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Dermatology (Expert Forum)
rapidly elevated papule within mole
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
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rapidly elevated papule within mole
by MollyM, May 30, 2007 12:00AM
Hi Dr. Rockoff,
My 30 yo fiance has a ~5mm mole on his forearm that is medium brown with slightly irregular borders and a little variation in color which over about a week developed a raised area. Initially, about half the mole was diffusely raised, after about 4 days it turned into a ~1 mm papule that is hard, round, and slightly darker brown than the rest of the mole (but not very dark brown or black). The area was originally a little painful; the skin around the mole but not the mole itself is slightly itchy. He has had ~5 moles removed in the past (never got results that were concerning), has numerous moles, has significant sun exposure now and as a child, and has fair skin. He checks the mole regularly and has not noticed any other changes including in size or borders; he last had this particular mole examined by a physician about 8 years ago. I'm positive the papule was not there two weeks ago, there may have been a small spot of slightly darker color at this location.
My understanding is that changes with skin cancer/melanoma generally do not occur this quickly (over days) and that this likely represents some small injury or inflammation. Is that correct? How quickly would you recommend evaluation by a dermatologist? Is there any reason not to do an excisional biopsy initially (he will soon be traveling out of the country)?
Thanks very much.
My 30 yo fiance has a ~5mm mole on his forearm that is medium brown with slightly irregular borders and a little variation in color which over about a week developed a raised area. Initially, about half the mole was diffusely raised, after about 4 days it turned into a ~1 mm papule that is hard, round, and slightly darker brown than the rest of the mole (but not very dark brown or black). The area was originally a little painful; the skin around the mole but not the mole itself is slightly itchy. He has had ~5 moles removed in the past (never got results that were concerning), has numerous moles, has significant sun exposure now and as a child, and has fair skin. He checks the mole regularly and has not noticed any other changes including in size or borders; he last had this particular mole examined by a physician about 8 years ago. I'm positive the papule was not there two weeks ago, there may have been a small spot of slightly darker color at this location.
My understanding is that changes with skin cancer/melanoma generally do not occur this quickly (over days) and that this likely represents some small injury or inflammation. Is that correct? How quickly would you recommend evaluation by a dermatologist? Is there any reason not to do an excisional biopsy initially (he will soon be traveling out of the country)?
Thanks very much.
Doctor's Answer
by Alan Rockoff, MD, Jun 01, 2007 12:00AM
, Jun 01, 2007 12:00AM
You are correct--fast changes usually mean little. I suggest he wait 3 weeks or so before having it evaluated. That will give any irritation changes to subside before the skin doctor takes a look. 5 mm lesions can be removed all at once easily enough, though I doubt his will need to be.
Best.
Dr. Rockoff
Best.
Dr. Rockoff
