Mole assessment and dermoscopy · Wrocław
Mole check in Wrocław: first the diagnosis, then the decision
A new lesion, a mole unlike the others, a change in colour, shape or surface does not automatically mean a cancer. They are, however, a reason to show the skin to a dermatologist. At HappyDERM a mole check begins with the history and the clinical assessment, and dermoscopy helps to plan observation, excision with histopathology or further diagnosis.
Which lesions require a dermatological assessment?
Most ordinary moles remain benign. The mere fact that a lesion is dark, raised or present since childhood does not settle its nature. More attention is required by what is new, what evolves, what differs from the remaining lesions or what produces symptoms. The dermatologist assesses all of this information together, and not from a single photograph found on the internet.
New or different
The lesion has appeared recently or looks different from the other moles on your skin. Such an “odd one out” appearance is important information for the doctor.
It is changing
It grows, changes shape, borders, colour, height or surface. A photograph showing how it looked earlier is helpful.
Clinical symptoms
Itching, tenderness, pain, bleeding, oozing, a crust or an ulceration without a clear injury should be discussed during the consultation.
It is in a difficult place
The scalp, the back, the soles, the spaces between the toes, the nails and the intimate areas are difficult to compare on your own.
Not every small pigmented spot is a mole
Patients use the word “mole” for many different lesions: fibromas, warts, haemangiomas, seborrhoeic lesions, pigmentation or inflammatory changes. They may look similar in a photograph, but they arise from different tissues and require different management. The dermatologist begins by naming the type of lesion, before answering the question about observation or removal.
A lesion without pigment may also require assessment
Skin cancers are not always brown or black. A pink or flesh-coloured nodule, a place that does not heal, a recurring crust or a patch that is gradually enlarging may also be a cause for concern. If a lesion does not fit the ABCDE rule but evolves or behaves differently from the rest of the skin, it is still worth showing it to a doctor.
The ABCDE of moles: what the letters mean
ABCDE helps to notice the features worth showing to a dermatologist. Not every melanoma has the full set of these features, and some benign moles may look irregular. E, that is change over time, is particularly important, together with the comparison with the other lesions on your own skin.
One half of the lesion does not resemble the other in shape or in the distribution of the pigment.
The borders are irregular, ragged, scalloped or in places difficult to define.
Several shades occur within one lesion, or the colour is distributed unevenly.
A larger size attracts attention, but a small lesion may also require assessment. The threshold alone does not diagnose disease.
The size, shape, colour or surface changes, or new symptoms appear.
ABCDE does not cover everything. A lesion may be pink, red, flesh-coloured or almost without pigment. It may also take the form of a rapidly growing nodule. For that reason a worrying lesion should not be considered safe merely because it does not match the typical picture.
When to arrange an earlier consultation?
The date should take account of the pace and the character of the lesion. It is worth telling the reception at once that the matter concerns a new, rapidly changing or bleeding lesion. This helps to describe the reason for the visit correctly, but it does not replace medical assessment.
Rapid evolution or a new nodule
A clear change over successive weeks or months, rapid growth, hardening, the appearance of a nodule or an appearance different from the remaining lesions.
Bleeding, oozing or failure to heal
Bleeding without a repeated injury, a recurring crust, an ulceration or a place that heals and opens again.
A lesion under a nail or on the sole
A new band of pigment, a dark patch that does not move as the nail grows, or a lesion on the foot require assessment, even if they are not painful.
A person at higher risk
Previous skin cancers, numerous or atypical moles, a family history, immunosuppression and intensive UV exposure affect the way the check-ups are planned.
What does dermoscopy of moles involve?
A dermatoscope is an instrument with magnification and suitable lighting. It allows the doctor to see the patterns of pigment, vessels and other structures invisible to the naked eye. The examination is performed on the skin and usually does not break its continuity. The meaning of the image depends, however, on the experience of the examiner and on the full clinical context.
History
Since when the lesion has been present, what has changed, whether it produces symptoms and whether risk factors are present.
Inspection of the skin
Assessment of the lesion in daylight and comparison with the other moles and with the surrounding skin.
The dermoscopic image
Magnification of the structures and assessment according to the criteria used by a doctor trained in dermoscopy.
A recommendation
Information on whether the lesion may remain under observation, requires documentation, excision or further management.
More information about the examination itself is available on the page dermoscopy Wrocław. If you have many moles, tell the reception when booking whether you want the assessment of one particular lesion or a wider examination of the skin. This makes it possible to plan the time of the visit better. If you are not certain whether the lesion you are observing is a mole, a seborrhoeic keratosis or an actinic keratosis, see the guide to similar-looking skin lesions.
