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Dermatology  (Expert Forum)
 | 
Possible Amelanotic melanoma
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.

Possible Amelanotic melanoma

by caribbeanguy, Dec 08, 2005 12:00AM
My wife, a 23 y/o female, recently showed me a new lesion on her shoulder that is just smaller than a pencil eraser.  It has well circumscribed borders and is about the same color as her skin.  It looks like a new colorless mole, but I cannot be sure. She said it has grown up in the last month or so.



About four months ago she had a mole biopsied which came back as an atypical nevus and more tissue was removed with MOHS surgery just to be safe.  



Unfortunately, we live in the caribbean temporarily where I go to medical school, and there is no dermatologist or a pathology lab I would trust.  I am wondering if I should get her back to the U.S. as soon as possible to have this looked at in case it is nodular amelanotic melanoma.



My main questions are:



How rare would it be for a 23 y/o to present with a amelanotic nodular type?



Are there any other lesions this could possibly be that could pop up within a month looking nodular and skin colored?



Any other thoughts you might have are appreciated.



Thank you.

by Alan Rockoff, MD, Dec 09, 2005 12:00AM
Very rare, indeed.  I'm a little perplexed as to why you are even concerned, if the lesion was read as atypical nevus.  I am also mystified as to why Mohs surgery was used for a mole on the shoulder, when a simple excision would do.



In any case, pathology is portable.  I suggest that you ask that the pathologist who read the slides send them to a skin pathology lab in the US for a second opinion--this is done all the time.  



There are many good labs.  One is http://www.cohenderm.com/.



Take care.



Dr. Rockoff
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