Black Moles on the Sole: When to Seek Further Evaluation

Black mole on the sole of the foot?

Hello Doctor: I have developed a black mole on the sole of my foot, approximately 0.6 cm in diameter, which is not raised.
I visited a nearby dermatologist who recommended a biopsy and referred me to a larger hospital.
However, the doctor at the larger hospital told me it was nothing to worry about and suggested monitoring it.
If I was concerned, I could consider having it removed later.
After returning home, I googled and became more worried because the mole's size has increased beyond 0.6 cm, and since it is located on the sole of my foot, I feel that the edges are somewhat irregular, although the doctor mentioned it still appears oval.
Should I seek a second opinion from another doctor for a diagnosis, or is it sufficient to just monitor it for now? Thank you.
I have attached a photo of the mole on my foot: http://i.imgur.com/c7QuUen.jpg

E, 30~39 year old female. Ask Date: 2015/08/21

Dr. Wu Yuxin reply Dermatology

If the lesions cannot be confirmed by the naked eye and they cause you psychological distress, you may choose to undergo excision and biopsy.
Otherwise, you can opt for observation to see if there are any significant changes.

Reply Date: 2015/08/21

More Info

When it comes to evaluating black moles, especially those located on the soles of your feet, it is crucial to approach the situation with caution and awareness of the potential risks associated with skin lesions. Based on your description of the mole being approximately 0.6 cm in diameter, flat, and with somewhat irregular edges, it is understandable that you are feeling anxious about its nature.
The first thing to note is that the characteristics of moles can vary widely, and not all moles are indicative of melanoma or other skin cancers. However, certain features can raise suspicion. The ABCDE criteria are commonly used to assess moles for potential malignancy:
- Asymmetry: If you draw a line through the mole and the two halves do not match, this is a warning sign.

- Border irregularity: Moles with jagged, notched, or blurred edges can be concerning.

- Color variability: Moles that have multiple colors or shades (brown, black, tan, red, white, or blue) should be evaluated further.

- Diameter: Moles larger than 6 mm (about the size of a pencil eraser) are more likely to be problematic, although smaller moles can also be malignant.

- Elevation: If a mole is raised or has changed in size or shape, this can be a cause for concern.

In your case, the fact that the mole is on the sole of your foot is particularly significant. The soles and palms are areas where melanoma can occur, and they can sometimes be more aggressive. Given that your mole is at least 0.6 cm and you perceive some irregularity, it is prudent to take this seriously.

The advice you received from the first dermatologist to have a biopsy is sound, especially considering the characteristics you described. A biopsy is a straightforward procedure that involves removing a small sample of the mole for laboratory analysis. While it may cause some discomfort, it is generally well-tolerated and is the most definitive way to determine whether a mole is benign or malignant.

If the second opinion from the larger hospital suggested observation, it may be based on their assessment of the mole's appearance and their clinical experience. However, if you are feeling uneasy or if the mole has changed in appearance since your last visit, seeking a third opinion is entirely reasonable. It is essential to advocate for your health and peace of mind.

In summary, while the second opinion may have reassured you, your concerns are valid, and it is essential to prioritize your health. If you feel uncertain, do not hesitate to seek further evaluation from another dermatologist, preferably one who specializes in skin cancer. They can provide a thorough examination and discuss the potential need for a biopsy based on the mole's characteristics. Remember, early detection and treatment are key factors in successfully managing skin cancer, including melanoma.

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