Assessment of a single lesion
This works when the patient can point to a particular problem: a new patch, a lesion under a nail, a bleeding nodule or a mole documented in photographs. The doctor may, however, propose looking at a wider area or at the whole skin if the image or the history indicates that this matters.
Examination of the whole skin
This requires time, privacy and a systematic scheme. It covers places that are easy to miss, for example the scalp, the ears, the back, the buttocks, the soles and the areas around the nails. The scope is agreed with the patient, and the intimate areas are examined only when this is necessary and with the consent of the person examined.
What may the doctor recommend after assessing a mole?
Not every mole has to be removed and not every lesion should only be observed. A good consultation ends with a clear explanation of what the doctor sees, what the level of uncertainty is and which next step is justified.
No indication for a procedure
The lesion may be considered benign in the current image. The doctor discusses self-examination and the situations in which it is necessary to return.
Documentation and follow-up
In selected cases a clinical or dermoscopic photograph is useful, together with a comparison after the interval set by the doctor. Do not assume on your own that every atypical lesion can safely be “watched for a year”.
Excision and histopathology
If the image or the history raises suspicion, the doctor may recommend a procedure allowing assessment of the tissue. The scope, the date and the place of the procedure depend on the type, the location and the urgency of the lesion.
What should a plan of observation contain?
If the doctor recommends follow-up, the patient should know which lesion is being observed, why it does not require immediate removal, after what interval the comparison is planned and which symptoms justify earlier contact. The documentation should make it possible to find the same lesion and to compare its appearance in similar conditions. The instruction “please keep an eye on it” alone is less useful than a specific reference point and a date.
The result of the histopathology should also be discussed in the context of further management. Not every result means the end of the follow-up, and not every one requires an additional procedure. What matters is the full diagnosis, the margins, the site of the lesion and the individual history of the patient. A decision should not be made on the basis of a single word taken out of the report.
How to check moles sensibly at home?
Self-examination does not consist in measuring every dot daily or comparing photographs from a search engine. Its purpose is to know your own skin and to notice a change. The frequency of professional check-ups is set individually, depending on the appearance of the moles and the risk factors.
A fixed scheme of inspection
- the face, the ears, the neck and the scalp;
- the front and the back of the trunk and the sides;
- the arms, the hands and the areas around the nails;
- the legs, the feet, the soles and the spaces between the toes;
- the back and the buttocks, using two mirrors or with the help of a close person.
Photographs that can be compared
- take them in similar light and from a similar distance;
- add a photograph of a wider area, so that the lesion can be found;
- do not judge the size only by the magnification on the screen;
- note the date and the symptoms reported;
- show the doctor the series of photographs instead of describing the lesion from memory.
An application or an algorithm does not close the diagnosis. A result from a telephone should not delay a visit if the lesion evolves, bleeds, does not heal or clearly differs from the others.
What affects the plan of skin check-ups?
The history of the skin
The number and the variety of the moles, earlier biopsies, previous skin cancers and new lesions appearing in adulthood help to determine the scope of the examination.
Family and treatment
Cases of melanoma in the family, medicines that lower immunity and certain diseases may change the assessment of the risk. Tell the doctor about them.
UV exposure
Sunburn, sunbeds, outdoor work and intensive holiday exposure are part of the history. Prevention covers shade, clothing, a head covering and a correctly applied sunscreen.
A plan for a person with a single stable lesion may be different from the plan for a patient with numerous moles, a previous melanoma or immunosuppression. There is no single safe calendar for everyone. The dermatologist decides whether a check of one lesion, a periodic examination of the whole skin or more extensive documentation is needed.
Moles in children
A child’s skin grows, so some moles enlarge proportionally and change appearance with age. This does not mean that every lesion is worrying. Rapid evolution, symptoms, a very atypical appearance or a large mole present from birth require an assessment adapted to the age and the history of the child.
Lesions in pregnancy
In pregnancy the skin and existing moles may look different, particularly in places that stretch. Every evolution should not, however, be attributed automatically to hormones. A new, clearly changing or symptomatic lesion is worth having assessed, telling the doctor about the pregnancy and its stage.
How to prepare for a mole check?
Information to give during the visit
- photographs showing the lesion over time;
- the results of earlier histopathological examinations;
- a list of previous skin cancers and significant diseases;
- information about melanoma in relatives;
- a list of medicines, particularly those affecting immunity or coagulation.
