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What Does A Lump On Shoulder Indicate?

Posted on Wed, 29 Oct 2014

Question: Back in July I noticed this small new lump or mole growing on my shoulder. It started out small red and round without any issues. The past few months it started growing larger and wider and appears crusty and hard when touched, I noticed some specks of black in the area as well. The area is tender and is itchy. I listed some pictures. Should I be concerned?
Thanks!!

Answered by Dr. Dr. Kakkar (27 minutes later)

Brief Answer:
Possibility of melanoma

Detailed Answer:
Hello. Thanks for writing to us at healthcaremagic

I am Dr. Kakkar. I have gone through your concern and I have understood it. I have also seen the photographs.

I would suggest an excision biopsy, as soon as possible. Melanoma is a likely possibility here, since the lesion has definitely changed from what it was before. It is ulcerated/eroded/crusted, itchy and has colour variegation/bleeding spots. These all are signs of a change that could very well be malignant.

I would suggest that you seek an appointment with a dermatologist for the needful, as soon as possible, as these changes look to be fairly advanced to be just speculating at the possibility.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (24 minutes later)

Could this be squamous or basal cell carcinoma? Or do you think its melanoma?
I have an apt with a dermatologist 11/3/14. Do I need to be seen sooner if you think its melanoma?

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
details below

Detailed Answer:
Hi.

Well, all types of skin cancers can produce similar looking skin conditions. Biopsy can effectively differentiate. I did consider a possibility of Basal cell carcinoma(BCC) but BCC is usually smooth and asymptomatic, whereas this lesion is ulcerated, itchy.
Squamous cell carcinoma(SCC) is a possibility but I would also consider melanoma as the likely possibility because of the black specks (possibly pigment but may be bleeding points/clotted blood) that this lesion has and because it is itchy. SCC is mostly asymptomatic unless it is infected.
However, the lesion does'nt have a lot of pigment as in melanoma, and is largely amelanotic.

I think you should consult at the earliest. I would have biopsied it the day I would have seen it. My differential diagnosis would be ?SCC and ?Melanoma (amelanotic)

-Is there a history of bleeding?

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (5 hours later)

I have never seen it actually bleed, but it itches a lot and its very hard like lesion. Could I die from this small lesion?

Answered by Dr. Dr. Kakkar (8 hours later)

Brief Answer:
Biopsy would be the first step

Detailed Answer:
Hi.

Fine.

No need to panic. Squamous cell carcinomas as well as Melanomas are very much treatable if detected at an early stage, when they are still localized.

The first step would be to biopsy it and take things forward depending on the biopsy report. If it is still localized, then it can be simply excised with a safe margin of normal skin.

Regards

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Dr. Kakkar (1 hour later)

Thank you very much. You have been so helpful

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
You are welcome

Detailed Answer:
Hi. Thanks you for writing to us at healthcaremagic. I would like to know what your doctor thinks about this lesion and also would like to know the Biopsy report.

So let me know as and whenever you get something conclusive. My profile can be directly accessed by this link: http://doctor.healthcaremagic.com/doctors/dr-kakkar-s/66939

Regards
Take care

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju