Moles and Melanoma: When to Seek Dermatological Advice - Internal Medicine

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Dear Patient,
Thank you for your thoughtful questions regarding moles and melanoma, especially considering your family history of melanoma. It’s essential to be vigilant about skin changes, particularly when there is a genetic predisposition to skin cancers.
Moles, or nevi, are common skin growths that can vary in size, shape, and color. While most moles are benign, certain characteristics can indicate a higher risk of melanoma, a serious form of skin cancer. The ABCDE rule is a helpful guideline for assessing moles:
- Asymmetry: If you draw a line through the mole, and the two halves do not match, it may be a cause for concern.

- Border: Irregular, scalloped, or poorly defined edges can be a warning sign.

- Color: A variety of colors (brown, black, tan, red, white, or blue) within the same mole can indicate malignancy.

- Diameter: Moles larger than 6mm (about the size of a pencil eraser) should be evaluated by a dermatologist.

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

Given that you have noticed a mole on your scrotum that seems larger but is not painful or itchy, it is still prudent to have it evaluated by a dermatologist. The fact that it is growing is significant, and while it may not be causing discomfort, changes in size can be a red flag. A dermatologist can perform a thorough examination and may recommend a biopsy if they suspect it could be malignant.
Regarding your question about laser removal, it’s important to note that laser treatments are typically used for cosmetic purposes and may not be appropriate for moles that require pathological examination. If the mole is suspicious, surgical excision is often the preferred method, as it allows for complete removal and histological analysis to determine if it is benign or malignant.

As for your concern about experiencing approximately 500-600 ventricular premature contractions (VPCs) per day, it’s essential to consider the context of your overall health. VPCs are common and can occur in healthy individuals without any underlying heart disease. However, if you are experiencing symptoms such as palpitations, dizziness, or chest pain, or if you have a history of heart disease, it would be wise to consult a cardiologist. They may recommend further evaluation, such as an electrocardiogram (ECG) or Holter monitor, to assess the frequency and nature of these contractions.

In summary, I strongly recommend scheduling an appointment with a dermatologist to evaluate the mole on your scrotum, especially given your family history of melanoma. Additionally, if you have concerns about your heart health related to the VPCs, a consultation with a cardiologist would be beneficial.
Thank you for reaching out, and I wish you the best of health. Please do not hesitate to seek medical advice when in doubt about your health concerns.

Best regards.