› Forums › General Melanoma Community › Severe Atypical
- This topic has 24 replies, 2 voices, and was last updated 11 years, 11 months ago by
eddiealmost.
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- September 21, 2013 at 10:26 pm
I have dysplastic nevi syndrome with 100’s if moles, at least 15 moderate dysplastic, and 2 recent severe dysplastic.My derm used a scalpel to dee a very deep cutting of the severe dysplastic mole, not a complete excision. She went very deep!!! There was no brown skin left (I am white) and the removed lesion had a lot of normal looking skin attached to it.
The margins came back as not clear and the derm did a wide complete excision down to the muscle.
The severe dysplastic mole was growing down into the skin, not staying on the surface.
Can moles grow vertically and still be benign??? Does this also mean that th atypical cells can grow in I pigmented cells??
I am glad that it was not a melanoma, but am concerned that hey might have made a mistake considering how deep it grew.
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- September 21, 2013 at 10:28 pm
Tipping on a iPad!!! I was trying to ask if atypical cells can grow in NON pigmented cells.-
- September 21, 2013 at 11:34 pm
Just because you didn't SEE any pigmented spots doesn't mean they weren't there or weren't pigmented. The pathologist uses different types of stains to illuminate melanocytes. Even having a few cells at the margins is enough to say there weren't clean margins. They want to see a clear delineation of no melanocytes.
All wide excisions should be taken down to the muscle, that's standard procedure. The non-clear margins could have also been on the sides (peripheral) and not the deep margin. Hard to know without you posting your path report.
You had the lesion removed and the WLE. It should be taken care of so I wouldn't spend much time worrying about this one. Just continue to watch the scar area for any pigment regrowth and the rest of all your moles for change.
Good luck!
Janner
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- September 21, 2013 at 11:39 pm
Thank you. That answer helps a great deal. Funny you should mention regroth, because I have had a shaving regrow. There are o many that I am in the derm office every 2 weeks or so to have stitches removed and new biopsies done. The derm doesn’t like to do more than 4 at a time. It is almost like a hobby at this point.I am thinking that I should start asking for copies of my path reports.
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- September 21, 2013 at 11:47 pm
So you do you have any type of photographs? I know people with dysplastic nevus syndrome can have moles changing all the time, but these would be the only moles I'd remove. And I'm personally not fond of shaves because they aren't always deep enough to remove the entire lesion. (I also think they hurt more healing). I prefer punches if possible. They get the deep margin. it seems to me having 8 or so moles removed every month is pretty excessive even for someone with DNS.
As for the path reports, I always get copies of mine. I wantto know exactly what I'm dealing with. I just keep them in a file for my own records.
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- September 21, 2013 at 11:52 pm
I am with a new derm. My old derm did not remove many, which is not a good thing because everything that the new derm has excised has come back as moderate or severe. So it is necessary for them to come off with clear margins. She has photographs everything and does use shaving. I agree that shavings are more aggravating than dealing with stitches. -
- September 21, 2013 at 11:53 pm
I hate typing on this iPad…. She does NOT use shaving -
- September 22, 2013 at 12:31 am
I guess I disagree with your statement that all moderate and severely dysplastic moles need to be removed. If they're not changing, they're not harming you. All of your moles are probably dysplastic to some degree. Wholesale removal of moles doesn't change your risk of getting melanoma because 50% of melanomas arise on new moles. My institution does "mole mapping" — new photographs at every visit with both doc and software doing comparisons for change. They map people with DNS and multiple primaries. 97% of the moles they map never change, and the remaining 3% are biopsied. Even all of those are not melanoma. So instead of doing wholesale removal of all your moles, I'd only be removing those that change. MOST MOLES – even moderate or severely atypical moles – WILL NOT TURN INTO MELANOMA. You do what makes you feel comfortable, but removing all those moles every visit would get old really quickly for me. I've had 3 primary melanomas so I know I'm high risk for more, but I only remove things that change.
Best wishes,
Janner
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- September 22, 2013 at 9:34 am
You would be, wholesale removal of all of them would leave me with very little skin left to cover my body.! Wholesale removal is not our goal. We have been focusing in the bad looking ones. There a just lot of bad looking ones. Your information in the pigmentation was helpful. -
- September 22, 2013 at 9:34 am
You would be, wholesale removal of all of them would leave me with very little skin left to cover my body.! Wholesale removal is not our goal. We have been focusing in the bad looking ones. There a just lot of bad looking ones. Your information in the pigmentation was helpful. -
- September 22, 2013 at 9:34 am
You would be, wholesale removal of all of them would leave me with very little skin left to cover my body.! Wholesale removal is not our goal. We have been focusing in the bad looking ones. There a just lot of bad looking ones. Your information in the pigmentation was helpful. -
- September 22, 2013 at 12:31 am
I guess I disagree with your statement that all moderate and severely dysplastic moles need to be removed. If they're not changing, they're not harming you. All of your moles are probably dysplastic to some degree. Wholesale removal of moles doesn't change your risk of getting melanoma because 50% of melanomas arise on new moles. My institution does "mole mapping" — new photographs at every visit with both doc and software doing comparisons for change. They map people with DNS and multiple primaries. 97% of the moles they map never change, and the remaining 3% are biopsied. Even all of those are not melanoma. So instead of doing wholesale removal of all your moles, I'd only be removing those that change. MOST MOLES – even moderate or severely atypical moles – WILL NOT TURN INTO MELANOMA. You do what makes you feel comfortable, but removing all those moles every visit would get old really quickly for me. I've had 3 primary melanomas so I know I'm high risk for more, but I only remove things that change.
