What Do Scars With A Dent In It Indicate After Mole Removal Surgery?

Posted on Fri, 13 Oct 2017

Question: I have a question about a mole (or really a mole removal). I had a mole removed back in May that came back as moderately atypical. They excised it and sent it back to pathology and the pathologist decided it was severely atypical and they re-excised it again. A second pathologist looked at it and decided that it was probably not really that atypical, but it was instead a regenerating mole that made the atypia worse. Nevertheless, it was removed a second time. The scar was a little rough as I essentially had two excisions in the same spot. The second excision was about seven weeks ago. The scar was very sore for about a month and is now only mildly sore to the touch. A few weeks ago I noticed that the scar appeared to have a hole (or a dent in it). Inside the dent was a white growth that looked like the head of a pimple. It looked like hardened puss. The white growth was "in the hole" for a week or so but then grew out and looked like a scab (but a whitish-yellow one). Then last night it fell off, but the texture was really strange. The best I can describe it is that it was like string. Is this normal? To have a scab like string?

Answered by Dr. Dr. Kakkar (58 minutes later)

Brief Answer:
Dried slough

Detailed Answer:
Hello. Thank you for writing to us.

I m Dr. Kakkar(Dermatologist). I have reviewed the image

Perhaps there was some bacterial superinfection of the stitch line which looked like pus and subsequently, it dried up and the thing that fell off was just dried slough.

I'd suggest you use a topical antibacterial ointment e.g Neosporin ointment at the stitch line.

Let me know if I can assist you further.

Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr. Kakkar (1 hour later)

Thank you. I have two questions....
Given that it was a bad mole, should I be worried about this being a cancerous growth at all? I assume cancerous growths don't dry up and fall off? It felt different than a normal scab though - like thicker and more dimensional.

My second question is should I be worried about the scar having a hole? My stitches were not all that close together and there was an opening in the wound during healing. Thanks!

Answered by Dr. Dr. Kakkar (4 hours later)

Brief Answer:
Regarding the mole excision scar

Detailed Answer:
hi.

I think they would have checked the excision margins and made sure that it was free of cancer cells.
If the wound edges are not approximated close together or if there is gaping due to bacterial superinfection/ pus formation causing wound dehiscence then the wound edges would subsequently heal with secondary intention and it takes longer to heal. Perhaps this happened in your case.
There is also a possibility that some part of
suture was left over and it later came out as a stringy thing and that hole is a tissue that organised around that suture.

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Kakkar (39 minutes later)

Thank you - they did check the margins and they were clear. What I pulled out looked very much like a thread - the stitches I had were black. Is it possible for them to turn white over time? They were not dissolvable - I had them removed but I could see it being missed.

Answered by Dr. Dr. Kakkar (7 hours later)

Brief Answer:
Regarding mole excision scar

Detailed Answer:
hi

Not sure whether the suture can change color if left inside for a long time. Ideally it should not change its color but I just thought that it is a possibility that the string like thing was a left over suture. You may enquire about this from your doctor or the pharma company that manufactures sutures.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (8 hours later)

Well does a scab or pus every have a string like texture? Or a texture that you can easily pull apart?

Answered by Dr. Dr. Kakkar (7 hours later)

Brief Answer:
Regarding mole excision scar

Detailed Answer:
hi.

A scab as thin as a string should not be as strong as a string..it should be friable. Since it came from deep within the hole and had some length to it then perhaps it was either a left over suture or a scab that formed inside the tiny tunnel due to epithelialization of suture tracks.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (11 hours later)

Oh it wasn't strong like a string - it came apart very easy in my hand. It just had a texture like a string. But it was crumbly.

Answered by Dr. Dr. Kakkar (21 minutes later)

Brief Answer:
Regarding mole excision scar

Detailed Answer:
Ok. Thank you.

So that means it was just a scab - dried up pus and secretions.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar