the Risks of Benign Moles Transforming into Melanoma

Questions about the transformation of benign moles?

Dear Dr.
Wu,
I would like to consult you regarding my questions about "benign mole transformation." Currently, many online articles and some physicians suggest that benign moles located in certain areas (such as the hands, feet, and other distal parts) have a higher likelihood of transforming into malignant melanoma due to external stimuli (for example, moles located in areas prone to friction).
Therefore, they advocate for preventive removal of moles in these locations if any changes occur, or even if no changes are observed, to avoid malignant transformation.
On the other hand, some physicians state that malignant melanoma is mostly spontaneous and rarely arises from pre-existing benign moles, suggesting that benign moles, regardless of their location (such as the hands, feet, etc.), are unlikely to transform into malignant melanoma due to external stimuli (like frequent friction).
I have noticed moles in my armpits, soles of my feet, and intimate areas, which are indeed the aforementioned friction-prone areas.
Since I cannot confirm the correct information, I would like to consult you on the following:
1.
Regarding the two statements above: (1) The likelihood of benign moles transforming into malignant melanoma due to external stimuli (such as frequent friction) is higher.
(2) Malignant melanoma is mostly spontaneous, so benign moles, even if frequently subjected to external stimuli (like friction), are unlikely to transform into malignant melanoma.
Which of these statements is correct?
2.
For the moles in the aforementioned friction-prone areas (armpits, soles of feet, and intimate areas), which have not shown any significant changes in recent years, what would be the best course of action? Should I consider preventive removal or is regular observation sufficient?
Thank you, Dr.
Wu.

Axiang, 30~39 year old female. Ask Date: 2019/07/11

Dr. Wu Yuxin reply Dermatology

1.
Both situations are possible, so both are correct.
In medicine, nothing is absolute; each case must be discussed and observed individually.
2.
I recommend monitoring, unless there are significant changes.

Reply Date: 2019/07/11

More Info

Understanding the risks associated with benign moles transforming into melanoma is a significant concern for many individuals, especially those with moles in areas prone to friction or irritation. Let’s break down the two perspectives you mentioned regarding the transformation of benign moles into melanoma.

1. The Risk of Transformation Due to External Stimuli: Some medical professionals suggest that benign moles located in areas subject to frequent friction or irritation (like the hands, feet, or underarms) may have a higher risk of transforming into melanoma. The rationale behind this viewpoint is that constant irritation could potentially lead to cellular changes in the mole, increasing the likelihood of malignant transformation. However, while this theory exists, it is essential to note that the actual incidence of benign moles turning into melanoma due to external stimuli is not well-established in scientific literature.
2. Spontaneous Development of Melanoma: The opposing viewpoint emphasizes that most melanomas arise spontaneously rather than from existing benign moles. This perspective is supported by numerous studies indicating that the majority of melanomas develop de novo (from normal skin) rather than from pre-existing moles. Thus, while external factors may influence skin health, they are not definitively linked to the transformation of benign moles into melanoma.

Given these two perspectives, it is crucial to consider the following:
- Regular Monitoring: Regardless of the location of your moles, it is advisable to monitor them regularly for any changes in size, shape, color, or texture. The ABCDE rule (Asymmetry, Border irregularity, Color variation, Diameter greater than 6mm, and Evolving) is a helpful guideline for self-examination.

- Consultation with a Dermatologist: If you have moles in areas prone to friction, such as your underarms, soles of your feet, or intimate areas, it is wise to consult a dermatologist. They can assess your moles and determine if any preventive measures, such as removal, are necessary.
- Preventive Removal: If a mole is in a location where it is frequently irritated and shows any signs of change, or if you have a family history of melanoma, a dermatologist may recommend preventive removal. This is particularly relevant if the mole has atypical features or if you have multiple dysplastic nevi (atypical moles).

- Regular Skin Checks: For individuals with a history of skin cancer or those with numerous moles, regular skin checks by a healthcare professional are recommended. This proactive approach can help catch any potential issues early.

In conclusion, while there are differing opinions on the risk of benign moles transforming into melanoma due to external stimuli, the consensus is that regular monitoring and professional evaluation are key. If your moles have not changed over the years, maintaining a routine of observation and consultation with a dermatologist is advisable. They can provide personalized recommendations based on your skin type, mole characteristics, and overall risk factors. Remember, early detection is crucial in managing skin health effectively.

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