Best wishes,
Janner
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- September 22, 2013 at 12:31 am
I guess I disagree with your statement that all moderate and severely dysplastic moles need to be removed. If they're not changing, they're not harming you. All of your moles are probably dysplastic to some degree. Wholesale removal of moles doesn't change your risk of getting melanoma because 50% of melanomas arise on new moles. My institution does "mole mapping" — new photographs at every visit with both doc and software doing comparisons for change. They map people with DNS and multiple primaries. 97% of the moles they map never change, and the remaining 3% are biopsied. Even all of those are not melanoma. So instead of doing wholesale removal of all your moles, I'd only be removing those that change. MOST MOLES – even moderate or severely atypical moles – WILL NOT TURN INTO MELANOMA. You do what makes you feel comfortable, but removing all those moles every visit would get old really quickly for me. I've had 3 primary melanomas so I know I'm high risk for more, but I only remove things that change.
Best wishes,
Janner
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- September 21, 2013 at 11:53 pm
I hate typing on this iPad…. She does NOT use shaving -
- September 21, 2013 at 11:53 pm
I hate typing on this iPad…. She does NOT use shaving -
- September 21, 2013 at 11:52 pm
I am with a new derm. My old derm did not remove many, which is not a good thing because everything that the new derm has excised has come back as moderate or severe. So it is necessary for them to come off with clear margins. She has photographs everything and does use shaving. I agree that shavings are more aggravating than dealing with stitches. -
- September 21, 2013 at 11:52 pm
I am with a new derm. My old derm did not remove many, which is not a good thing because everything that the new derm has excised has come back as moderate or severe. So it is necessary for them to come off with clear margins. She has photographs everything and does use shaving. I agree that shavings are more aggravating than dealing with stitches. -
- September 21, 2013 at 11:47 pm
So you do you have any type of photographs? I know people with dysplastic nevus syndrome can have moles changing all the time, but these would be the only moles I'd remove. And I'm personally not fond of shaves because they aren't always deep enough to remove the entire lesion. (I also think they hurt more healing). I prefer punches if possible. They get the deep margin. it seems to me having 8 or so moles removed every month is pretty excessive even for someone with DNS.
As for the path reports, I always get copies of mine. I wantto know exactly what I'm dealing with. I just keep them in a file for my own records.
-
- September 21, 2013 at 11:47 pm
So you do you have any type of photographs? I know people with dysplastic nevus syndrome can have moles changing all the time, but these would be the only moles I'd remove. And I'm personally not fond of shaves because they aren't always deep enough to remove the entire lesion. (I also think they hurt more healing). I prefer punches if possible. They get the deep margin. it seems to me having 8 or so moles removed every month is pretty excessive even for someone with DNS.
As for the path reports, I always get copies of mine. I wantto know exactly what I'm dealing with. I just keep them in a file for my own records.
-
- September 21, 2013 at 11:39 pm
Thank you. That answer helps a great deal. Funny you should mention regroth, because I have had a shaving regrow. There are o many that I am in the derm office every 2 weeks or so to have stitches removed and new biopsies done. The derm doesn’t like to do more than 4 at a time. It is almost like a hobby at this point.I am thinking that I should start asking for copies of my path reports.
-
- September 21, 2013 at 11:39 pm
Thank you. That answer helps a great deal. Funny you should mention regroth, because I have had a shaving regrow. There are o many that I am in the derm office every 2 weeks or so to have stitches removed and new biopsies done. The derm doesn’t like to do more than 4 at a time. It is almost like a hobby at this point.I am thinking that I should start asking for copies of my path reports.
-
- September 21, 2013 at 11:34 pm
Just because you didn't SEE any pigmented spots doesn't mean they weren't there or weren't pigmented. The pathologist uses different types of stains to illuminate melanocytes. Even having a few cells at the margins is enough to say there weren't clean margins. They want to see a clear delineation of no melanocytes.
All wide excisions should be taken down to the muscle, that's standard procedure. The non-clear margins could have also been on the sides (peripheral) and not the deep margin. Hard to know without you posting your path report.
You had the lesion removed and the WLE. It should be taken care of so I wouldn't spend much time worrying about this one. Just continue to watch the scar area for any pigment regrowth and the rest of all your moles for change.
Good luck!
Janner
-
- September 21, 2013 at 11:34 pm
Just because you didn't SEE any pigmented spots doesn't mean they weren't there or weren't pigmented. The pathologist uses different types of stains to illuminate melanocytes. Even having a few cells at the margins is enough to say there weren't clean margins. They want to see a clear delineation of no melanocytes.
All wide excisions should be taken down to the muscle, that's standard procedure. The non-clear margins could have also been on the sides (peripheral) and not the deep margin. Hard to know without you posting your path report.
You had the lesion removed and the WLE. It should be taken care of so I wouldn't spend much time worrying about this one. Just continue to watch the scar area for any pigment regrowth and the rest of all your moles for change.
Good luck!
Janner
-
- September 21, 2013 at 10:28 pm
Tipping on a iPad!!! I was trying to ask if atypical cells can grow in NON pigmented cells. -
- September 21, 2013 at 10:28 pm
Tipping on a iPad!!! I was trying to ask if atypical cells can grow in NON pigmented cells.
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Tagged: cutaneous melanoma
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