I have LOTS of moles. On my torso and legs, more on my right side than on my left. I also get them on my face–they might not technically be “moles,” but they’re bumps, same color as the skin they are on. All of my friends regularly go to the dermatologist for the “mole patrol” (as Grace Adler of Will & Grace calls it). But I never did. No particular reason.
A couple of years ago, I finally went to a dermatologist thinking she was going to go over every inch of my body, because, as someone posted, melanomas can show up anywhere, even where the sun don’t shine. I stripped down to my bra and panties and she gave me a very quick once over. She unhooked my bra and glanced at my back, but never looked at my abdominal area, let alone my genital area. She definitely did not look at my feet at all. Where was the thorough once-over I was expecting? <shrug> She identified a place on my nose that looked suspicious to her (I didn’t see anything at all) and used liquid nitrogen on it. Okay.
The following year I still wanted to get all of my moles at least looked at, so I went to a different, highly recommended, dermatologist. Same story. I expected him to at least glance at basically every square inch of my body. I wasn’t particularly looking forward to that…but I figured that was what he was supposed to do. Once again, the cursory glance at the exposed areas of my body (I was in a paper gown, so I had some of my clothes off). He removed a couple of miles from my legs and biopsied one of them.
Am I getting a proper exam from these dermatologists?
P.S. Last year I was diagnosed with breast cancer that was detected in a routine mammogram.
After I actually had three separate moles removed and identified as atypical (or whatever they call moles that are about to go bad), a dermatologist decided to “section” me. That means they took my body section-by-section (the front and back of each arm, each leg, and my torso, iirc) and drew a map of my moles to compare against in future exams. It resulted in three immediate removals, two of which were atypical.
Maybe you need a track record of having *atypical *moles. There is a single gene that controls whether a person has a lot of moles or not, and these genetic nevi rarely go cancerous. Point the dermatologist to a place that’s gotten badly sunburned several times, or find a mole with suspicious features. Then you’ll get on their radar.
Anyway, I was surprised that I had to ask a dermatologist about every little bump on my body. Possibly he was so good at identifying these things that he didn’t need to focus on each one. None of them indicated a medical problem, I just had him remove keratoses that were annoying me.
I had a once-over last summer after having a carcinoma removed from my scalp. The CNP did a quick, but I think thorough exam. There were a few things I specifically asked about, but she said I didn’t need to be concerned.
I’m hoping that she’s seen so much over the years that she doesn’t need a magnifying glass to examine every square inch of skin. When I go back next month, I have a couple more things to ask about, but nothing of major concern, or I’d have been there already.
An experienced doctor can tell at a quick glance. I have a spot on my farmer-tan arm where there is a persistent patch of reddish dry flaky skin, and I asked my doc if that might be skin cancer. He was still sitting six feet away, and said no, it doesn’t have the characteristic signs.
I understand that s/he can tell at a quick glance at the places that are exposed/visible. But what about between my toes and the parts that are covered by underwear (that I’m not asked to remove)? THAT’S my question…
I have the same question. I had a superficial melanoma removed some years back, and so have an annual dermatologist appointment. They look over all of the skin not covered by my boxers. As the OP says, I’m not crazy about having to take off my boxers, but I am also not crazy about not having a complete exam. My assumption is that the boxer area is so low-risk for sun-related cancers that they can safely skip it, but I have never asked about it.
I’ve been to three dermatologists at two different practices. Each time, I’ve had my whole body examined (swiftly but thoroughly) including my scalp and in between my toes. The last exam, I was given a paper gown, with only one private section uncovered at a time. The “sectional” exam did seem less intrusive, oddly enough.
My dermatologist examines my entire body including my scalp and in between my toes. It’s very quick , but I did strip down completely, and put on a paper gown which was uncovered section by section.
Have you brought up to either of these doctors or their scheduling staff that you are interested in a “mole map”?
I’ve been to a dermatologist a handful of times but not for moles (adult acne! yay!) and no one attempted to make a mole map of my body. I don’t think I even had to take any clothes off (because the acne was on my face! yay!)
But I suspected if I told them that is what I wanted and that is what I was coming in for, that is what they would do.
Well, the first time I went, I didn’t know what to expect. Never heard of a “mole map.” I made the assumption that they knew what to do, not that I would have to tell them. The nurse/PA asked me if I wanted an all-over mole check and I said yes. The doctor (female) stopped short of what I took “all-over” to mean. But this was my first visit to a dermatologist.
The next time I went to a doctor recommended by a friend who insisted he was fantastic, very thorough, etc. Once again, I got the cursory once over, but he did remove a couple of MOLES from my legs. Call me a 67-year old wimp, but I did not feel comfortable on my initial visit to (male) Dr. #2 (still not 100% sure what to expect), “Okay, aren’t you going to go over every square inch of my body, including my genitals and between my toes?? Hmmm??”
Next time, I WILL be more assertive, now that I’ve gotten some feedback from this site, The Fountain from Which All Knowledge Flows.
Fifteen years ago the backs of my hands suddenly began turning white (pigment loss). I was kind of freaked out. I’d heard of vitiligo, but wanted to know what was up.
I went to my PCP and he wrote up a derm referral. I called for an appointment and the receptionist told me the next available appointment was in seven months. Seven months later I sat in the waiting room for a several hour wait, then the doctor and a second person walked in. The doctor looked at my hands, then mumbled something to the second person, who fetched me a vitiligo handout.
I’ve has psoriasis for nearly forty years and have been going to a derm on a pretty regular basis for most of that time just to get scripts changed/refilled. Five or six years ago he asked if I’d ever had a “full skin check”. I hadn’t and followed his recommendation to have one. He found a very early stage (in situ) melanoma and removed it. A year or two later he found another, slightly more advanced, melanoma. He then recommended that I see a skin cancer specialist. His exam was more thorough and didn’t find anything. Its been three or four years and I still get annual checks. Head to toe with magnifying thingy when necessary. If he’s the slightest bit concerned he does a shaving and sends it to the lab. No problems. I feel that I really dodged a bullet because I, too, am covered with all sorts of freckles and moles and things and never would have noticed either growth. I can’t overstate the importance of these exams if you are at risk.
About 10 years ago, at my wife’s suggestion, because she was having a few moles removed and biopsied, I went in for the same treatment. My PCP sent me to the dermatologist across the street from his office, the guy took off one mole near my navel, stitched it up, and send me on my way. Biopsy was clean. Asked to go to where my wife was going, and PCP took a look at me again and said the moles were normal and “don’t worry”, but I persisted and got referred to where my wife was going. That dermatologist was very aggressive and started plucking them off by twos and threes and biopsy, until lo and behold, one came back with melanoma. Sent me to surgery to remove upper-end stage 1 tumor, and now I get scanned 2x a year for the duration, and she will take them off if even a low level of concern. And yes, she examines every crevasse.
Moral: don’t depend on your PCP - get referred to an expert dermatologist - find an aggressive one. She saved my life.
Okay. I’m sold. Calling tomorrow to make an appointment at the medical center where my PCP, oncologist, and surgeon practice. I’m going to make sure they do the stem-to-stern examination. I really appreciate the info y’all have provided.
