Pigment regrowth next to punch biopsy site dysplastic nevus

Thanks for ongoing advice on this pesky atypical mole.

Trail below but short story is displastic nevus reviewed by x2 derms who said mild / mild – moderate displaysia. The first report said clear margins.

I have been keeping an eye on the biopsy site and noticed a darkish spot next to (not within) the biopsy site. I thought it was just healing from the stitches but it is in fact pigment. This has grown quickly (since biopsy 2 December) and is probably 2mm which is as big as original mole but lighter in colour.

I have an apt Tues to reexcise as derm said this is unusual. Any thoughts/ advice here please?

Any questions I should ask at my apt. I know regrowth happens but in the space of 3 weeks?

Many thanks

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Hi all – copy and paste from last post. Newest to oldest below. Im a little confused and more concerned than before

Many thabks.

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Re: Help interpreting pathology report – atypical mole (Att… mannines – (12/25/2016 – 10:38pm)
Hi Janner/all – advice needed am more worried than before.

In my first post I mentioned that I was going to get a 2nd opinion from a derm as I found the initial pathology report for my dysplastic nevus to be a little vague.

Well that derm called me xmas eve (great timing) to say that the team of specialists on review felt that the mole was mild / moderate (I had spoken to the first pathologist myself who said it was mild).

My original path report apparently didnt mention any cellular atypia which they found on review.

He also said that they were going to run some new slides as ‘sometimes when we look deeper we find some worrying things’. Added that if it was on his arm he would want it cut out.

I am now obviously a bit concerned as to why they would a) upgrade and level of atypia and b) think they needed to run further tests. Do you know what these would be? The clinic where I had the punch biopsy done said no further excision is required.

I tend to suffer from health anxiety so I realise I’m probably blowing this out of proportion but looking for any advice here.

Many thanks

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Re: Help interpreting pathology report – atypical mole (Att… Janner – (12/14/2016 – 9:11am)
There is nothing about this path report that screams worrisome to me. If I had clean margins (like this one does), I’d just move on. Not all pathologists classify atypical moles as mild, moderate or severe and that doesn’t mean the report is lacking if it doesn’t. (It makes it easier for us but we’re not really the audience this pathologist is writing for). The description itself usually indicates more worrisome architecture or cellular atypia and this one specifically rules out typical melanoma features. (I am not a medical person or pathologist).

http://www.MelanomaResources.info

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Re: Help interpreting pathology report – atypical mole (Att… mannines – (12/15/2016 – 8:11am)
Many thanks for taking the time to reply Janner – much appreciated
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Re: Help interpreting pathology report – atypical mole (Att… Janner – (12/14/2016 – 9:11am)
There is nothing about this path report that screams worrisome to me. If I had clean margins (like this one does), I’d just move on. Not all pathologists classify atypical moles as mild, moderate or severe and that doesn’t mean the report is lacking if it doesn’t. (It makes it easier for us but we’re not really the audience this pathologist is writing for). The description itself usually indicates more worrisome architecture or cellular atypia and this one specifically rules out typical melanoma features. (I am not a medical person or pathologist).

http://www.MelanomaResources.info

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Re: Help interpreting pathology report – atypical mole (Att… mannines – (12/15/2016 – 8:11am)
Many thanks for taking the time to reply Janner – much appreciated

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Hello all

thank you in advance if you are able to help.

I had a mole biopsied and the pathology report didn’t state whether it was mild, moderate or severely dysplastic. It was a punch biopsy of a 2mm mole with 1mm margins.

The clinic said all margins were clear and that no further excision is required, however, I’m seeking a second option (from this forum and another dr) as the report was vague. Any interpretation of the report would be much appreciated.

REPORT:
Skin with increased pigmentation of tthe basal cell layer and a junctional melanocytic proliferation composed of nested groups along the tips of elongated and variably fused rete ridges. There is also lamellar fibroplaysia, mild chronic inflammation, pigment incontinence and a few banal melanocytes in the upper dermis.. There is no confluence, mitototic figures or pagetoid scatter seen.

Conclusion: Compound melanocytic naevus, dysplastic

This is a fantastic forum and source of information and comfort which I have been reading over the past few weeks.

Any advice appreciated and I will update also with 2nd opinion from Dr when I get it. I know aypical moles are contentious in terms of their ability to turn into melanoma and also that there is no general consensus on treatment so I’m finding it all a bit ‘grey’…

Best wishes to everyone here

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Re: Conflicting advice on dysplastic nevus – confused debwray – (12/27/2016 – 1:08pm)
Hi,

Dysplasic naevus by definition have some abnormal /unusual features. They can evolve – and MM can develop within a dysplasic naevus which happened in my case – but only in a small part of it.

HavIng said all that- you have asked for a second opinion .The reports seem to tally so far but are expressed slightly differently. I’m guessing that the second lab is doing the same as they did for me and are running some further stains that might possibly indicate melanoma cells. Given that the lesion has already been removed with clear margins – you are in a good place. In the rather unlikely case that the stains were positive then you would probably be advised to have further margins..but the first level of tests were OK ,so you just need to sit tight unless you are told further action is needed.

If it is so hard to identify- chances are all will be well as it has been caught early.

Wishingyou well

Deb

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Re: Conflicting advice on dysplastic nevus – confused Janner – (12/27/2016 – 5:07pm)
You asked for a second opinion and you got it. If you asked for a third opinion, it would likely differ. Pathology is an art as much as it is a science and you are dependent on the person who reads and “interprets” what they see.

The 2nd lab interprets things differently – more cellular atypia. They are just going to do their own analysis. I would absolutely NOT WORRY about any of this. This isn’t going to come back as melanoma. And it hardlly matters how much atypia exists in the grand scheme of things. It’s removed. I’ve had 3 melanoma primaries and I don’t even give a second thought to any dysplastic moles removed if they have clean margins. Don’t let this get to you because it isn’t worth the angst!