By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER’S NEWLY DEVELOPED MOLE NEEDS TO BE EXAMINED BY DOCTOR

Question: I was hoping you could give me some advice on a mole that formed recently on my upper right shoulder. I am a 36-year-old man, and this mole originated in the last 4-5 weeks. I would describe it as gray and about the size of a raised pencil eraser. Is this something I should see a doctor about?

Answer: People tend to use the word "mole" to describe any kind of growth on the skin, but to physicians a mole is a specific type of growth. More properly called a nevus, this kind of growth usually contains pigment that makes it appear darker than the surrounding skin. It may be flat, raised above the skin, or even hanging from a little stalk.

While most nevi are harmless, there are many signs that you should look for to help determine if a mole is a “bad” one or not. Most people have between 10 and 50 moles, and some are even called “beauty marks” when they occur on the face. There are two basic classifications of moles -- normal nevi and dysplastic nevi. Let’s take a look at each type.

Characteristics of normal nevi are:

• Color -- ranges from pink to tan to dark brown, sometimes almost black; • Shape -- usually round or oval with well-defined borders; • Size -- ranges from 1 to 10 millimeters; and
• Location -- anywhere on the body.
Normal nevi may also be either flat or elevated and may or may not have hair growing in them. They tend to develop in childhood and adolescence.
Dysplastic nevi are moles that are abnormal and look different from “normal” moles. These moles are more likely to turn into melanoma, a deadly form of skin cancer. While most moles -- both normal and dysplastic -- never turn cancerous, the dysplastic moles should cause concern and are usually removed.
Characteristics of dysplastic nevi are:
• Color -- Tan to very dark brown on a pink background; • Shape -- Asymmetric, with irregularly shaped and poorly defined borders; • Size -- Ranges from 5 to 12 millimeters (usually larger than a pencil eraser); and • Location -- Most common on sun-exposed skin, but sometimes develop on covered areas.

Unlike normal moles, dysplastic nevi continue to appear after age 35. While most of us have just a few abnormal moles, some people have more than 100 of these dysplastic nevi. This tendency runs in families. Members of these families have a very high risk of melanoma. A person with this condition should have his or her doctor do a skin exam every three to six months so that any problems can be detected early.

Given our reader’s age and the recent appearance of his mole, I would advise him to make an appointment to see his family doctor or a dermatologist promptly. That’s also good advice for anyone who is concerned about a new mole or one that appears to be changing in size, color or texture.

Of course with Spring Break and summer quickly approaching, be sure to use sunscreen to protect your skin from harmful ultraviolet rays. Unprotected sun exposure can increase your risk of developing skin cancer, especially a dangerous melanoma.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.