Unusual Skin Growths: When to See a Family Doctor or Dermatologist?

Abnormal growths on the skin?

In recent years, I have noticed many small flat moles on my chest and arms, but I didn't pay much attention to them.
However, in the past month, I suddenly discovered raised lesions along my hairline, under my armpits, and on my buttocks.
They are not painful, but the one along my hairline seems to feel more prominent.
When I scratch or squeeze the one under my armpit, it sheds some skin, then breaks open, revealing bright red tissue underneath.
After a few days, it grows back, and occasionally, if I accidentally scratch the one on my buttocks, it also breaks open and becomes a bit red.
I want to see a doctor, but I would like to know if I should make an appointment with a family medicine physician or a dermatologist.
Should a biopsy be performed?

myfamily, 30~39 year old female. Ask Date: 2006/06/15

Dr. Lin Mingxing reply Family Medicine

Dear Dr.
Lin Ming-Hsing of the Family Medicine Department at Tainan Hospital, Executive Yuan Health Department:
As you mentioned, the diagnosis may be flat warts.
It is recommended that you visit a dermatologist for further management.
Tainan Hospital cares about your health.

Reply Date: 2006/06/15

More Info

When it comes to unusual skin growths, it's essential to understand when to seek medical advice and whether to consult a family doctor or a dermatologist. Based on your description of the skin changes you've noticed—specifically, the appearance of flat moles on your chest and arms, as well as protruding growths on your forehead, armpits, and buttocks—it's wise to take these symptoms seriously.

When to See a Doctor
1. Changes in Existing Moles or Growths: If you notice any changes in size, shape, color, or texture of existing moles or skin lesions, it is crucial to consult a healthcare professional. The "ABCDE" rule is a helpful guideline for identifying potentially problematic moles:
- Asymmetry: One half is different from the other.

- Border: Irregular, scalloped, or poorly defined edges.

- Color: Varied colors (brown, black, tan, red, white, or blue).

- Diameter: Larger than 6mm (about the size of a pencil eraser).

- Evolving: Changes in size, shape, or color over time.

2. New Growths: The sudden appearance of new growths, especially if they are protruding and causing discomfort or breaking the skin, warrants a visit to a healthcare provider. This is particularly true if they bleed, ooze, or become painful.

3. Persistent Symptoms: If you experience symptoms such as itching, redness, or irritation around the growths, it’s advisable to seek medical attention. These could indicate an underlying issue that needs to be addressed.

Family Doctor vs. Dermatologist
- Family Doctor: A family doctor can provide a general assessment of your skin condition. They can evaluate your symptoms, perform an initial examination, and determine if a referral to a specialist is necessary. If the growths appear benign and are not causing significant issues, your family doctor may manage the situation.

- Dermatologist: A dermatologist specializes in skin conditions and is better equipped to handle unusual skin growths. They can perform a thorough examination, order necessary tests (such as a biopsy), and provide specialized treatment options. If your family doctor feels that the growths require further investigation, they will likely refer you to a dermatologist.

Diagnostic Procedures
In cases where there is uncertainty about the nature of the skin growths, a biopsy may be recommended. This involves removing a small sample of the skin for laboratory analysis to determine whether the growth is benign or malignant. A dermatologist is typically the one to perform this procedure, as they have the expertise to ensure it is done safely and effectively.

Conclusion
Given the symptoms you've described, it would be prudent to schedule an appointment with a dermatologist. They can provide a comprehensive evaluation of your skin growths and recommend appropriate treatment options. Early intervention is key in managing skin conditions effectively, especially when there are changes in your skin that could indicate a more serious issue. Remember, it’s always better to err on the side of caution when it comes to your health.

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