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What Causes Unusual Looking Moles On Body?
Question: Hi - I am really really worried. I have been to have a mole check done and the dermatologist found three moles that she did not like the look of. I have lots of moles. One was about 5mm diameter - like a big freckle not round but not overly misshapen and not typically like the melanoma pics on the internet. It was in the hard ribby area between my breasts. I know it has been there a long time as I have holiday pics with it on. It was flat but she said she could see more than one colour in it. I don't think it has grown much from the pics from a few years ago - maybe a very slightly different shape but it is hard to tell? The other two were one to each upper arm. One was about 1mm and very black (but I have found photos since of my arm from years ago and it was there then. The other was about 1.5 - 2mm and I was unable to confirm from holiday snaps if it was there before or not. I am awaiting biopsy results and it is killing me.
Now I have been on the internet and have found images of distant skin metastases and these have got me real worried. You see - for just over two weeks or so I have had a red pimple like bump on the inside of my wrist. It came up out of nowhere one day and when I squeezed it, it oozed clear fluid. It was I guess about 2mm and very raised. I didn't take much notice when it first appeared and did not mention it to the dermatologist who checked my moles as I thought it was nothing, I handle hay a lot (I have horses) and sometimes I get bits of prickles and stuff in my fingers and I guessed maybe there was a sliver of a foreign body in there that I could not feel and it would work its way out.
Now I thought that after 2 weeks it would be completely gone - it did go down a lot and looked like it was going but there was still this smaller pimple there (not so red but still there) and so I squeezed it and a little more clear fluid came out. And now it is red again -not as raised as it was but now bigger again. I am now thinking that the moles I had off were melanoma and that this is actually a metastasis. I have also found a little lump in the skin on the top of the same arm too but it's not visible for a photo.
I am not sure if I can attach a picture as I cannot see an attach button?
I am going out of my mind. Why hasn't this pimple thing gone away by now. If it did have a tiny foreign body in originally - how long for it to heal?
Now I have been on the internet and have found images of distant skin metastases and these have got me real worried. You see - for just over two weeks or so I have had a red pimple like bump on the inside of my wrist. It came up out of nowhere one day and when I squeezed it, it oozed clear fluid. It was I guess about 2mm and very raised. I didn't take much notice when it first appeared and did not mention it to the dermatologist who checked my moles as I thought it was nothing, I handle hay a lot (I have horses) and sometimes I get bits of prickles and stuff in my fingers and I guessed maybe there was a sliver of a foreign body in there that I could not feel and it would work its way out.
Now I thought that after 2 weeks it would be completely gone - it did go down a lot and looked like it was going but there was still this smaller pimple there (not so red but still there) and so I squeezed it and a little more clear fluid came out. And now it is red again -not as raised as it was but now bigger again. I am now thinking that the moles I had off were melanoma and that this is actually a metastasis. I have also found a little lump in the skin on the top of the same arm too but it's not visible for a photo.
I am not sure if I can attach a picture as I cannot see an attach button?
I am going out of my mind. Why hasn't this pimple thing gone away by now. If it did have a tiny foreign body in originally - how long for it to heal?
Brief Answer:
This is not metastasis
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have also reviewed the Image.
No. This is not a metastasis. First of all, the most common site of metastasis in case of a melanoma is 'lymph node' rather than skin.
Secondly, the skin lesion in question is on wrist whereas the moles which were removed were on chest, and one each on upper arm, respectively. Therefore this lesion isn't even located along the anatomical drainage path of lymphatics to regional lymph nodes i.e axillary lymph nodes in this case. This lesion is distant or opposite from the direction in which lymphatics drain.
Yes, this could be a foreign body granuloma. I suggest you to apply a topical moderately potent steroid e.g triamcinolone acetonide 0.1% cream or mometasone furoate 0.1% cream. Avoid squeezing this bump.
Regards
This is not metastasis
Detailed Answer:
Hello. Thank you for writing to us
I have gone through your query and I have also reviewed the Image.
No. This is not a metastasis. First of all, the most common site of metastasis in case of a melanoma is 'lymph node' rather than skin.
Secondly, the skin lesion in question is on wrist whereas the moles which were removed were on chest, and one each on upper arm, respectively. Therefore this lesion isn't even located along the anatomical drainage path of lymphatics to regional lymph nodes i.e axillary lymph nodes in this case. This lesion is distant or opposite from the direction in which lymphatics drain.
Yes, this could be a foreign body granuloma. I suggest you to apply a topical moderately potent steroid e.g triamcinolone acetonide 0.1% cream or mometasone furoate 0.1% cream. Avoid squeezing this bump.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Dr Kakkar ... thank you for your thorough and obviously knowledgeable answer. I have left the lesion on my wrist alone and it is going away - thank goodness - so you are right!!
You mention lymph nodes and yes, I am also worried about lymph nodes as I do have a palpable lymph node in each armpit when you dig in there and I know that melanomas can spread there! There is one in pretty much the same place each side.... quite small and XXXXXXX Just a couple of week or so before all this mole issue - I had a mammogram and also an ultrasound of the lymph nodes in the axilla. It said the lymph nodes looked normal ... I just wish they were not palpable!! I am pretty skinny though.
