Is this a melanoma?

[Sue S]

I am a 40 year old woman.  I had a BCC 3 years ago on my upper chest area.  I now have a small bump on my upper right arm.  It is the size of a large pimple with very angry red circle all around it.  It doesn't hurt or itch at all.  It is a raised bump with a translucent quality to it.  It also has a small circular scab on the top.  The scab does not appear to ever heal over. It has not really changed in appearance in the 2 weeks since I've noticed it, except to maybe be more red around the edges.  What concerns me, and makes me wonder if it could be melamona, is that there is a dark area that appears underneath the bump...like you're looking through the bump at a teeny tiny mole.  The dark pigment is not on the surface, but underneath.  Does BCC ever have brown or black in it?  The research I've done on the web always seems to mention that the dark color is a sign of melanoma, that BCC don't usually have that charactertic.

I do have an appointment in 2 weeks with my dermatologist.  I am worrying myself that this could be really serious.  What do you think?

Thanks so much.

[Erin]

I have a mark on my vaginal area on the lip.  It's dark in color but not very big.  It's not a bump the skin is very smooth.  I'm worried that it might be melanoma.

[sue]

You were right, the lesion stayed the same for about 3 weeks and then one day the scab fell off.  The raised bump also went down and now its almost invisible.  I would guess it was just a blocked pore.

Thanks for calming my nerves...it's nice to have a place such as this to ask questions.

[Alan Rockoff, MD]

"Or, are you saying that cancer usually doesn't develop until a skin lesion has been there awhile?"

Yup.

Could be a blocked pore or some such trivial thing.

Let me know how it turns out.

Dr. R

[Sue S]

Thanks for the quick reply!  I'll try not to worry too much!

I am confused about one thing, you said that because it is a relatively new bump, it probably won't be malignant.  I guess that confuses me.  Don't all cancers start out small and get bigger?  Or, are you saying that cancer usually doesn't develop until a skin lesion has been there awhile?

The presentation of this bump seems classic to me of the descriptions and pictures I've seen of basal cell carcinomas.  It's raised and transulecent and has a small scab that won't heal and seems to be scaling in little round circles on top.  I will grant you that it hasn't been there long, but it shows no sign of healing.  What else could it be?

Thanks so much.

Sue.

[Alan Rockoff, MD]

Sue:

First, basal cell carcinomas may indeed have pigment in them --  this variant is called (reasonably enough!) "pigmented basal cell."

The fact that this bump is apparently of fairly recent onset, a couple of weeks, argues strongly against melanoma.  (In fact, it argues against any sort of malignancy.)  Your doctor will tell you for sure, but I'm confident the news you get won't be bad.

Good luck.

Dr. R