the Risks and Treatments for Raised Moles in the Armpit

(Continuation of the question) #172059 Raised mole in the armpit?

Dear Dr.
Wu,
Thank you very much for your personal response and suggestions regarding the article "#172059 Axillary Raised Nevus." I have greatly benefited from your insights.
I still have a few questions, which are as follows:
1.
Regarding the removal of the 0.2 cm raised nevus in the axilla, you suggested that surgical excision, electrosurgery, or laser removal would be preferable.
However, "cryotherapy" was not included in your recommendations.
Could you please explain why cryotherapy is not considered a viable option for the removal of the nevus?
2.
Concerning the raised nevus in the axilla, which is located in an area subject to frequent friction, you mentioned that cases of "malignant transformation" are "not common." I have the following questions:
(1) Is there a specific probability or statistical figure associated with the statement "not common"? Does this imply that the risk is extremely low?
(2) For this type of raised nevus (which is likely an intradermal nevus or compound nevus), even if it is located in an area of frequent friction like the axilla, is it still true that the likelihood of "malignant transformation" due to constant friction is almost negligible?
I appreciate your clarification on these matters.
Thank you, Doctor.

Axiang, 30~39 year old female. Ask Date: 2021/08/13

Dr. Wu Yuxin reply Dermatology

1.
Moles typically develop from the dermis.
If cryotherapy aims to reach the dermis, multiple treatments are required, and it can easily damage excessive tissue, which is a less preferred option for me, although it is not impossible to perform.
2.
There are no specific numbers, just clinical experience.

Reply Date: 2021/08/13

More Info

When it comes to raised moles, particularly those located in areas like the armpit, there are several important considerations regarding their removal and the associated risks. Raised moles, or nevi, can vary in type, and their management often depends on factors such as size, appearance, and location.

1. Removal Methods: You mentioned that Dr. Wu recommended surgical excision, electrosurgery, or laser removal for a 0.2 cm raised mole, while cryotherapy (freezing treatment) was not included in the options. The reason for this could be that cryotherapy is typically more effective for superficial lesions and may not provide the precision needed for deeper or more complex moles. Surgical excision allows for complete removal and histological examination, which is crucial if there are any concerns about malignancy. Electrosurgery and laser treatments can also be effective but may not always allow for the same level of tissue analysis.

2. Risk of Malignancy: Regarding the concern about raised moles in friction-prone areas like the armpit, Dr. Wu indicated that the occurrence of malignant transformation is rare. While specific statistics can vary, it is generally understood that the risk of a benign mole becoming malignant due to friction is low. The phrase "not commonly undergo malignant transformation" suggests that while it is possible, it is not a frequent occurrence.
To provide some context, studies have shown that most benign moles remain stable over time. However, any changes in size, shape, color, or texture should prompt further evaluation by a dermatologist. The risk of malignancy is often assessed based on the mole's characteristics rather than its location alone.
3. Friction and Mole Changes: Even though the mole is located in a friction-prone area, it does not necessarily mean that it will undergo malignant transformation. The body has mechanisms to repair minor skin injuries, and while chronic irritation can lead to changes in the skin, it does not directly correlate with an increased risk of cancer in benign moles. However, it is always advisable to monitor any changes in moles, especially if they are subjected to consistent friction.

4. Follow-Up and Monitoring: If you decide to proceed with the removal of the mole, it is essential to have a follow-up plan in place. This may include regular skin checks to monitor for any new moles or changes in existing ones. Dermatologists often recommend self-examinations and professional evaluations annually, especially for individuals with a history of skin lesions.

In summary, while raised moles in areas prone to friction are typically benign and have a low risk of malignancy, it is crucial to approach their management thoughtfully. Surgical excision remains the gold standard for definitive diagnosis and treatment. If you have further concerns or specific questions about your mole, consulting with a dermatologist who specializes in skin lesions would be beneficial. They can provide personalized advice based on your medical history and the characteristics of the mole in question.

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