Large Irregular Mole on Scrotum: Should I Be Concerned? - Dermatology

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There is an irregular and large mole on the scrotum?


Hello Doctor: I remember having an issue with scrotal eczema during middle school, but I did not seek treatment at that time.
Later, it became severe enough to discharge a clear and foul-smelling fluid.
During one instance of itching, I accidentally scratched off a thin layer of skin, and that area turned black.
Recently, I came across articles about skin cancer, which made me wonder if it could be skin cancer.
It has been seven years, and I don't recall the original size of the mole or scar, but it has always been black in color and irregular in shape, although it is not raised or discolored.
Currently, when I stretch the skin of the scrotum, the maximum diameter is 0.7 cm (0.5 cm when not stretched).
When I accidentally scratched it off years ago, it was still indented, but now it is almost unnoticeable.
It does not hurt or itch.
Should I visit a small clinic for an examination, or go to a larger hospital? The scrotum feels very thin; will it require stitches if a biopsy is needed? Thank you!

Zhong Xiansheng, 20~29 year old female. Ask Date: 2017/06/06

Dr. Wu Yuxin reply Dermatology


You may need to undergo a biopsy at the urology department of the hospital.

Reply Date: 2017/06/06

More Info


When it comes to skin lesions, particularly those that have changed in appearance or have been present for an extended period, it is essential to approach the situation with caution. In your case, the large irregular mole on your scrotum, especially given its history of eczema and the trauma you described, warrants a thorough evaluation by a healthcare professional.


Understanding Skin Lesions
Skin lesions can vary widely in their characteristics and implications. Moles, or nevi, are common skin growths that can be benign or malignant. The key factors to consider when assessing a mole for potential malignancy include:
1. Asymmetry: If one half of the mole does not match the other half.

2. Border: Irregular, scalloped, or poorly defined edges.

3. Color: Varied colors (brown, black, tan, red, white, or blue) within the same mole.

4. Diameter: Moles larger than 6mm (about the size of a pencil eraser) are more concerning.

5. Evolving: Any change in size, shape, color, or elevation, or any new symptom such as bleeding, itching, or crusting.

Given that your mole is irregular in shape, has been black for a long time, and has a diameter of approximately 0.7 cm, it is prudent to have it evaluated. The fact that it has not changed in terms of pain or itching is somewhat reassuring, but it does not eliminate the need for further investigation.


Next Steps
1. Consultation: It is advisable to see a dermatologist, who specializes in skin conditions. A larger hospital or dermatology clinic may provide more comprehensive services, including the ability to perform a biopsy if necessary. A biopsy involves removing a small sample of the mole for laboratory analysis to determine if it is benign or malignant.

2. Biopsy: If the dermatologist deems it necessary, they may perform a shave biopsy or excisional biopsy. A shave biopsy removes the top layers of skin, while an excisional biopsy removes the entire mole along with some surrounding tissue. Given the thin skin of the scrotum, there is a possibility of needing stitches, but this will depend on the method used and the size of the lesion removed.

3. Follow-Up: Depending on the biopsy results, further treatment may be required. If the lesion is benign, monitoring may be sufficient. If it is malignant, additional treatment options, such as surgery, radiation, or chemotherapy, may be discussed.


Conclusion
In summary, while your mole may not currently exhibit alarming symptoms, its irregularity and history necessitate a professional evaluation. It is always better to err on the side of caution when it comes to potential skin cancers. Early detection and treatment are crucial for the best outcomes. Therefore, I recommend scheduling an appointment with a dermatologist as soon as possible to address your concerns and ensure appropriate management of the lesion.

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