Should I Remove My Other Mole? Insights from a Dermatology Case

Medical Report

Hello Doctor,
I have developed two moles on the edge of my foot (each less than 0.1 cm), which I discovered at the same time.
Due to changes in size and irregular edges, I underwent excision surgery at the hospital.
The outpatient physician indicated that the health insurance covers the removal of only one mole at a time, so we chose to operate on the larger one.
When reviewing the report, the doctor mentioned that the examination results were normal.
After returning home, I checked the medical report on the health app, which states:
"Microscopic examination of the biopsy shows skin tissue with small nests of nevus cells at the dermal-epidermal junction.
There is a small amount of melanin pigment present.
Focal mild cellular atypia is noted within the nevus cells.
No evidence of malignancy was found.
The margins of the excised tissue are free of atypical cells."
I would like to ask if the other mole also needs to be excised.
I appreciate your time and assistance.
Thank you!

zh, 40~49 year old female. Ask Date: 2020/02/20

Dr. Wu Yuxin reply Dermatology

These are two different matters.
Whether or not surgical removal is necessary should be evaluated separately.
Clinical changes in appearance need to be assessed in person to determine the situation.
It's advisable to discuss this with your physician.

Reply Date: 2020/02/20

More Info

When it comes to moles, or nevi, it’s essential to monitor any changes in size, shape, color, or texture. Your situation raises a few important points regarding the management of moles, particularly in light of your recent experience with the larger mole that was removed and examined.

Based on the pathology report you received, it appears that the mole that was excised showed some mild cellular atypia but no evidence of malignancy. This is a reassuring finding, as it suggests that the mole was not cancerous. However, the presence of mild atypia indicates that there may be some abnormal cells present, which can sometimes warrant closer observation or further action.

Now, regarding the second mole that you mentioned, there are several factors to consider before deciding whether to proceed with its removal:
1. Size and Characteristics: You noted that the second mole is smaller than 0.1 cm, which is relatively small. However, the characteristics of the mole are crucial. If it has irregular borders, changes in color, or any other atypical features, it may be prudent to have it evaluated further.

2. Changes Over Time: If you have noticed any changes in the second mole since its discovery, such as growth, color change, or bleeding, these are significant indicators that it should be assessed by a dermatologist. Regular monitoring is key, especially if you have a history of atypical moles.

3. Family History and Skin Type: If you have a family history of skin cancer or if you have fair skin that burns easily, you may be at a higher risk for developing skin cancers, including melanoma. In such cases, proactive management of moles is often recommended.

4. Dermatologist’s Recommendation: Since the dermatologist has already evaluated one of your moles, it would be wise to consult them regarding the second mole. They can provide a professional opinion based on their expertise and your medical history. If they feel that the second mole warrants removal for any reason, they will guide you through the process.

5. Follow-Up Care: If the second mole is left in place, ensure that you have a follow-up plan. Regular self-examinations of your skin can help you catch any changes early. If you notice any changes, contact your dermatologist promptly.

In conclusion, while the second mole may not need immediate removal, it is essential to keep an eye on it and consult with your dermatologist for a thorough evaluation. They can provide personalized advice based on your specific circumstances and help you make an informed decision. Remember, early detection and management are crucial in preventing potential skin issues, including skin cancer.

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