Mole on the plantar surface of the foot

[Eddee]

Our daughter is 17 weeks old and has had a flat brown oval mole with regular margins on the plantar aspect of her foot that has been present since 2 weeks of age but continues to grow in size. It is now approximmately 2mm by 3mm.

Our Pediatricain noted that if it was on the toes and not on a weight bearing protion of the foot, he would have it removed due to the possibility of progression to a melenoma. He doesn't want to remove it due to the potential of scar formation.

I appeciate that the lesion currently is not a melenoma and that progression to that would be an extremely rare circumstance. However, he noted that plantar melenomas do have a higher incidence of progreesion to melenoma.

She is caucasion and there is no family history of melenoma despite the family being fair-skinned and having Czech, English, Irish and Scandinavian genetics.

I know the adage of watchful waiting for it to develop asymetry, a change in coler etc.

If it isn't too agressive to remove a mole from a distal appendage such as a toe, why not follow the same approach for the plantar aspect of the foot?

With early detection being a key variable in survival statistics, why wait until changes are identified?

What percentage of plantar moles in caucasion children progress to melenoma?

Would you recommend that the mole be removed?

Any other thoughts are appreciated.

Thank you for your time and expertice.

Ed

[Alan Rockoff, MD]

The notion that moles on the palms, soles, and genitalia are more risky than other moles is tradtional, not supported by data.  The fact that a mole is repeeatedly traumatized is likewise not a reason per se to remove it.  Finally, excising a mole from the sole of an infant is not a trivial matter--it may indeed scar, which can be painful and irreversible.

My advice is to seek the opinion of a dermatologist, perhaps someone with a special expertise in melanoma, if there is someone in your area, perhaps at a teaching hospital.

I'd wager that the consultant will recommend photographing the lesion but otherwise leaving it alone.  In any case, you'll feel more relaxed about the mole if you get that kind of expert opinion.

Best.

Dr. Rockoff

[Eddee]

thank you