My mother passed away from melanoma, so my wife looks at my moles pretty carefully. About 3 years ago, I had 3 removed from my back (one on my belt line that was chafing, and 2 others that were large and irregularly shaped, but generally not too worrisome).
About 2 weeks later, I got a call from the doc asking me to come back in. They wanted to excise more tissue around one of the moles, as it came back with some oddities, but not cancer. I now have a large scarred over spot on my back, they took about 1.5 inches out.
I’m guessing they want to do something similar for you, just to make sure they got it all. It doesn’t mean cancer, it just means they want to make sure they got everything because something triggered a warning in the tests.
Something else kind of interesting from the notes.
The sample on my face was excised to the level of superficial subcutaneous fat, and the sample on my arm was excised down to the deep reticular dermis, which are both really freakin’ deep.
My first time around the bend, the dermatologist just shaved it off, no digging or anything, just a straight swipe across the bow. No wonder it came back.
I really hope that the double extra re-excision doesn’t leave me with a scar on my face, unless it can be made to resemble a scar one might receive in a knife fight.
I had an ugly-looking mole removed last winter. It wasn’t especially worrisome for cancer, but it was a rather nasty shade of deep purple, which had me and my doctor somewhat concerned, since I’m pretty fair-complected. Fortunately, it wasn’t cancer (it was diagnosed as a dermatofibroma), but now that I know I can get it, I’m a little more careful in the sun. As in, I avoid it like Dracula.
wierddaron, your mole may well be benign, but your posts are killin’ me - hilarious.
If they were wanting to do all this digging around on MY face, I’d be demanding a plastic surgeon. Seriously. Might be something to consider, especially if you are devastatingly handsome…
I haven’t had to have a mole removed from my face in ages.
I used to get sun spots/ cancers burnt off in amounts of 60 or more every visit. I had a number removed by the plastic surgeon with small grafts from other areas.
So first you are worried about croaking prematurely; now you want a cosmetic result. That’s progress.
Were it I, I’d want them to take a nice margin. I’d want the “them” to be an individual well-qualified to do so (which I am assuming you have, so I am not making a negative inference here based on your care so far).
After the borders are clean, then it’s time to worry about the cosmetic result to see if you want a scar revised. A good looking face in a coffin is still dead.
Blut, that’s not such a good idea IMO. I’m not an MD, but I’ve learned that the best thing to do is get suspicious moles under a microscope for evaluation. I’d suggest the "ABCDEF" Guideline (I’ve seen the additional “F” for “looks Funny” - if it seems odd to you in an undefined way, get it checked!) The Wiki page points out that the ABCD guidelines can cause false alarms. Some nasty looking moles are harmless, and vice versa. That’s why I defer to a professional dermatologist. If I hadn’t had my moles checked, I’d be in a bad way now.
Actually, there is a great deal of merit in have a plastic/reconstructive/cosmetic surgeon do the excisions, especially on the face. Particularly a guy who specializes in facial surgery. It is not always possible, but there are times when a skilled approach can minimize scarring and damage to muscles/nerves/other structures from the get go. The angle at which the skin is cut in an area of high mobility (such as the face) can either help or hinder healing, depending on whether or not normal face movements put tension on the scar. Many cosmetic/plastic surgeons are quire competent to excise skin cancer, and many of them split their practice between purely cosmetic and doing things such as surgery for cancer, infections, injuries, etc.
When I had the infamous Zit From Hell that required emergency surgery my insurance company - yes, the profit sucking leeches - sent me to a plastic surgeon with no questions asked and full approval. The inch and a half long, 3/8 inch deep canyon that had to be gouged on my face healed so well that most people never see the scar on my left cheek/jaw with when I’m not wearing any sort of makeup or concealer. If insurance companies - not known for generosity - are willing to send people to plastic surgeons it is certainly worth an inquiry.
I’d be annoyed getting back a report like that too. If it was me, I’d consider getting another consult opinion by someone with national reputation in dermatopathology (I have no idea what background the outside consultant in your case has, they could be great). In all likelihood, the bottom line recommendation would be the same - get a re-excision with good clear margins.
Architecture is probably the most critical feature of pigmented lesion evaluation microscopically. It refers to things llike asymmetry, location of cells in the epidermis and so on.
This is a really, really bad idea for two reasons.
Moles often have an invisible (microscopic) component growing down into the dermis. If you rip off the obvious mole the remaining cells can re-form a lesion, and post-trauma can look weird and simulate a melanoma. Worse, you could mistake a melanoma for a benign mole and leave malignant cells behind to proliferate.
There are websites selling a caustic salve derived from bloodroot, which they claim will burn off moles safely leaving no scars. The reality is that people have wound up disfigured from these agents and with tumors that grew back and metastasized. I’d never have anyone but a trained physician remove a pigmented skin lesion.
Best wishes, wierdaaron, and may your annoying Spitzoid friends begone for good.
I second, third, or fourth (whatever the count is up to, I can’t remember) the seeing a plastic surgeon for the surgery – if your doctor isn’t one already.
I’m glad it doesn’t appear to be life threatening!
Yeah, it’s been a plastic surgeon (or “aesthetic surgeon” I think he likes to be called) the whole time.
This was initially never about scary, potentially evil moles. I wanted the moles removed for cosmetic reasons, so I went to a cosmetic surgeon (referred by my GP), in the interest of having it done properly with minimal scarring. The whole spitzoid thing only came as an after-event.
Like if I’d gone in for liposuction, and then a week later I got a call saying “we tested your fat, and there’s some weird-ass cells in there. We need to do it again.” Except, in that event I’d be getting extra lipo for free (good thing) and in the real case, I’m just getting more pain and stitches for free (with no real benefit).
It’s impossible for me to feel good about this, or relieved that the funky cells are going to be gone, because I’ve got so many damn moles still. If one seemingly-normal face mole can make someone, whose job it is to examine moles, scratch his head, there’s no telling what any of my other moles are! The only way to find out would be to have all of them extracted and tested, and that would probably be a pound of flesh.
And I’ve got a few moles near… sensitive… zones. Not sure how that happened, anyway. Aren’t moles supposedly caused by sun exposure? Like freckles.
I’d just like to point out, for the people with way too much interest in my life, that I had the re-excision done today, so I get to deal with stitches on my face for a week again. Joy joy.
If the labs on the chunk of flesh show the spitzoidswallows extending to the border again, I think I’ll just elect for total face removal.
I had a mole on the back of my ear. My son asked me about it.I could not see it so i had no answer. My wife looked and said go to doc. I did , he referred me to a specialist who removed it. It was a basal cell. Because of its location ,i never saw it. I can not give a description at all. So I had one and am still not able to give advice about moles.
But the doc and the specialist still asked me to describe it and tell them if I thought it was changing in shape and color. I was the only person on earth who could not tell them a thing.
