Melanoma?

Sunil Khemaney syama at delphi.com
Sat Dec 9 22:52:03 EST 1995


I'm looking for some help for a friend who is presently overseas
and in the boonies not near any dermatologist (or doctor for that
matter).  He's had a mole on his upper back for at least a couple
of years (flesh and brownish colored in skin tone.)  Approx. 4
weeks ago, it was noticed that it had gotten a little bit redder
but nobody took it very seriously.  

About 3 weeks ago, it was noticably redder and was starting to
get taller.  At this time, it was still smooth in the sense that
it was roundish on the top and not crusty and looked relatively
uniform to the eye.

Approx. 2 weeks ago, it started getting bigger and taller and
rougher looking and little specks (one main one and several
smaller ones) started appearing on the summit which appeared to
the eye like tiny little freckles or blood points.

Today, looking at it with a magnifying glass, the shape is
irregular and it is warty-looking (little eruptions of skin
coming out).  The little freckles appear to be blood and there
are six of them--some very small.  They appear almost as if
they're linked up to each other like a threadlike web.

It is multicolored in the sense that it seems to have a slight
grayishness to part of it.  Closer to the back, it's reddish and
inflamed around the edges down around the bottom of it.  It's
pinky, fleshy colored overall.  The freckles are the color of
dried blood.

The present size is approx. 0.5 cm at its widest part and approx.
1.3 mm high.  It is at least twice as high as it was 4 weeks ago
and a little wider than it was.

Some other factors which may be relevant here: he began having
massage in the sun with oil about 4 weeks ago and he's had 3
massages.  The type of massage is one that may have irritated it
since it was right on the muscle massage line so it would have
been rubbed quite vigorously in that area.

The question that we have is since this is warty-looking, could
it be a wart that started growing from a mole or could it have
always been a smoother wart that has now begun to grow and
explode because of irritation?

Or could it be a mole that has always been a melanoma or a mole
that is now becoming a melanoma?  And if so, do melanomas usually
grow this quickly in the sense of the changes they go through
(i.e. the mole being there for a long time but major changes like
this occuring so quickly in the last 3-4 weeks?

There does not seem to be an indentation on the top of it.  In a
sense, it sort of looks like it could be a basil cell carcinoma,
however, it's not smooth any more on the surface--it's more warty
and rough and there's no one clear dimple in the middle.  Rather,
there doesn't seem to be any real concave in the top or middle of
it.

If it is a melanoma, do days matter?  In other words, it may take
5 days to get a proper biopsy vs cutting it out himself in an
improper way now and sending it for analysis.  He has the
necessary scalpel and Formalin preservative.

Could irritation from massaging have created some type of
melanoma change in it?

Any help or advice would be much appreciated.



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