only a few years old – what’s very reassuring is if over that time period, the mole’s appearance has stayed the same in all respects (color, size, border).
However…what if you know with absolute certainty that a mole that’s now sticking out — was previously flat?
What can make a previously flat mole become raised?
Trauma to the mole that caused bleeding can make it appear elevated from the collection of old blood on top of it. Do not pick at it.
Another explanation is that the newly raised spot was never a mole; it could be, for example, a harmless skin tag that has mimicked the appearance of a light colored mole due to its difficult-to-view location, and now it’s gotten bigger.
Moles that Are Raised … but not the Intradermal Type
“If a previously flat mole is now raised, this may be normal depending on age,” says Dr. de Golian.
“Most moles are flat in children, and as the moles mature, they sometimes (but not always) raise up into small bumps as we age, typically through the teens, 20s and perhaps early 30s.
“For patients in their early 30s or older with newly raised moles or moles with other changes, this may be suspicious for atypical cells and should be examined by a dermatologist.”
Dr. de Golian focuses on the surgical treatment of skin cancer via Mohs surgery, cutaneous oncology (melanoma and basal cell carcinoma), surgical defect reconstruction and cosmetic dermatology.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image source: sciencesource.com/archive/Intradermal-mole-(nevus)-on-skin-SS2425295.html
Why Is the Prognosis for Nail Melanoma Much Worse than Skin?
Yes, melanoma can grow in the nail unit, and it’s a well-known fact among dermatologists that this type of melanoma has a poor prognosis.
“Nail melanoma, which is in the category of acral lentiginous melanoma encompassing melanomas of the palms, soles and nail apparatus, may have a worse prognosis vs. melanoma elsewhere on the skin — not because they are inherently more aggressive, but because they may not be diagnosed until later in their course,” explains Emily de Golian, MD, a board certified dermatologist with Forefront Dermatology in Atlanta, GA.
Even with all the media attention that melanoma has gotten over the years, many people still don’t think to check these particular areas of the body when conducting a monthly self-exam, especially if they are dark skinned.
Though Caucasians can get nail as well as palm and sole melanoma, this cancer is more common in those with dark skin.
The brown band or streak in a nail, plus the dark patches on the sole of a foot or palm, “may be mistaken for trauma (hemorrhage under the skin, which may look very similar to pigment to the naked eye) or benign lesions,” says Dr. de Golian.
“If caught early, just like any melanoma, nail apparatus melanomas have a very good prognosis, but if the melanoma is not identified early and continues to grow, the prognosis may become worse.”
Melanoma of the nail unit is also called subungual melanoma.
“About 5% of all melanomas are acral lentiginous melanomas, and while they may affect any racial group, African-American and Asian individuals are more likely to develop this type of melanoma since sun related melanoma elsewhere on the skin is less likely in these groups.
“Any person with a new brown, black, asymmetrical spot on the palms, soles or around the nail, as well as new brown linear streaks under the nail plate itself, should seek evaluation with a board certified dermatologist.
“Untreated melanoma may metastasize to other parts of the body and could be life threatening if it continues to grow.
“The truth is this potential killer can occur anywhere on the skin, even in non-sun exposed areas,” such as inside the nose and mouth.
When melanoma is caught early, including subungual, the prognosis is excellent.
Dr. de Golian focuses on the surgical treatment of skin cancer via Mohs surgery, cutaneous oncology (melanoma and basal cell carcinoma), surgical defect reconstruction and cosmetic dermatology.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
How Ugly Can a Tiny Melanoma Look?
Tiny melanoma, 1.6 mm. Source: Dermatol Pract Concept. 2013 Apr. Copyright ©2013 Pellizzari et al.
Articles and pamphlets refer to melanoma as the “ugly duckling” or “ugly mole.”
But how “ugly” or “different” can a tiny melanoma look if it’s only 1 mm or even half a mm? (more…)
What Can a Black Dot on the Top of the Toe Be?
