mole in dark spot? melasma?

[viktoriag]

Hi,
I have a dark spot on my cheek which I have probably had for at least a couple of years. Recently I have noticed that my entire face seems to be developing melasma (previously diagnosed in only one spot on my forehead).  
I now have become obsessed with one spot on my cheek, larger and darker than the rest, mainly because it has one tiny pinhead-sized 'mole' that I can feel when I put sunscreen on it.
I have an appointment with the dermatologist at the end of next month. To most, this looks like an 'age spot' and to me it would as well, if it were on someone else!  
My question is: can these spots of melasma have a raised 'freckle' type thing, or are they always uniformly raised? My other self-diagnosis is 'lentigo' but I wonder if they can have an area that can be felt.
The entire color of this spot is a light brown. The darker spots are just a little darker brown, nothing is close to black, and the flat tan and freckle colors are the only two colors in the whole thing.
Well, thanks for any thoughts. I'm trying to keep myself from calling the doctor in a panic.

[viktoriag]

Thank you so much for your prompt reply. I am sure that the elevated area (which is about the size of the scab one would get it pricked by a tiny pin) has always been there. What I am not sure of is if the flat tan area may be getting a little larger. I have to turn my head to the side to study it, so I have only begun to pay close attention to it, which hopefully is the problem.

The melasma is everywhere - my chin has it the worst, but it's splattered about my cheeks and forehead as well. This is not really such a problem yet, and I'm trying to take all steps to keep the sun from getting at my face; my skin is fair, and I have unfortunately done much damage to it over the past 42 years.

Thank you again! I realize that a diagnosis can only be made once it has been seen and/or removed for testing.

[Dr_Aparna]

Hi,
Both Melasma as well as age spots or moles are varying types of skin pigmentation disorders.

Age or "liver" spots are a common form of hyperpigmentation. They occur due to sun damage, and are called solar lentigines. These small, darkened patches are usually found on the hands and face or other areas frequently exposed to the sun.
Melasma or chloasma spots are similar in appearance to age spots but are larger areas of darkened skin that appear most often as a result of hormonal changes.

Most of the times these lesions are flat i.e. only at the skin level. However, if the small spot was always felt when you touched it, then there may not be cause to worry. Moles can sometimes be elevated. If the development is recent then perhaps it could be something of concern.

A biopsy of the skin leson should be able to settle the issue. So, you will have to wait and hope for the best. Only changes in color, size . shape, border or elevation of the pigmented spots are significant.
ref:http://aocd.org/skin/dermatologic_diseases/hyperpigmentation.html