Concerns About Black Moles on Feet: Should You Seek Medical Advice?

Concerns about a black mole between the sole and the big toe?

Hello Dr.
Wu,
- Description of the condition - I have a black mole approximately 0.4 mm in size on the sole of my right foot; on the left foot, there is a black mole about 0.2 mm in size between the ring and little toes.
Both moles are symmetrical, have a light black color, and are flat without any elevation (appearing to be located beneath the skin).
- Concerns regarding the condition - I am worried that these moles may be related to "malignant melanoma," so I searched for relevant information online, which can be broadly categorized into two statements: 1.
Moles located on the palms or soles may undergo changes due to friction or irritation, thus it is recommended to seek medical attention for removal as early as possible.
2.
(According to Dr.
Tsai Cheng-fang from National Taiwan University Hospital's dermatology department) - Malignant melanoma is mostly spontaneous in nature, with only a few cases arising from pre-existing moles.
Currently, it is not believed that benign moles will transform into malignant ones due to irritation.
(Text omitted) Although acral malignant melanoma is more common in East Asians, benign acral moles are even more prevalent.
- Inquiry regarding the condition - I would like to ask Dr.
Wu, based on Dr.
Tsai's statement that malignant melanoma is spontaneous and that benign moles generally do not transform into malignant ones due to irritation, if the moles on my feet are benign (which is more likely), is it still necessary to proactively seek removal at a hospital? Or is it sufficient to continue monitoring them?
Thank you for your time, Dr.
Wu.
I look forward to your response.

Axiang, 30~39 year old female. Ask Date: 2014/07/01

Dr. Wu Yuxin reply Dermatology

"Malignant melanoma mostly arises spontaneously, with only a few cases developing from pre-existing moles." This statement addresses everything.
Generally, it is recommended to closely monitor moles on the soles of the feet that are larger than 6mm; however, this does not mean they will definitely become malignant or need to be excised.
In fact, the likelihood of benignity is much greater than that of malignancy.
Each case must be discussed individually.

Reply Date: 2014/07/01

More Info

When it comes to concerns about black moles on the feet, it's important to approach the situation with a combination of caution and informed decision-making. Based on your description, you have two black moles: one on the sole of your right foot and another between the fourth and fifth toes on your left foot. Both moles are small, flat, symmetrical, and have a faint black color. Your concern about the possibility of these moles being related to malignant melanoma is understandable, especially given the information you've gathered from various sources.

Firstly, it’s essential to recognize that while most moles are benign, any changes in size, shape, color, or texture can be a cause for concern. The characteristics you described—small size, flatness, symmetry, and lack of elevation—are generally indicative of benign moles. However, the location of these moles, particularly on the soles of the feet, does warrant some attention. As you noted, there is a higher incidence of melanoma in these areas, particularly in certain populations.

The two perspectives you mentioned regarding the potential for benign moles to become malignant are important to consider. Dr. Tsai from National Taiwan University Hospital suggests that while malignant melanoma can arise spontaneously, it is less common for benign moles to transform into malignant ones due to irritation or friction. This aligns with the general understanding in dermatology that while irritation can lead to changes in the skin, it does not typically convert benign lesions into malignant ones.

Given this context, here are some recommendations for your situation:
1. Observation: If the moles have not changed in size, shape, or color over time, and they remain asymptomatic (not itchy, painful, or bleeding), it may be reasonable to monitor them. Regular self-examinations can help you keep track of any changes.

2. Consultation with a Dermatologist: Even if the moles appear benign, it is advisable to consult with a dermatologist for a professional evaluation. A dermatologist can perform a thorough examination and may recommend a dermatoscopic evaluation, which allows for a more detailed assessment of the moles. If there is any doubt, they may suggest a biopsy to rule out malignancy.

3. Education on ABCDE Rule: Familiarize yourself with the ABCDE rule for moles, which stands for Asymmetry, Border irregularity, Color variation, Diameter greater than 6mm, and Evolving changes. If any of these characteristics develop in your moles, it would be prudent to seek medical advice promptly.

4. Consideration of Removal: If the moles are causing you anxiety or if they are located in areas prone to friction (like the soles of the feet), discussing the option of removal with your dermatologist may be beneficial. This can provide peace of mind and eliminate any potential for irritation.

5. Regular Skin Checks: Regardless of the current state of your moles, regular skin checks are important, especially if you have a family history of skin cancer or other risk factors.
In summary, while your moles may likely be benign based on their characteristics, it is always best to err on the side of caution. Consulting with a dermatologist will provide you with the most accurate assessment and peace of mind regarding your skin health. Regular monitoring and awareness of any changes are key components in managing skin lesions effectively.

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