A black dot on the top of your toe could be melanoma, but does this mean it’s likely melanoma? (more…)
Chest Pain from Lung Cancer vs. Heart Disease: Comparison
Both lung cancer and heart disease can cause chest pain though it’s far more common in heart disease.
What are the differences in how the chest pain feels when it’s being caused by lung cancer vs. heart disease? (more…)
Holding onto the Side of a Treadmill Mimics Using a Walker
If you hold onto the side of a treadmill when walking, are you aware this mimics using a walker?
You’re training to use a WALKER when you hold onto a treadmill! (more…)
Can a Baby Be Born with Nail Melanoma?
A baby can be born with a brown pigment “in” a nail. What are the odds that this can be melanoma?
Certainly, if your newborn has a pigmented area under a fingernail, this needs to be examined. (more…)
6 Year Old’s Nail Mole Likely Melanoma or just a Birth Mark?
A mother of a six year old wanted to know if an elongated mole in her child’s nail could possibly be melanoma.
How likely would this just be a harmless mark of pigmentation from birth? (more…)
Severely Atypical Mole with Regression: Time to Worry
If you have a severely atypical, irregular or dysplastic mole that’s showing signs of regression (new areas of milky-white color), this is very worrisome for melanoma.
A white “spot” in a mole isn’t always cancerous, and may be a harmless hair follicle.
It’s very important to closely monitor any areas of even a normal-looking mole that appear to be disappearing — or seemingly filling in with a dull white or the color of one’s baseline skin tone: in other words, regressing.
Have you been told you have dysplastic moles?
These moles tend to be larger than average, often larger than the diameter of a pencil eraser, and usually are asymmetrical, lopsided, “odd” or “funny” in appearance.
Regression in Moles: Can Be Normal, Can Mean Melanoma
“Regression is a phenomenon in which a mole appears to be fading or disappearing, often in an irregular manner,” says Kara Shah, MD, an adult and pediatric dermatologist and founder of Kenwood Dermatology in Cincinnati, OH.
“To the naked eye, regression typically appears as one or more areas within a mole that are lightening in color,” continues Dr. Shah.
“Complete loss of pigment in some areas may result in areas that appear milky white in color.
“Regression is an immune-mediated phenomenon that results from activation of a type of white blood cell called a T-lymphocyte.
“It is considered part of the body’s innate cancer-surveillance system.
“Although benign moles may sometimes gradually and uniformly fade as part of a phenomenon called a halo reaction, signs of regression in a mole that appears atypical are concerning for melanoma.
Halo nevus (mole)
“If such a mole is biopsied and the dermatopathologist notes that the mole is severely atypical or dysplastic, the areas of regression may represent an area of regressing cutaneous melanoma.”
If you have an irregular or odd looking mole that has recently begun showing signs of regression – you should promptly make an appointment with a dermatologist.
Do not settle for a naked-eye exam. The dermatologist should use a handheld lens (dermatoscope) to inspect the mole.
If the doctor says that the mole appears to be atypical or dysplastic, and that there’s signs of regression, it should be biopsied.
In fact, the development of new areas of white in even an otherwise normal-appearing mole may represent areas of regression suspicious for melanoma.
Malignant regression in any mole, for that matter, will appear in specific areas rather than causing a diffuse, evenly distributed regression.
When the entire mole seems to be fading evenly throughout, or diffuse fading – this “can be a sign of natural involution of normal melanocytic nevi, which is common in the aging population but can be selectively noted in younger persons and is generally a benign and harmless phenomenon,” says Dr. Shah.
Mole with Regression from Melanoma Is More Dangerous than Typical Melanoma
“If the T-lymphocytes have been mobilized to destroy melanoma cells as evidenced by areas of regression, it may make it more difficult to identify the melanoma on the skin, as some of the visual cues (e.g., brown or black areas within the melanoma) have been erased,” says Dr. Shah.
Consequently, diagnosis may be delayed.
What is a better description of an atypical mole with regression?
