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"Should I have a skin pathology consultation if I might have melanoma?"


Female, 42, some symptoms of melanoma. Is this cause for a consultation? I don't want to overreact.


Melanoma is an aggressive form of skin cancer characterized by abnormally dark, large, irregular-shaped moles. Sun exposure (or exposure to UV rays from other sources such as tanning beds) is the greatest risk factor for development of melanoma, and it typically (though not always) occurs in sun-exposed areas of the skin. It is unique among skin cancers for its particularly invasive and aggressive nature.

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Metastatic melanoma (melanoma that invades through the skin into the bloodstream and spreads to other parts of the body) has a very poor prognosis and is very difficult to treat. Although I have mentioned some of the concerning features for melanoma above, a good rule of thumb is that any new, expanding, or otherwise concerning moles are grounds to make an appointment with your doctor. Melanoma can only be diagnosed by an in-person consultation with a licensed physician. If you have any new or worrisome skin lesions that you believe may be a melanoma, you should seek referral to a dermatologist immediately. They can remove the suspicious mole and send it for "pathology," where licensed pathologists will examine the mole and decide whether or not it is indeed melanoma. They will also be able to examine the depth of invasion through the skin and counsel you as to whether further workup to detect metastatic spread of the melanoma is indicated.

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