Melanoma or just freaking myself out?

[OuchStomach]

Hello,

I am driving myself nuts.  I have an upcomming Derm appointment but I looked online first, and scared myself silly about nodular melanoma.  I am 28 yrs old.

First off, I am going to the derm because I am a picker.  I get acne a lot on my arms and I pop them.  So if something shows up that looks like a zit I try and pop it.

What I have:
I have one red spot on my right side of my ribcage.  Its small and not too elevated.  I have picked at it often however, and I believe it has been there for as long as two years.

I have a hard very small hard place on my left chest.  There was a hair folicle growing out of it, but the hard spot has been there for some time as well.

On by left arm/back (where they meet) I have another hard spot that I know I have picked at a lot.  This hard spot has been there for over a year as well. It currently has a scab on it from me picking and the skin around the scab is raised.  There are a couple small hard spots by this one that I have picked at as well.  I assumed these were just all acnes.

Of all these little hard spots they are colored by the blood under the skin (when I press on them they become white and then fade back to red).

All of these hard spots have been picked at.  I don't know if they were acne at one point or not, but I know I picked at them as if they were.  They have not gotten really big, but like I said I have picked.

I never knew there was such a thing as nodular melanoma till I looked it up.   My question is, would melanoma act differently than I have described?  What I have does not look like the pictures of melanoma online, but I do pick at them.  I assumed that Melanoma would be harder, or more obvious than what I have, but I'm scared big time that I have had it and just been slicing off the top layers for a long long time.

Also, if it were Melanoma for a year or more, would it be more obvious, even with picking, and would it have spread somewhere else where I'd notice it? I read how nodular is super fast acting and I am talking about spots I have had for 12+ months.  Just really scared.

[Bhupinder Kaur, MD]

Hello,
I think that it is simply a picked hair follicle.It has happened after trauma and so chances of melanoma are less.Melanomas are usually >6 mm in size,with irregular borders ,asymmetrical and dark in color.Melanomas cannot be picked.So rest assured that this healed lesion can be a melanoma.If however it appears again and starts increasing in size even without trauma inflicted to it,then skin biopsy may be needed.

Melanoma has an irregular border, is asymmetrical,uneven color and increasing in size. If you notice changes in the mark’s color, height, size or shape, you should have a dermatologist evaluate it. You also should have it checked if it bleeds, oozes, itches, appear scaly, or become tender or painful.Otherwise it should be left as such.

Hope it helps.Take care and pls do keep me posted on how you are doing or if you have any additional doubts.Warm regards.

[OuchStomach]

Thanks for replying.  The spots in question are all there, and have been there for a long time, a year or more for two at least.  It bleeds when I pick at it, naturally, but no oozing or itching, or  tender or painful,  except because I've picked at it a ton.  You said "rest assured that this healed lesion can be a melanoma."  Please tell me you meant "cannot be a melanoma".

The big thing they all do, which I guess is a sign its not cancer is the blanch when I press on them.  Of course, there is no info on the web about people who have picked at nodular melanoma.  There is one forum where a woman said she would shave it off when she shaved her legs and thats why she didnt know she had it until 6 months in.  I am just afraid I am doing the same thing by scratching/picking...(which on a side note I found out is a disorder, yay)

[Bhupinder Kaur, MD]

Hello,
I meant to say it cannot be a melanoma. Nodular melanoma which you are suspecting is the most serious and life threatening form of skin cancer and it spreads very fast.However to put an end to the mental agony and suspicions ,a skin biopsy can be done to confirm the status whether it is a melanoma or not.

Hope it helps.Take care and regards.

[OuchStomach]

Tomorrows the big day.  

Just really wondering now if skin becoming super agitated, raised, and firm is normal when someone picks at a spot too much.  The only place really that its bad is my shoulder area where there is the one large bump.

Funny thing, there were 4.  I have tried to leave them alone.  One spot is completely flat now, one is almost flat, one is smaller, and the big one is well...still pretty nasty with a big scab right on its top.  I am hopeful that these 4 spots are all the same, just varying degrees of my picking at them.

[OuchStomach]

Back from derm.  Evidently the spot on my side is nothing, the lumps on my back/arm are from picking and they are heavily scarred (skin there doesnt heal very well) and theres no way they are melanoma.  The one on my chest and face I had picked off earlier in the week and are just scabs so he told me to come back once the scabs heal if I feel like I need to.  He froze the lumps on my back/arm and the areas on my arm where I have picked.

He did cut 2 moles out.  One in the middle of my lower back and one on the back of my right leg.  Said they were bad moles and the one on my leg was larger, but the one on my back was goofier and more concerning.  He said though that they both were super small (both way less than an eraser and no elevation) that I have nothing to worry about.  That even worst case they got them early enough.  They did a deep shave biopsy and will let me know results next week.  The one on my back I've known about for 18+ months cause I went to a derm then and he said wait and watch.  This new derm says they never tell a patient to wait and watch and just cut to be safe.

He said its actually very normal for people in their 20s to have the signs of beginning skin cancer and that people just dont go to the derm until years and years later when its bad.

So thats about that.  Evidently I had something bad, but we caught it in time.  Does this all sound about right and things were taken care of? It sounds good to me and that I may have just saved myself a lot of hardship in the future.