Is Re-Excising A Mole Necessary?

A long running debate in the field of dermatology is whether or not to re-excise a mole that has been identified as moderately dysplastic, or atypical, by the pathologist who examined the initial sample of the mole.  Some dermatologists will re-excise the entire mole with this feedback from the lab, while others believe re-excising the mole is unnecessary without further cause (such as change in shape, size, or color, to name a few).  At Skin Solutions Dermatology we have discussed both options at length.  Since there is no definitive correct answer, we have found the best course of action is to discuss both options with our patients and let them decide what next steps to take, so long as there are no other signs of concern.  If the patient is most comfortable with re-excising the area in question, we will happily do so, in order to verify there are no atypical cells present.  Alternatively, the mole can be monitored and watched to ensure there are no changes in color, size, diameter, or any other similar warning signs.  It is about a 50/50 split on which course of action the patients prefer to take when presented with this situation.


"Since there is no definitive correct answer, we have found the best course of action is to discuss both options with our patients and let them decide what next steps to take, so long as there are no other signs of concern."


In a recent study published by the JAMA Dermatology Journal they provided additional findings that suggested re-excising the mole is not necessarily necessary.  Their results showed these atypical moles that had already been excised were unlikely to develop melanoma at that specific site going forward.  In their study, the authors followed 467 patients over a 7-year period, these patients had atypical moles with positive margins diagnosed by the pathologist, however none of these patients developed melanoma at that specific site.  Instead, nearly 23% of the observed group developed melanoma at a new site on the skin.  Ultimately, this suggests that re-excising a previously sampled mole may not be necessary, but keen observation and monitoring of the patients’ skin in its entirety definitely is.


"...re-excising a previously sampled mole may not be necessary, but keen observation and monitoring of the patients’ skin in its entirety definitely is."


At Skin Solutions Dermatology all of our medical providers believe annual full body skin checks are highly advisable.  It is a simple preventative measure to help ensure that if skin cancer ever developed, it would be caught early, and therefore would be less likely to reach any potentially life-threatening stages.  Since melanoma is highly treatable when caught early, regular skin checks are ideal for everyone.  For patients who are already skin cancer survivors the annual skin check is a must!  With this particular article in mind, I personally believe that patients with two or more biopsied atypical moles, should also be more proactive, and have annual full-body skin checks as well.  The re-excision of a specific mole may not be necessary - but close monitoring always will be. 


"The re-excision of a specific mole may not be necessary - but close monitoring always will be."


If unsure about the best course of action for your skin health please feel free to call and schedule an appointment, or initial skin check, with any one of our providers.  We have offices throughout middle Tennessee located in Nashville, Brentwood, Franklin, Columbia, Hendersonville, Mt. Juliet, Smyrna, and Pulaski.  We would be happy to address any concerns you may have and come up with a good course of action to put your mind at ease.



Article Source:  JAMA Dermatology



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Dr Pena

About The Author

Dr. Pena is a Board-Certified Medical Dermatologist, Mohs skin cancer surgeon, and cosmetic dermatologist. Her mission is to educate the diverse patient populations she serves, and their communities, on the importance of skin care in decreasing the risk of skin cancer and minimizing the early signs of aging. She founded Skin Solutions Dermatology with numerous clinics in Nashville, Tennessee and surrounding Middle Tennessee.

Dr. Julia Pena, MD

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