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Dermatology  (Expert Forum)
 | 
Solar Lentigos that may have been traumatized...????
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.

Solar Lentigos that may have been traumatized...????

by MakaveliMOB, Jul 22, 2005 12:00AM
Hi Doctor...Please answer my concerns...Thanks!!!



I had a mole flat brown that was getting darker on one edge on my hip-butt area,then i noticed one more on the leg, which had hair in it but it had some darker pigmentation in it, and i had that removed too. Then i had this old one right on the belt line, and nothing was wrong with it, so i had that one removed too, just for the hell of it. So 3 moles right?



So Biopsy Report #1 stated,



1.)inflamed lentiginous junctional nevus (the one on the calf)



2.)inflammed lentiginous focal spindle cell junctional nevus (associated architectural disorder and focally mild cytologic atypia). (this was the one on the belt line, it looked fine though)



3.) The one on the butt i lost...but my doctor said it was a regular mole





Then i saw another doctor who is only a Mole doctor Specialist, and works at a Cancer Institute and is involved in Melanoma Research, and he didnt like that pathologist and sent these slides to another pathologist who is an expert in the field and who only deals with Moles and has been for 25 years 8 hours a day, 7 days a week, and who does research on moles.



His interpretation...



1.)Solar Lentigo with focal melanocytic hyperplasia (the one on the calf)



2.)Solar Lentigo with focal melanocytic hyperplasia (the one on the hip-butt)



3.)Junctional nevus with Minimal atypia, lentiginous type. (belt line one)





If you can please address these issues that are on my mind, i would appreciate it.



Derm said with old moles, the cells become spindle like over a long time.  And spindle cells are common in the skin, and thats normal. He said everything is benign. He said on a scale of

1 - 10 (being the worst), he said my moles were like 2-3.



I toyed with the one on the belt line a lot before i got it taken off, and I'm guessing that with the friction of the belt caused focally minor atypia (doctor agreed). Although research shows that most benign (not atypical) moles have mild atypia in it.



Question...how can I get a Solar Lentigo on a sun-covered area?

What do these results really mean???



All the doctor said was that this is a good report and that he told me the first patho was not good at reading moles too well.





So,  say we go by Path report #2, are these atypical moles? I've  read that hyperplasia is present usually in Solar Lentigos? And the Minimal atypia that was present in the One mole

was only focally, and research shows that there is some mild cytologic atypia in even benign (clinically) moles.



I dont have many moles, hardly any on my body, just a few on the face and a few in the genital  area, both of the 2 solar lentigos were in places where i scratch a lot and im sure i could

have had some trauma in the past, the Derm told me that could have caused some Melanocytes to come up to higher layers of the skin and cause pigmentation to be more darker. What are your

thoughts?



So are they Atypical or Benign?



Thanks. always.

by Alan Rockoff, MD, Jul 24, 2005 12:00AM
A lentigo is not a mole, just a freckle.  You can get one even in places where there isn't much sun.  Mild atypia doesn't mean much anyway.



All these reports are benign, in both sets.  That is what the tests really mean--what the doctor told you they mean.



When you have tests done by professionals, it's a good idea to let the professionals interpret them, and not try to do it yourself.  If you have questions, you should ask the doctor you consulted.  If you don't trust that doctor, you should find another one you do trust.  If you do trust the doctor, why would would you question his interpretation that everything is OK?



Dr. Rockoff
Member Comments (5)

by MakaveliMOB, Jul 24, 2005 12:00AM
To: Dr Rockoff
Thanks for the reply.



Well its not that I dont trust them, its just that my questions never get answered. Its partly my fault, because I have so many questions.



Like what caused the varying degrees of pigmentation?



Thanks again.

by Alan Rockoff, MD, Jul 24, 2005 12:00AM
The questions you have essentially can't be answered.  Moles vary in pigmentation just as people vary in height.  



Dr. Rockoff

by MakaveliMOB, Jul 25, 2005 12:00AM
To: Dr. Rockoff
I understand now. And they check moles that look a little different just to make sure its not malignant.



Thanks a bunch!!!

by MakaveliMOB, Jul 25, 2005 12:00AM
To: Dr. Rockoff
it just interests me i suppose. from what 1 doctor told me, that scratching it could have altered the locations of the pigment cells, causing some to rise to the higher layers and cause a darker pigment.





thanks.
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