melanoma concern

[cebdone]

I am a 43 year old white female.  Brown hair, hazel eyes,  medium skin, 1/4 hispanic, history of some severe sunburns, usually burn a bit and then tan well, blistered probably three times in my life. Family history of melanoma - a half niece had it in her youth. I had a basil cell carcenoma removed from my forehead a year and a half ago.  Since then, I have had 3 dermatology full body exams that raised no concerns. About six months ago, I noticed a small mole on my face.  I think a pimple occurred on the site, but am not sure.  I picked at it, probably repeatedly, and it would not heal.  I went to my GP, who prescribed an antibiotic cream and said if it did not heal to get it looked at by a dermatologist.  It healed after about a week or two with the cream.  I scheduled an appointment anyway with a new (and seemingly more conservative dermotologist as mine retired). The soonest I could get this was 3 months later (about 5 months since I first noticed the problem).  I told her the history, and she is concerned about melanoma and has requested a biopsy in two weeks.  When I asked her if the fact that the mole was small, 4 mm total was a positive sign, she said not necessarily, but not to worry too much until the biopsy resluts.  That is easier said than done for me.  What I realized after I saw her is that I have had this mole at least since 1997, as I confirmned in a picture. I think it got a little more noticable since 2000 from what I can tell from looking at pictures.  It is 4mm in width, round, fairly symmetrical, no rough edges.  Protrudes very very slightly.  The outer ring is skin color but not translucent.  There is a light brown circle in the middle of the ring about 2mm, with a small very faint white dot in the middle. I am really concerned about melanoma, particularly nodular type.   One thing that makes me feel better is the fact that I have had three other uneventful exams in the past year and a half. I really can't say that the mole has changed significantly during that time other than the episdose with my picking at it, which has fully healed.

What are your thoughts on possibility of melanoma, and the type?  If it is positive for melanoma, is there any way to predict the prognosis based on the number of seemingly normal exams I have had recently?  I am worried sick over this.

[Alan Rockoff, MD]

Nodular melanoma can be small but is usually larger than what you have.  They are more often black than brown.  These are just generalities--the biopsy will tell the tale.  I think it will be a good tale.

Dr. Rockoff

[cebdone]

was hoping you could answer the above...thanks

[cebdone]

Thank you Dr Rockoff.  I feel a bit better.  As for the size, I thought that nodular melanoma was often small. Is this not the case? As far as color, is it uncommon for a melanoma to be brown?

[Alan Rockoff, MD]

Melanoma on the face is quite uncommon.  The most common form of melanoma there occurs in very elderly, sun-damaged people.  It's hard for me to imagine that such a lesion would be overlooked by people doing full skin exams.  Also, the size and color you describe don't sound worrisome to me.   I guess you won't know for sure till you get the results, but I'm confident you have nothing to worry about.  Hang in there.

Best.

Dr. Rockoff