FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

MOLE-LIKE MELANOMA DEMANDS IMMEDIATE ATTENTION TO SAVE LIFE

Question: I have many small moles on my body. There is one on my right arm that is about one-fourth inch across and growing. I've treated it with erythromycin 2 percent solution, Absorbine Jr., and with alcohol. None have made it get smaller. Is there anything I can do to remove these little brown spots? Oh, by the way, I'm 57 years old and I work outside a lot in case this makes a difference in your recommendations.

Answer: Moles are quite common. Most people have some moles, and many people have up to 40 of them. Generally, the number of moles increases with age, and they are most common on sun-exposed parts of the body. Ordinary moles cause no health problem, although they may be cosmetically undesirable.

My experience as a family physician has lead me to believe that the term "mole" means different things to different people. We physicians use the term to describe an inherited skin defect that can be either flat or raised and usually has an increased amount of pigment within it. A raised mole can have only a slight elevation above the skin surface or it may grow quite tall as if on a stalk of tissue. Some moles are hairy or have an increased number of small blood vessels. Non-physicians often use the term mole to describe any skin blemish be it a wart, a seborrheic keratosis, one of several types of skin cancers, or an actual mole. So, I don't know for sure what the growth on your arm is. But from your description I'd guess it's probably a mole since it is relatively small, accompanied by many similar appearing growths, and occurs in a sun-exposed area.

However, you could have a more serious skin growth instead of a mole. I'm concerned about a particular type of skin cancer called melanoma that occurs most often in sun-exposed areas. This cancer produces pigmented growths that look a great deal like moles. One important difference is a melanoma grows or changes size and shape while a mole changes very little. A melanoma also itches or hurts while a mole causes no unusual sensations.

Melanoma is a very serious type of cancer because it can spread to other areas of the body while the original cancer is still small. A melanoma that is one-fourth inch across, the size of the growth on your arm, could have already started to spread. Fortunately, early removal of the cancer and additional therapy can often stop this deadly killer.

The medications you have used on your arm will have no benefit for moles or cancer. The only treatment for these conditions is removal of the growth. It is important to have the skin that is removed sent to a pathologist to be studied for signs of cancer. This ensures that your doctor and you know the cause of those dark-colored growths on your arms.

So don't try to remove your moles with medications. Let your family doctor or a dermatologist look at them to be sure cancer isn't present. Then you and your doctor can decide if any of the growths need to be removed for cosmetic reasons or because they pose a cancer risk. And you should also protect your skin from excessive sun exposure to reduce your risk of developing skin cancer and other skin problems in the future. Wear a long-sleeved shirt, long pants and a hat, or use sunscreen on your arms, the back of your hands, your face, your legs and other exposed parts of your body.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.