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I recently had a 8mm mole removed by a PA who thought it

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looked suspicious. She performed a...
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: 1 year ago.Category: Dermatology
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Answered in 2 minutes by:
4/24/2016
Dermatologist: Dr. D. Love, Doctor replied 1 year ago
Dr. D. Love
Dr. D. Love, Doctor
Category: Dermatology
Satisfied Customers: 18,904
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Verified

Hello from JustAnswer.

I am sorry, but no picture was attached.

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Customer reply replied 1 year ago
Are you a derm or family physician
Customer reply replied 1 year ago
I would like a dermatologist
Dermatologist: Dr. D. Love, Doctor replied 1 year ago

I am a Family Physician.

I will opt out.

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Customer reply replied 1 year ago
Thank you
Dermatologist: Dr. D. Love, Doctor replied 1 year ago

You are welcome.

But when a Dermatologist will be available, there still is no picture attached.

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Customer reply replied 1 year ago
I will be happy to attach when/if I get response
Dermatologist: Dr. D. Love, Doctor replied 1 year ago

OK

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Dermatologist: DrRussMd, Internist/homeopath replied 1 year ago
DrRussMd
DrRussMd, Internist/homeopath
Category: Dermatology
Satisfied Customers: 65,549
Experience: Internal medicine doctor/homeopathy medical and homeopathic approaches to skin disorders.
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Hello

I 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.

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Customer reply replied 1 year ago
Prefer to wait for dermatologist, thank you
Dermatologist: Dr. David, Board Certified Physician replied 1 year ago
Dr. David
Dr. David, Board Certified Physician
Category: Dermatology
Satisfied Customers: 47,205
Experience: Experienced Physician trained in New York City. I'm ready to help.
Verified

This is Dr. David

I 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 it

then select the "chain" icon above the textbox or the paper clip icon to upload a jpg

this 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 JustAnswer

http://ww2.justanswer.com/help/how-do-i-send-photo-or-file-expert-0

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Customer reply replied 1 year ago
I have added a picture. This was biopsied by shave teqnique by my PA. How suggestive is this of Melanoma?
Dermatologist: Dr. David, Board Certified Physician replied 1 year 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 moles

do you have any other higher resolution images ?

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Customer reply replied 1 year ago
That was the only one on my visit info file
Dermatologist: Dr. David, Board Certified Physician replied 1 year 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?

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Customer reply replied 1 year 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 reply replied 1 year 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.
Dermatologist: Dr. David, Board Certified Physician replied 1 year ago

nevi is a benign looking mole

from 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 mole

I would bet on not malignant and benign nevus at this point.

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Dermatologist: Dr. David, Board Certified Physician replied 1 year 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 today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

here 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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Customer reply replied 1 year 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
Dermatologist: Dr. David, Board Certified Physician replied 1 year ago

I think your dermatologist had a low suspicion that the mole or nevus was a melanoma

that is why a shave biopsy was done

and 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.

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Customer reply replied 1 year 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 reply replied 1 year ago
Sorry, I have pretty severe health anxiety and this wait is killing me 😢
Dermatologist: Dr. David, Board Certified Physician replied 1 year 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 workup

it does sound like you have a lot of bad anxiety

I am sorry you are having to wait

but that mole was cut out

try 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 today

we only get credit for helping clients after positive feedback

you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

here 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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