Questions - Is it normal in some (maybe skinny) people to be able to feel a small lymph node in same place each armpit? Also - does diameter of a melanoma often indicate likely depth... ie as my biggest mole was about 5mm and flat - if it is a melanoma is it likely to be an early one. I realise you cannot say for sure!
It is hell waiting for the biopsy results... no sign of them yet either!
You mention lymph nodes and yes, I am also worried about lymph nodes as I do have a palpable lymph node in each armpit when you dig in there and I know that melanomas can spread there! There is one in pretty much the same place each side.... quite small and XXXXXXX Just a couple of week or so before all this mole issue - I had a mammogram and also an ultrasound of the lymph nodes in the axilla. It said the lymph nodes looked normal ... I just wish they were not palpable!! I am pretty skinny though.
Questions - Is it normal in some (maybe skinny) people to be able to feel a small lymph node in same place each armpit? Also - does diameter of a melanoma often indicate likely depth... ie as my biggest mole was about 5mm and flat - if it is a melanoma is it likely to be an early one. I realise you cannot say for sure!
It is hell waiting for the biopsy results... no sign of them yet either!
Brief Answer:
A skin biopsy would direct future course of action
Detailed Answer:
Hi.
Obviously a lymph node would be more easily palpable in a thin individual as compared to others and in case of an axillary lymph node a size of lymph node either less than Or equal to 1 cm is actually taken as normal. Having said that, not all lymph node enlargements above 1 cm are only due to malignancy! They may be reactive.
A skin biopsy would be very valuable in your case. You should wait for it. It would not only clarify whether any of the moles that were removed were indeed a melanoma but it would also tell the depth of melanoma (whether in situ or deeper) and only then your doctor would be conerned about lymph node, not before that. Therefore you should first wait for the biopsy report.
Even in case of a histopathologically proven melanoma, enlarged lymph node needs to be sampled to know whether they are actually due to malignant involvement or only reactive (a sentinel lymph node biopsy).
Having said that, it is also true that a melanoma may involve lymph nodes even without obvious enlargement (involvement is detected only histopathologically).
Therefore, once the diagnosis of melanoma is established on skin biopsy and based on whether it is in situ (confined to epidermis) or deeper (involvement beyond epidermis), your doctor would then contemplate doing a sentinel lymph node biopsy from regional lymph nodes, to know the extent of spread. A sentinel lymph node is usually the closest lymph node that drains the site of melanoma and is therefore likely to be the earliest to be involved. Only if sentinel lymph node biopsy is positive for a melanoma then your doctor would remove the entire lymph draining area in that region.
A mole that is <5 mm is less likely to be a melanoma though that is not a rule.
Depth of a melanoma is measured on histopathology/ biopsy and cannot be meausred clinically. It is not possible to know for sure whether a melanoma would be superficial or deep, just by palpating it or looking at its size, unless it has an obvious nodular component e.g a superficial spreading melanoma has long a horizontal growth phase and before it progresses to a vertical growth phase and therefore even though a superficial spreading melanoma is big in size (> 5 mm) it may still be confined to epidermis and therefore has a good prognosis.
Regards
A skin biopsy would direct future course of action
Detailed Answer:
Hi.
Obviously a lymph node would be more easily palpable in a thin individual as compared to others and in case of an axillary lymph node a size of lymph node either less than Or equal to 1 cm is actually taken as normal. Having said that, not all lymph node enlargements above 1 cm are only due to malignancy! They may be reactive.
A skin biopsy would be very valuable in your case. You should wait for it. It would not only clarify whether any of the moles that were removed were indeed a melanoma but it would also tell the depth of melanoma (whether in situ or deeper) and only then your doctor would be conerned about lymph node, not before that. Therefore you should first wait for the biopsy report.
Even in case of a histopathologically proven melanoma, enlarged lymph node needs to be sampled to know whether they are actually due to malignant involvement or only reactive (a sentinel lymph node biopsy).
Having said that, it is also true that a melanoma may involve lymph nodes even without obvious enlargement (involvement is detected only histopathologically).
Therefore, once the diagnosis of melanoma is established on skin biopsy and based on whether it is in situ (confined to epidermis) or deeper (involvement beyond epidermis), your doctor would then contemplate doing a sentinel lymph node biopsy from regional lymph nodes, to know the extent of spread. A sentinel lymph node is usually the closest lymph node that drains the site of melanoma and is therefore likely to be the earliest to be involved. Only if sentinel lymph node biopsy is positive for a melanoma then your doctor would remove the entire lymph draining area in that region.
A mole that is <5 mm is less likely to be a melanoma though that is not a rule.
Depth of a melanoma is measured on histopathology/ biopsy and cannot be meausred clinically. It is not possible to know for sure whether a melanoma would be superficial or deep, just by palpating it or looking at its size, unless it has an obvious nodular component e.g a superficial spreading melanoma has long a horizontal growth phase and before it progresses to a vertical growth phase and therefore even though a superficial spreading melanoma is big in size (> 5 mm) it may still be confined to epidermis and therefore has a good prognosis.
Regards
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Above answer was peer-reviewed by :
Dr. Sonia Raina
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