What’s this mole?

All you need to know about skin maladies
Fri, 09/22/2017 - 11:30am

Ed. Note: The following was sent to The Block Island Times by the Block Island Medical Center as part of its Community Health and Wellness Series:

Author: Allegra M. Parrillo, Brown Medical Student.

Medical content edited by: Dr. Mark Clark, Medical Director, BIMC. 

For such a tiny island, Block Island sports a surprising 17 miles of beaches. While surfing the waves and basking in the sun is the ultimate form of relaxation, our skin tends to take a hit and moles that were once benign may begin to change into more dangerous lesions.  Every year between 2007 and 2011, approximately 240 Rhode Islanders were diagnosed with melanoma. This article will serve to help you notice which lesions are ones to not worry about and which ones should be of concern.  Of course, if you are ever questioning the appearance of one, do not hesitate to make an appointment for a skin exam at the Medical Center or at your primary care provider, or dermatologist’s office. We recommend prevention with yearly skin exams and daily sunscreen use of at least SPF 30 — unless you have a history of skin cancer, in which case we recommend using SPF 50.

The following are some common skin lesions which you may be wondering about:

A) Cherry Angioma: A very common skin lesion that appears with age anywhere on the body. These appear as little red dots that arise from an overgrowth of the tiny blood vessels below the skin. They are completely benign (harmless)  and should not be of concern. (See photos A and B)

B) Seborrheic Keratosis is another common benign skin lesion that appears with age, usually after 30 years old. These are typically called barnacles for their “stuck on” appearance like those of barnacles on a dock or boat. They can appear anywhere on the body, but usually do not occur on the palms, soles, or mucous membranes such as the mouth. They span the range of appearances and can be flat or raised, small or large, smooth or warty, and they are skin-colored, black, brown, yellow, or multi-colored.  Most do not require removal although many people opt to have them removed for cosmetic reasons or if they become irritated or inflamed.  This is a simple 20-minute procedure that can be done at the Medical Center or at your dermatologist’s office.  In most cases, any lesion that is removed from the skin is sent to the laboratory for identification. (See photos C and D)

C) Dermatofibroma: This is a benign common lesion that can occur at any age, and is more common in females. Usually found on the lower legs or arms, these lesions can appear pink or light brown with a pale center. They are usually firm and cause a dimple with pinching.  These may be removed if they become painful or itchy. (See photos E and F)

Dangerous Skin Lesions to Know About:

D) Squamous Cell Carcinoma:  A type of skin cancer, this lesion is concerning because of its fatal nature due to its ability to spread to other areas of the body (metastasize). Usually these are found in sun-exposed areas (lips, ears, scalp, arms), grow rapidly and may be painful. However, they can also occur on non-sun exposed areas such as the soles of feet. Other risk factors include: being male, elderly, smoking now or in the past, previous skin cancer, or having had an organ transplantation.  They usually appear as little ulcers, but can look like a pink bump or have a corn-like appearance. If they have not spread to other areas, this type of cancer is easily treated by removing the lesion. (See photos G, H and I)

E) Basal Cell carcinoma: This is another common type of skin cancer.  It is usually found on the face, with the exception of the lower lip. Although this cancer type does not spread to other areas of the body, it can invade locally and cause destruction to the areas surrounding the lesion, including the nerves and muscle.  Risk factors are similar to squamous cell carcinoma and include being male, being elderly, having a history of sun damage, and having had prior skin cancers. This cancer usually appears as a shiny bump that is smooth, but may have a tiny depression in the center with blood vessels on its edges. Basal cell carcinomas are rarely life-threatening, but can be disfiguring depending on how much it has grown. You can be completely cured by removal of the lesion. (See photos J, K and L)

F) Melanoma: This is the most well-known form of skin cancer, but is not as common as the other two mentioned in this article. However, this is a deadly lesion. Risk factors for this type of cancer include increasing age, prior skin cancer, family history, or easily burned skin type.  Melanoma takes many differing forms and appearances and does not need to be colored. It can occur anywhere on the body including the scalp, palms, fingernails, and soles of the feet. To best monitor moles for this cancer, we recommend the ABCDE method (asymmetry, border, color, diameter, and evolution). If the mole in question is Asymmetric, has irregular Borders, more than one Color, is large in size (Diameter), and has changed (Evolution), you should bring it to your doctor’s attention for a biopsy. If caught early, melanoma can be cured with removal of the lesion. If the lesion is more advanced, more aggressive measures will need to be taken. (See photos M, N, O and P)

To sum up: 

Be smart with the sun, wear a hat and sunscreen while enjoying the outdoors. 

Get a skin check up at least once every year with your primary care provider or dermatologist.

Many skin lesions are benign, but if you notice one that concerns you for any reason—get it checked out.

Many skin cancers are easily treatable if caught early!

Photos courtesy of: DermNet New Zealand/DermNetNZ.org (http://creativecommons.org/licenses/by-nc-nd/3.0/nz/.)