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Questions about some moles/freckles [images]

Who
Posts: 1
Joined: Aug 2015
I'm a 25 year old skinny brown eyes, black hair Asian male. I guess compared to other Asians I'm not really tanned but I recently went through a spontaneous pneumothorax last month. I rarely ever get sick and been in pretty good shape. Anyways after being in the hospital for 3 days with a tube in my chest to keep my lung inflated, I've been super careful with my well being. I stopped smoking and started eating better more vegetables, even more then I normally do, I even started eating fruits. I think I've become a hypochondriac, first it started with looking up dosages radiation from X-rays and stuff and now I turned my attention to my skin. I never been on a tanning bed, I rarely go to the beach if I'm not working I'm on the computer at home. No one in my family has skin cancer. I don't use sunscreen but I never had a sunburn, maybe the closest thing I got was some pealing of skin on my left shoulder but I am the typical Asian guy with moles. I recently got health insurance too so I been kind of abusing it, better now then ever. Recently I went to see my primary care doctor to ask him about a few things on my skin I had questions about for years but never caused me any discomfort or problems. I had this 1 mole on my arm for as long as I could remember, it's the only one that is raised, always has a hair growing out of it. I can even remember kids making fun of me when I was young and I tried to scratch it off but now I have well over 20 moles all round and flat solid black and smaller then 4 mm, only a few look like freckles or something which are the ones that concern me. I got them in my early 20s late teens? I guess it is true what they say about hormones and puberty can cause new moles to grow. 
 
I showed these to my PCP and he said it was nothing, especially if they remained the same for years and caused no problems, he even called in another doctor to take a look which only took a quick glance and said the same thing but I don't them I'd like to see a dermatologist just in case, they gave me a referral so I went the same day to a clinic but I also asked if they would do a biopsy and according to my PCP he said they won't do a biopsy unless there is concern or suspicion because anytime they cause "harm" they need a reason. Only thing is instead of seeing a doctor I saw a PA that checked my whole body and said non of them looked concerning based on the size and color except for the one I had since I was a kid that never really grew or anything. She said I should get it removed but I said it's been the same way for as long as I can remember and there was a hair on it so isn't that a good sign? She said yeah but based on the color alone [which has been the same] she was concerned so she took note of the size. I felt like she didn't really know what she was talking about, especially since the ones I was concerned about she said it was nothing, maybe it is nothing. 
 
Old Chinese culture says getting rid of moles or messing with them can cause cancer, even when I told my mom she looked at me and said you shouldn't mess with them if they aren't giving you trouble but that's what my PCP meant as "harm". I know there's no science to that but maybe you guys can help me out. I'm going to see another dermatologist in October and in November I have to go back to the other clinic so they can see if they mole I had since I was a kid had any changes but this time I'll actually be seen by a doctor so it's definitely more reassuring.
 
so here are some of my questions:
 
I had this on my leg for awhile, no texture at all it's as if it was just skin. I showed my PCP he said it's a vein that is really close to the skin which is why when I put pressure on it, the color fades. The PA thought it was a scab... it's about 8 x 8 mm maybe got a little bigger since I first seen it years ago?
 
This mole or freckle on my upper right arm I had since I was going through puberty I believe it's about 2 x 2 mm, flat no texture just like skin, not raised but I was kinda worried because it has "blurred" borders. PCP and PA both said it's nothing to worry about.
 
This behind my right elbow I had since 20 it's been the same size and color. I remember going to my old PCP the first time I noticed it and he said it's nothing to worry about unless it grows or starts giving me problems. I asked my current PCP about it and he said it's a noncancerous growth, a skin lesion I forgot the exact name he told me but he said he seen really big ones and they never really cause any problems. Mines is about 6 x 3 mm, no texture, if you run your finger along it you can barely feel how much it's raised. He said I can get it removed if I really want but it's not a problem, of course the PA didn't think anything of it.
 