This would be “parts of it are disappearing” rather than “it’s fading.”
Dr. Shah is triple board certified: general dermatology, pediatric dermatology and general pediatrics. Her special interests include melanocytic nevi (moles), melanoma, psoriasis, acne, atopic dermatitis/eczema, hair and nail disorders, birthmarks and genetic skin diseases.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
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Image Sources
blog.melanomaeducation.net/melanomas-with-no-identified-primary-site/
British Journal of Family Medicine, Sept. 13; bjfm.co.uk/melanocytic-lesions-effective-management-in-primary-care-part-2
http://blog.melanomaeducation.net/melanomas-with-no-identified-primary-site/
Can Melanoma Cause Weird Feelings in a Mole?
That one particular mole, or maybe several of them, are generating weird feelings. Could this mean melanoma?
This isn’t about itching. It’s about weird sensations that seem to be coming from a mole that’s gotten your attention lately.
If you’ve already been diagnosed with melanoma, you may be at risk for noticing strange feelings from other moles.
“In general, melanoma does not produce any symptoms in the skin such as pain or itching, although rarely these symptoms may be noted,” says Kara Shah, MD, an adult and pediatric dermatologist and founder of Kenwood Dermatology in Cincinnati, OH.
Even though it’s an uncommon sign of melanoma, an itchy or painful mole should never be ignored, because melanoma CAN cause these symptoms.
“While any mole that is painful, itching or bleeding should be evaluated by a dermatologist, if the mole itself appears normal with none of the worrisome features for melanoma, it does not need to be removed,” says Kara Shah, MD, an adult and pediatric dermatologist and founder of Kenwood Dermatology in Cincinnati, OH.
What’s happening when someone notices odd or weird sensations coming from a mole?
As mentioned, a previous diagnosis of melanoma can put a person at risk for these perceptions.
Dr. Shah explains, “Receiving a diagnosis of melanoma can be a frightening experience, and this may result in increased anxiety and concern for the development of additional cutaneous melanomas.”
The anxiety can play tricks on the patient’s mind. There was the case of a man who’d been diagnosed with a single melanoma.
Soon after, he became convinced that about 20 additional moles were generating “weird feelings.”
Suspecting that they were cancerous, he requested removal of all of them. Every one came back benign.
“However, as the majority of moles never develop into melanoma, removal of otherwise benign-appearing moles is not recommended,” says Dr. Shah.
Anxiety About Getting Another Melanoma
Dr. Shah says, “Strategies that can be helpful in reducing anxiety surrounding melanoma in someone with a previous diagnosis include periodic skin examinations by a dermatologist and use of mole mapping and digital dermascopy to document and monitor existing moles.”
Worrisome Features of a Mole
• Increase in size
• Change in shape or texture
• Change in color or darkening
• Appearance of tiny bumps on the surface
• Any other change, such as a once-smooth border is now jagged.
• Appearance of tiny “satellite” moles near it
• Unexplained bleeding
• Oozing or crusting
• Center of the mole is disappearing
• A new bump that looks like a pimple but won’t go away
• A new, rapidly growing nodule (bump)
Any one of these signs does not automatically mean melanoma.
For example, what you thought was a mole all along might actually be a benign skin growth called a seborrheic keratosis. But have your dermatologist make this diagnosis; don’t assume.
Seborrheic keratosis
Furthermore, melanoma simply does not cause “weird feelings” or strange sensations to come from a mole.
Serial digital dermoscopy is an excellent way to track your moles over time.
Dr. Shah is triple board certified: general dermatology, pediatric dermatology and general pediatrics. Her special interests include melanocytic nevi (moles), melanoma, psoriasis, acne, atopic dermatitis/eczema, hair and nail disorders, birthmarks and genetic skin diseases.
Lorra Garrick is a former personal trainer certified by the American Council on Exercise. At Bally Total Fitness she trained clients of all ages for fat loss, muscle building, fitness and improved health.
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