Conditions that make examining the skin easier
- do not cover the lesion with make-up or self-tan;
- remove the varnish from the nail if a change under the plate worries you;
- point out to the doctor the places not visible at first glance;
- wear clothing that can be taken off or moved aside easily;
- note since when the bleeding, itching or pain has occurred.
Mole check at HappyDERM in Wrocław
A patient looking for a good consultation should receive something more than a quick “please keep an eye on it”. What matters is the comparison of the lesion with the rest of the skin, the explanation of the dermoscopic image in understandable language, clear signals for earlier contact and a plan for the next step. If removal or a consultation at another centre is needed, the reason should be discussed.
The doctors
Check the qualifications and experience of dr n. med. Małgorzata Micał-Strąk and lek. Ireneusz Pijanowski.
The scope of dermatology
See what a dermatology consultation in Wrocławlooks like. For younger patients there is also paediatric dermatology.
Information needed when booking
Check the locations, current price list or go to the page contact and booking.
Mole check in Wrocław: FAQ
Is every dark mole dangerous?
No. Many benign moles are brown or almost black. The colour is assessed together with symmetry, borders, structure, change over time and the appearance of the remaining moles. A single feature or a photograph gives no certainty.
Can a small mole require assessment?
Yes. Diameter is only one element of ABCDE. A small lesion that is new, evolving, bleeding or different from the others should also be shown to a dermatologist.
Is a raised mole more dangerous?
That cannot be determined from the height. Some benign moles are raised, but a new or rapidly growing nodule requires assessment. What counts is the appearance, the pace of change and the dermoscopic image.
Does a damaged mole have to be removed at once?
An injury in itself does not identify the nature of a lesion. If a mole bleeds after being caught, is repeatedly irritated or heals abnormally, show it to a doctor. The decision on removal depends on the examination and on the location.
Does dermoscopy hurt?
Examination with a dermatoscope takes place on the surface of the skin and is usually painless. The doctor applies the instrument to the lesion or views it without contact, depending on the equipment and the site.
Does dermoscopy give one hundred per cent certainty?
No. It increases the amount of information available during the assessment and supports the clinical decision, but it does not replace histopathological examination if a lesion requires removal and assessment of the tissue.
Can all the moles be examined during one visit?
The scope depends on the number of lesions, the reason for the visit and the time needed for a careful assessment. When booking, say whether the matter concerns one lesion or an examination of a larger area of skin.
How often should moles be checked?
There is no single schedule for everyone. The doctor takes into account the appearance of the moles, earlier results, the personal and family history, UV exposure and medicines affecting immunity.
Can a mole be removed with a laser?
The method is chosen only after the diagnosis. If a lesion is suspicious or requires confirmation, the possibility of histopathological examination may be important. Do not destroy a lesion cosmetically without an earlier assessment by a doctor.
Is a photograph taken with a telephone enough for a consultation?
It can document a lesion and its location, but it does not show dermoscopic structures and does not replace an examination of the whole skin. With an evolving or symptomatic lesion an in-person consultation is needed.
Are moles in a child assessed in the same way as in an adult?
Moles may naturally appear and change as a child grows, but an atypical, rapidly evolving or symptomatic lesion requires assessment. The dermatologist takes the age and the pace of development into account.
What should be brought to the first visit?
Photographs of the lesion with dates, earlier dermoscopy or histopathology reports, a list of medicines and information about skin cancers in you and in your family. Do not cover the lesion with make-up or self-tan.
Medical sources used in preparing this page
- American Academy of Dermatology: ABCDEs of melanoma.
- American Academy of Dermatology: How to find skin cancer.
- National Cancer Institute: Common moles, dysplastic nevi and risk of melanoma.
- NICE: Quality statement 3 – Dermoscopy.
- NICE: Melanoma – assessment and management.
- NHS: Melanoma skin cancer – symptoms.
The content is educational and does not replace a consultation, dermoscopy, histopathological examination or individual recommendations. Self-assessment with ABCDE and a photograph from a telephone do not allow skin cancer to be excluded.
Mole check in Wrocław – price
- Dermoscopic assessment of melanocytic naevi – 50–200 PLN
- Medical visit – dermatological examination – 280–350 PLN
- Cryosurgical procedures (including seborrhoeic keratoses, soft fibromas) – from 150 PLN
The price of the dermoscopic assessment depends on the number of lesions assessed. We recommend a check once a year, and more often with numerous moles or a family history. The full list is available in the HappyDERM price list.