What Do Pigmented Lesions On The Back Indicate?

Question: Hi Doctor!

About seventeen years ago, my primary care doctor removed about six pigmented lesions from my back using electrodessication and currettage. He said the lesions were all normal on visual inspection, and I had actually visited a dermatologist about a year prior, who expressed no concern with them. I had the lesions before removal for about sixteen years with none of them changing, all were light to medium brown, symmetrical, uniform in color, and none bigger than a pencil eraser. All that is left now, seventeen years later, are flat white hypopogmented areas where the lesions were removed. I go for yearly skin exams and my doctor has said that everything on my back looks fine.

My concern is that my doctor never had biopsies performed on the lesions removed. Is it safe to say that, after seventeen years now, if they had been anything dangerous, changes would have been apparent on the skin by now in the locations, such as pigment changes, etc. and that there would have been metastases to different parts of my body by now?

Thank you for any reassurances you can provide!

Hello Dr. Sera! Thank you so much for your kind and reassuring reply!

As a follow up, my dermatologist just removed three pigmented lesions last week by shave biopsy; one came back as mild dysplastic neuvus and the other two came back as mild to moderate dysplastic nevi. Now I'm concerned as i read that having dysplastic nevi puts you at greater risk of melanoma. I go for yearly skin exams with a dermatologist and am vigilant about checking my skin. Is there a great deal for me to be concerned about? I had two other moles removed last year and biopsies showed both were normal. The only other larger moles which I had (in addition to the above five) were about six others on my back, which my primary care doctor removed by electrodessication and curettage 17 years ago (no biopsies were done), the ones I had asked you about already. Those were the total of the eleven larger moles I had since I was 17 years old (I'm 50 now); any other pigmented lesions I have are smaller moles and or freckles. I just had a skin exam completed and everything was fine. Unfortunately I turned to google and ran across FAMMM, which I understand is a family genetic predisposition to melanoma, and now I am very concerned about that. My father died 11 years ago from cardiac arrest, but I remember seeing that he had a lot of strange looking pigmented lesions on his back, one on his arm and one on his leg; of course he never went to a dermatologist to be checked, and I'm hoping that perhaps they were just seborrheic keratosis, as they seemed to have that stuck in appearance. Also, I remember seeing them in him for a period of about twenty years, so I presume if it was melanoma he certainly wouldn't have lasted that long. Do you think I have anything to worry about in relation to that FAMMM? (My googling of medical conditions will kill me from anxiety before anything else!). Thank you!