Nodular Melanoma on scalp?

Dear Doctor,
I am a 35 years old female, fair skin and dark blond hair.  I have over 200 moles around my body and am frequently checked by a dermatologist. 5 months ago I discovered a sligthly erased skin-coloured mole on my scalp. It seemed dry and not like a usual mole. In the beginning I did not check it myself, had my husband look at it. However, now it is about 6 mm in diameter, perfectly round and firm to touch. Hair grows out of it.1 months ago I went for the usual check and showed the dermatologist the new mole. In her opinion it was a dermal naevus, not to worry about. However, I do, since I have not any other mole like this on my body, and since it grows on a sun exposed area (right on top of my scalp, where my hair is divided). And not least because I think from its characteristics it could look like a skin-coloured nodular mole (Erased, Fast growing, Firm). Should I get a second dermatologist opinion on it?
With kind regards
Mrs Pedersen

[Jasmina Jankicevic, MD, MSc, CCRP]

Dear Mrs. Pedersen,

Based on description you posted, diagnosis established by your dermatologist seems reasonable and correct. One of clinical characteristics that particularly goes in favor of it is hair growing out of nevus.

However, differential diagnosis of skin-coloured dermal nevus is amelanotic nodular melanoma (ANM), and ANM has to be ruled out especially in patients with multiple risk factors for melanoma. If clinical diagnosis is not clear-cut, biopsy would resolve doubts.


Take care,
Dr. Jasmina Jankicevic