Skin Spots on Fingers and Soles: Melanoma Risks Explained

Q: Skin Spots on Fingers and Soles: Melanoma Risks Explained

Dear Mr. Wei： 1. Melanoma, also known as malignant melanoma, is more commonly found in Caucasians and individuals with fair skin. The primary causative factor is damage from sunlight (ultraviolet radiation). Other contributing factors for melanoma include dyspl

Skin spots on fingers and soles of the feet?

Hello Doctor, I just saw the news that spots on the fingers and soles of the feet could potentially develop into melanoma.
I have noticed brown spots on my hands and feet (which have been there for several years) that are irregularly shaped and symmetrical.
I would like to ask if there is a possibility that these could be melanoma, or could they be due to mosquito bites that I have scratched, or perhaps benign skin deposits? Here are the links: [hands](https://ppt.cc/fFen8x), [feet (one spot on each foot)](https://ppt.cc/fSMQbx).
Additionally, I would like to know if melanoma always presents as a raised lesion.
I have observed that many of the spots on my body are actually flat, which makes me a bit worried.
Thank you, Doctor.

Wei, 20~29 year old female. Ask Date: 2021/07/24

Dr. Xiao Yongxun reply Family Medicine

Dear Mr.
Wei:
1.
Melanoma, also known as malignant melanoma, is more commonly found in Caucasians and individuals with fair skin.
The primary causative factor is damage from sunlight (ultraviolet radiation).
Other contributing factors for melanoma include dysplastic nevi and certain genetic abnormalities.
2.
Clinical manifestations may include changes in the color of a common mole (typically exhibiting multiple colors), an increase in size, irregular shape, uneven borders, or the presence of necrosis, bleeding, itching, and pain.
3.
The four diagnostic criteria for cutaneous melanoma include asymmetry of the lesion, irregular border, color variegation, and a larger diameter, sometimes accompanied by elevation of the lesion.
4.
Most melanomas contain melanin, and in the early stages, the tumor cells located in the epidermis exhibit radial growth, primarily spreading horizontally.
At this stage, there are few cancer cells invading the dermis, and the tumor does not possess metastatic capabilities.
After some time, the tumor begins to grow vertically into the deeper layers of the skin, at which point the melanoma acquires the ability to metastasize, resulting in a significantly worse prognosis compared to the radial growth phase.
The deeper the tumor invades, the higher the likelihood of metastasis, leading to a poorer prognosis.
5.
Your concerns should first be discussed with your primary care physician before making any decisions; alternatively, you may seek care at a dermatology clinic in a regional hospital or higher, where some necessary examinations may be required.

Reply Date: 2021/07/24

More Info

When it comes to skin spots, particularly those that appear on the fingers and soles, it is essential to understand the potential risks associated with melanoma, a serious form of skin cancer. Melanoma can manifest in various ways, and while not all skin spots are indicative of melanoma, certain characteristics can raise concern.

From your description, you mention having irregularly shaped, symmetrical brown spots on your hands and feet that have been present for several years. The fact that they are asymmetrical and have irregular borders can be a cause for concern. Melanoma typically presents as a mole or spot that changes in size, shape, or color over time. The ABCDE rule is a helpful guideline for assessing moles:
- Asymmetry: One half of the mole does not match the other.

- Border: The edges are irregular, ragged, or blurred.

- Color: The color is not uniform and may include shades of brown, black, tan, red, white, or blue.

- Diameter: The spot is larger than 6mm (about the size of a pencil eraser).

- Evolving: The mole is changing in size, shape, or color.

If your spots exhibit any of these characteristics, it is advisable to consult a dermatologist for a thorough examination. They may recommend a biopsy to determine whether the spots are benign or malignant.

Regarding your question about whether melanoma must be raised or can be flat, it is important to note that melanoma can indeed present as flat spots. While many melanomas are raised, they can also appear as flat, discolored patches on the skin. This is particularly true for lentigo maligna melanoma, which often appears as a flat, tan or brown spot.

You also mentioned the possibility of these spots being the result of mosquito bites or irritation from scratching. While it is possible for post-inflammatory hyperpigmentation to occur after skin trauma, the characteristics you described warrant further investigation. It is crucial not to dismiss any changes in your skin, especially if they persist or evolve over time.

In terms of risk factors for melanoma, several elements can increase your likelihood of developing this condition, including:
1. Skin Type: Individuals with fair skin, light hair, and light eyes are at a higher risk.

2. Sun Exposure: Excessive sun exposure, especially sunburns during childhood, can increase risk.

3. Family History: A family history of melanoma or other skin cancers can elevate your risk.

4. Moles: Having many moles or atypical moles can increase your risk of melanoma.

To summarize, while not all brown spots are indicative of melanoma, it is essential to monitor any changes in your skin closely. Given your description, it would be prudent to schedule an appointment with a dermatologist for a professional evaluation. They can provide a definitive diagnosis and recommend appropriate treatment if necessary. Early detection is key in managing melanoma effectively, so do not hesitate to seek medical advice.

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