Mole removal and Path reports question

[zachsmom413]

I am a 41 yo female. Very "moley". No history of any type of skin cancers on either side of my family. ly. I decided to see a Derm 2 yrs ago for a skin check. I had some ( at least 15 )  atypical moles I wanted checked out. His  words to me were "Everyone in America has atypical moles. If you want them off, here is the name of a surgeon and take them off. If you don't, then don't. Come back and see me in a year." I was a little put off

My husb. needed to have skin tags removed off of his eyelids. He needed to see a Plastic surgeon.  So when my husb had his skin tags rem., I made an appt., for a consult with him.

At that time, he said that he saw 5 that really should be excised. And if there were any more that I didn't like, to let him know and he could shave them off. So I went in April 21st, and had 5 excised(2 on my back, one on my front upper rt thigh, and one under my left breast), and 2 shaved.  Out of all 7 of them, 1 on my back came back with this on my path "Compound melanocytic nevus with architectual features of dysplastic nevus".

When I went in for my follow up with my Pl Surgeon, he said because one came back with that result, he recom. having 8 more excised.

On May 19th, I went again, and had 6 excised off my upper back(actually punch biopsied out  they were small, about 0.3 cm), one shaved off of my back, and one excised on the back of my left thigh.

Path came back, and all of them on my back, except the one that was shaved, says this "Compound melanocytic nevus with features of a mild dysplastic nevus, the lesion appears to be completely excised"

So now, the surgeon wants me to come back and have ALL of my atypical moles excised. The rest are small as well. I counted myself about 10 more.

So, he is not a derm.. I made an appt with another derm. for 2nd opinion.

In your profess opinion, based on what I told you, and my Pathology report. Would you recomm to your patient to have ALL of their atypical moles excised?


  

[BarbieLajune]

I had a itchy spot on my back for 10 yrs.A mole popped up.So I had it removed,but the spot itched so bad and would still burn,So I went to the doctor again and the mole was back.I dont care about the mole.I care about how bad it itches about 1/2 inch under the skin and how sometimes it burns and itch..What should I do.I go back to the Doctor 2morrow and will tell him again.But I know something is not right with this spot on my back!

[zachsmom413]

Thank you. I am glad I decided to get a second opinion from a Dermatologist then. I am seeing a different Dermatologist this time though. Because I see a plastic surgeon, I am not sure if he just wants to do this because he is a plastic surgeon or what. He did call the ones though, that looked atypical, and they did come back "mild" on Path report.  
The rest of my "atypical moles" are about 0.3 cm or smaller as well.

I thank you for all of your help.
Cindy

[Alan Rockoff, MD]

I would not.  Your first dermatologist may have had a brusque manner, but I agree with what he said.  It is not necessary to remove all moles that look as though they may be atypical (dysplastic.)  It is just necessary to remove any that look strange or suspicious.  The presence of mild dysplasia on a pathology report means little, if anything.  It sounds as though you have as much surgical work as you need, perhaps more.  From now on, I suggest consulting a dermatologist about this, who can perform surgery or refer you for surgery, but only if you actually need it.

Best.

Dr. Rockoff