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Dr. David
Dr. David, Board Certified Physician
Category: Dermatology
Satisfied Customers: 42844
Experience:  Experienced Physician trained in New York City. I'm ready to help.
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I recently had a 8mm mole removed by a PA who thought it looked

Customer Question

I recently had a 8mm mole removed by a PA who thought it looked suspicious. She performed a shaved biopsy due to size and "ugly duckling" rule. She also believed it was growing. Her Ddx on report stated displaystic nevi vs benign. Wondering how strongly Melanoma is suggested. Picture attached
Submitted: 7 months ago.
Category: Dermatology
Expert:  Dr. D. Love replied 7 months ago.
Hello from JustAnswer.I am sorry, but no picture was attached.
Customer: replied 7 months ago.
Are you a derm or family physician
Customer: replied 7 months ago.
I would like a dermatologist
Expert:  Dr. D. Love replied 7 months ago.
I am a Family Physician. I will opt out.
Customer: replied 7 months ago.
Thank you
Expert:  Dr. D. Love replied 7 months ago.
You are welcome. But when a Dermatologist will be available, there still is no picture attached.
Customer: replied 7 months ago.
I will be happy to attach when/if I get response
Expert:  Dr. D. Love replied 7 months ago.
OK
Expert:  DrThomasMd replied 7 months ago.
HelloI am a double board certified US doctor, in internal medicine and integrative medicine, with advanced training in functional dermatology.Board certified internists must test and train in dermatology as well, and we probably diagnose as many malignant moles as any doctor out there.No one in the derm category has taken the question.If you would like, I can look at your picture.I have done this for over 20 years.
Customer: replied 7 months ago.
Prefer to wait for dermatologist, thank you
Expert:  Dr. David replied 7 months ago.
This is Dr. DavidI am a cancer doctor who treats patients who have melanoma.I don't think there are any dermatologist online here yet.I don't see that you have uploaded the photo yet of your skin lesion. here are instructions.type a word in the textbox and highlight itthen select the "chain" icon above the textbox or the paper clip icon to upload a jpgthis opens a window where you can click next to the text box to select the jpg or pdf file on your computer to upload into JustAnswerhttp://ww2.justanswer.com/help/how-do-i-send-photo-or-file-expert-0
Customer: replied 7 months ago.
I have added a picture. This was biopsied by shave teqnique by my PA. How suggestive is this of Melanoma?
Expert:  Dr. David replied 7 months ago.
the photo is very small and not very high resolution.usually dermatologist and cancer doctors use much higher resolution photos and magnification to have the best look at skin molesdo you have any other higher resolution images ?
Customer: replied 7 months ago.
That was the only one on my visit info file
Expert:  Dr. David replied 7 months ago.
well, that image is not enough to make any sort of meaningful conclusion.it is a tiny photo that is not high resolution.I would bet that your shave biopsy will not show melanoma.most moles are shown to be benign.only a very small percentage of moles excised show any evidence of melanoma.when do you go back to your doctor to get your pathology results from this shave biopsy?
Customer: replied 7 months ago.
They said it could take about 10-14 days. I'm very worried because I have had this mole since 2009 about, and she said under the scope it seems to be growing. Already at 8mm. Scared it could be advance stages. I also read shave biopsy is not a great option for suspected melanoma.
Customer: replied 7 months ago.
She also noted on the report ddx: dysplastic nevi vs benign nevi. Not sure what that means. Wish I would have asked her more questions, the appointment was very quick.
Expert:  Dr. David replied 7 months ago.
nevi is a benign looking molefrom the naked eye, they can tell what type of cells are there. that is why your doctor said she didn't know if there were dysplastic cells or not in the nevus. dysplasic cells are just bizzar or odd or malformed looking cells.that is why a biopsy is needed.if there is melanoma cells in mole, you will need another surgery for a wider excision of the area to make sure all the bad cells are cut out with a wide excision of the skin by a surgeon.I know you are worried and are trying to get an answer before the biopsy results are back.try your best not to worry.it sounds like you are under the care of good doctors.the shave biopsy is fine for initial biopsy and sampling of the moleI would bet on not malignant and benign nevus at this point.
Expert:  Dr. David replied 7 months ago.
let me know if you have other questions.if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you todaywe only get credit for helping clients after positive feedbackyou can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questionshere is my website if you need to reach me:http://www.justanswer.com/medical/expert-dr-david/Thanks for using JustAnswers.com
Customer: replied 7 months ago.
One last thing. I have read numerous reports that shave biopsy for suspected Melanoma is not great because it can effect the staging process if it is indeed Melanoma. Just find it disconcerting a punch biopsy wasn't used, especially if she felt Melanoma a strong possibility
Expert:  Dr. David replied 7 months ago.
I think your dermatologist had a low suspicion that the mole or nevus was a melanomathat is why a shave biopsy was doneand so the whole benign mole would be cut out with the shave biopsy. the mole would not be cut out completely with a punch biopsy.
Customer: replied 7 months ago.
If it does turn out to be Melanoma, do you have to wait for the WLE for staging or would the original biopsy tell you?
Customer: replied 7 months ago.
Sorry, I have pretty severe health anxiety and this wait is killing me 😢
Expert:  Dr. David replied 7 months ago.
if it turns out to be melanoma, then the shaved biopsy will give a lot of information to help with staging.but you will still need a while local exicision and also sentinel lymph node dissection and systemic PET/CT scan imaging to complete your staging workupit does sound like you have a lot of bad anxietyI am sorry you are having to waitbut that mole was cut outtry not to worry.let me know if you have other questions.if done for now, please leave positive rating of 3-5 stars so I can get credit for helping you todaywe only get credit for helping clients after positive feedbackyou can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questionshere is my website if you need to reach me:http://www.justanswer.com/medical/expert-dr-david/Thanks for using JustAnswers.com

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