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

[WHEN A "MOLE" IS NOT A MOLE, IT COULD BE SKIN CANCER]

Question: I have a mole that has been on my arm for many years. Now, I have many little new ones that are just hanging on by a thread. What can I do for them?

Answer: To a physician the term "mole" means a specific type of pigmented skin growth. More properly called a nevus, this growth may be raised above the surface of the surrounding skin.

A mole may be present at birth, but most develop with the passing years. In fact, the majority of us ultimately develop at least 25 of them. Moles are usually less than 1/4 inch across and have a darker pigmentation than the surrounding skin. In addition to the "raised mole" I mentioned earlier, they may be flat, or even hanging from a stalk. They may be smooth, rough or even have hair growing from them. The junction between the mole and the surrounding skin, both its change in texture and color, is quite distinct.

In my practice, I've noticed that most non-physicians use the term mole to describe any type of clearly defined area of different appearing skin. Therefore, I'm concerned that your "mole" may actually be something quite different. There are a number of non-mole skin growths that can look like an innocent mole to an untrained eye. The most serious of these, of course, is cancer. One million new skin cancers are diagnosed each year, so they are quite common. Many of these were first thought to be a mole. Early detection and removal of skin cancer almost always produces a cure. This is true even for the most serious form of skin cancer, melanoma.

So what can you do for your moles? The short answer, in your case, is to see your family doctor or dermatologist soon so that a correct diagnosis can be made. For the rest of my readers, the question is when should a mole or other skin growth prompt a visit to the doctor. Since we all have moles on our skin, this can sometimes be a difficult decision. Here are some tips to help identify potential skin cancers, the scariest type of skin lesion:

- a skin lesion that has recently changed in appearance (not compared to last year but compared to last month);

- one that has an irregular border;

- one that has changed in color, particularly gotten darker;

- one where the color fades into the surrounding skin instead of having a distinct border; or

- one that has become painful or started itching.

May is Melanoma/Skin Cancer Detection and Prevention Month. Therefore, I suggest that in May you recruit the help of a spouse or very good friend and examine every inch of your skin, including your back, between your toes and other areas where the sun don't shine. Any mole that fits one or more of these criteria should be brought to the attention of your doctor. He or she may recommend that the entire growth be removed if it is small, or that a part of it be excised so that it can be studied under the microscope.

Fortunately, your moles may actually be moles. In that case, you can just leave them alone. Your doctor, however, will probably suggest removing them anyway if they are over 1/2 inch in size, are frequently irritated by clothing or activities, or if you find them cosmetically objectionable.

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.