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Scab like mole, has darker side. Seborrhic keratosis or melanoma?

Jul 2012
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Practicing since : 1993
Answered : 1196 Questions
Hi I have a mole that is scab like and has darker side and I am very concerned it is melanoma. I have a pic that i would like to send to you as well. Its scaby and the sides if i scratch it peel up. Is it a sebborhic keratosis? Its very light colored but has some darker pigmentation inside of it. The borders are undefined.
Posted Wed, 5 Sep 2012 in Skin Hair and Nails
Answered by Dr. Praveen Rodrigues 1 hour later
Hi there XXXXXXX I read your description & have viewed all 4 photographs. Off the cuff, i am unable to decide one way or the other. I would recommend biopsy of the lesion making sure to excise it in toto with a 1 cm ring around it. This will serve both as definitive therapy & be diagnostic. Having said that, if there is no strong family history of cutaneous malignancies or any such lesions earlier, you dont really have much to worry about. But, in my book, better safe than sorry. I would biopsy such a lesion every single time. Please do make an appointment with your dermatologist. It is not urgent & relax, no need to panic. Have just chalked out a plan of action for you. I wish you good health & my clinical opinion is that it is NOT melanoma. However, your dermatologist may have an instrument called a dermatoscope which may aid him arriving at a more definitive diagnosis or/& just go for the skin biopsy in any case. Take care & do hope this opinion together with that of your dermatologist on the ground will help you make an 'informed' decision. In any case, i dont expect it to be malignant but one can do with its removal even from a cosmetic view point & as i reiterate, better safe than not . Cheers & Godspeed.
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Follow-up: Scab like mole, has darker side. Seborrhic keratosis or melanoma? 11 minutes later
Hi thank you for your reply. My 87 year old grandmother did have a melanoma removed from her foot a year or so ago. Otherwise, not other family history. I had moles removed that were atypical in nature, otherwise, nothing else was noted about them that i can recall. certainly, none were melanoma. I have an appt on Friday with my dermatologist. Is it cause for concern that i noticed this more than a year ago? I do not believe that it has changed at all since I first noticed it.
Answered by Dr. Praveen Rodrigues 27 minutes later
Hello again XXXXXXX I reiterate & wish to reassure you that there is absolutely NO cause for concern; just vigilance. As you say, it has not 'changed' at all over the last year, then even less to worry about. Relax & dont fret till friday. It is nowadays as common as going to the supermarket to do one's weekly groceries...absolutely not an issue. If my guess is right, the dermatologist will say it is 99.9% not a malignant lesion & nothing to worry about. But, most docs like to err on the side of safety first in light of all the law suits going around nowadays ;-)
It is a good sign for the future that your grandma is a ripe 87 & going strong. I wish her a fruitful life & dont you sure you will be around well into your nineties! Take care & is just another mole (beauty spot)! & this one is not even atypical :) smile..all will be well. Hope have managed to reassure & calm thine nerves. Do give us a shout when done & am sure all will work out..Nothing to worry about absolutely!! Goodnite & Good luck!
Dr Praveen Rodrigues MD
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Follow-up: Scab like mole, has darker side. Seborrhic keratosis or melanoma? 10 minutes later
One last thought: When I look at it closely, it looks like it has those "horns" that is what is making it rough. Does this change anything with regards to your clinical impression?
I just uploaded one better quality photo. Can you please take one last look? TO clarify, its scaly throughout the mole with a dark streak through it.
Answered by Dr. Praveen Rodrigues 47 minutes later
Hi again. Noted your concern & viewed the recent photo. Stil maintain my stand. Clinically, nothing to fear. Practically would excise & biopsy with margin as a definitive treatment & to clear the mindspace besides getn a histopathological view to be crystal clear:-). Again, Relax..keep urself busy till is a routine check. Do close this query & do find time for a feedback. Dont worry am always around should you require an opinion after the biopsy as well. Best to get it outa system. Cheers and am certain you have absolutely no cause for worry. Dr XXXXXXX rodrigues
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Answered by Dr. Praveen Rodrigues 10 minutes later
Tx for your appraisal XXXXXXX I do appreciate your viewpoint but beg to disagree that i contradicted myself. I maintained the same view point in all my that i felt it needs to be excised in order to be safe. No dermatologist can give you a 100% guarantee that his/ her clinical opinion is 100% accurate. We all put the patients' best interests first. So sorry you felt i contradicted myself. All the best regardless. Dr Praveen Rodrigues MD
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