Concerns About Moles on the Glans: When to Seek Help

Glans issues

Hello Doctor: I would like to ask about a black mole that has developed near the coronal sulcus of the glans, measuring approximately 3 to 4 mm (it has been present for 8.9 years).
It is flat, not raised or indented, and is not painful or different in texture from the surrounding skin.
I am very concerned about potential issues (because I read online that moles located in areas of frequent friction or mucosal surfaces are more likely to evolve into malignant melanoma).
Does this need to be removed? If so, what type of surgery would be required? Should I see a urologist or a dermatologist? What would the approximate cost be? Thank you.

R.C., 10~19 year old female. Ask Date: 2008/04/24

Dr. Xu Weikai reply Urology

Hello R.C., I personally recommend removing moles that are typically located here.
Either a dermatologist or a urologist can perform the procedure; the important thing is to ensure that the mole is sent to the pathology department for examination.
If there are any details that are unclear, feel free to ask again, and we can discuss and research further.
Sincerely, Dr.
Hsu Wei-Kai, Head of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2008/04/24

More Info

When it comes to moles or pigmented lesions on sensitive areas such as the glans (the head of the penis), it is understandable to have concerns, especially given the potential for changes in such lesions to indicate more serious conditions, including melanoma.
Based on your description, the mole you have had for 8 to 9 years, measuring about 3 to 4 mm, is flat, non-painful, and smooth, which are generally reassuring signs. However, it is important to remember that any changes in a mole's appearance, size, color, or texture can warrant further evaluation. The concern you mentioned regarding moles in areas that experience frequent friction or are in mucosal regions is valid; these moles can sometimes have a higher risk of developing into malignant melanoma.

When to Seek Help
You should consider seeking medical advice if:
1. Change in Appearance: If the mole changes in size, shape, or color.

2. New Symptoms: If you experience any itching, bleeding, or discomfort.

3. Personal or Family History: If you have a personal or family history of skin cancer or melanoma.

Evaluation and Diagnosis
To evaluate the mole, you would typically start by consulting a dermatologist. They can perform a thorough examination and may recommend a biopsy if there are any concerns about the mole's appearance. A biopsy involves removing a small portion of the mole for laboratory analysis to determine if it is benign or malignant.

Surgical Options
If the mole is determined to be suspicious or if you choose to have it removed for peace of mind, there are a couple of surgical options:
1. Excisional Biopsy: This involves cutting out the mole along with a margin of surrounding skin. This is often done under local anesthesia.

2. Shave Excision: This method involves shaving off the mole with a scalpel, which may be suitable for flat moles.

Referral and Costs
You can start by visiting either a urologist or a dermatologist. A dermatologist is typically more specialized in skin lesions and would be the preferred choice for evaluating moles. The costs can vary widely depending on your location, the healthcare facility, and whether you have insurance. Generally, a consultation might range from $100 to $300, and the cost of a biopsy or excision can range from a few hundred to over a thousand dollars, depending on the complexity of the procedure.

Conclusion
While your mole has not shown any alarming characteristics over the years, it is always better to err on the side of caution. Regular monitoring and professional evaluation are key to ensuring that any potential issues are addressed early. If you have ongoing concerns, do not hesitate to seek a consultation with a dermatologist who can provide personalized advice and treatment options based on your specific situation.

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