Is a mole? a freckle? I don't even know. Can you get freckles on you arm? This is on my upper left arm, I had since I was 20 also. I don't think it's grow but it's tiny like 1 x 1 mm tiny. No texture just like skin, not raised, only thing is I'm not sure what it is but it doesn't look like any mole I have that's why I'm guessing it's a freckle but it's a little be irregular which was why I was concerned. I also have a similar looking "freckle" on the shaft of my privates, same size just a little darker which look a little different from the other few tiny spots I have down there. PCP and PA said it was nothing.
 
This was the main reason I start looking at all the moles on my skin. It's right under the "freckle" from picture number 4 and as you can see I have a few other freckles in the area total of 5 but they are mostly round except for this one. I had this since at the same time as the others around it. It has no texture just like skin, no raise but it's "asymmetric" or irregular blurred borders, the ones around it all seem to be this way with the blurred borders but this one I been staring at because of the "asymmetric" shape of it. It is about 2 x 2 mm still pretty small but just like the others it hasn't changed in shape/color/size from what I remember. PCP and PA said it was nothing, what you guys think?
 
This is the mole I had for as long as I can remember, this was the one the PA was worried about. It always has this long black hair growing out of it, the typical Asian mole, every few months the hair would fall out but it'll grow back. My PCP said it's nothing if it's been the same size/color/shape since I was a kid. It's about 4 x 3 mm slightly raised but smooth no rough texture nor has it ever gave me problems. All my other "normally" looking moles look like this round/flat just without hair. The PA is concerned about it I'm not sure if it's because she had no record of this mole before since it was the first time I went to that clinic or what but in November I'll be going back to that clinic because they want to make sure there isn't any changes. However the little 2 x 1 mm freckle or mole recently came up maybe a year ago, hasn't changed much in size or color since maybe it did grow but has to be less then 1 mm if it did but has no texture just like skin and it's not raised but that means I had it since I was 24, is it normal to get a new spot at that age?
 
I really want to hear what you guys think. I asked my PCP and the PA if I got fat does that mean my moles will grow? They said no it should stay mostly the same size. I've been doing all this research and reading all these different articles and post I feel like I'm going insane. I know the "ABCDE" when it comes to looking at moles but I also heard it's not so accurate. I heard of "gut" feelings but I also read ones which turned out to be nothing. Moles that people had since they were young that turned into something and at the same time moles that never turned into anything. I know it's not healthy for me to dwell on this especially since 2 PCP and a PA both didn't seem concerned about the one's I was concerned about. According to the PCP they won't do a biopsy unless there is something to be concerned about, according to my mom picking at these things aren't good and can cause problems. I also know 2nd opinions are always good which is why I'm seeing another Dermatologist in October and going back to the other clinic to see an actually doctor in November but it is also why I'm here on this forum. Mostly because I'd like to know why you guys think and because I'm officially and hypochondriac. Sorry for this giant essay, I hope you guys can give me some insight on what to do and of course thank you for your time!
ChD
Posts: 9
Joined: Jan 2014

Who, I just don't think it's possible for anyone on an internet forum to tell you anything definitive about these moles.  The fact is that it is almost impossible to diagnose a mole from a photograph, especially for a layperson.  It is challenging enough for a professional.  Though they are overall pretty good at telling the risky ones from the harmless, it is not an exact science.  For a layperson, it is almost impossible.  If you are worried, ask to have them removed and/or biopsied.  Removing a mole does not cause cancerous changes and it is a rather simple procedure to have done.  And you can continue to interview dermatologists until you find one who is willing to remove a mole that concerns you.

A few things:  It sounds like the doctor/PA has said most of these are not concerning, which is good.  You are getting a second opinion, which is also good.  If this next doctor also feels the moles are not concerning and you both agree not to have any of them removed or biopsied, what I would suggest is monitoring them closely for change, and many dermatologists will take photographs of moles to do this, especially when people have many of them.  It is a good way to keep an eye on your skin.  If the doctor doesn't do this, you can do this yourself.

With hypochondria, the anxiety you feel may be stronger than the reassurance you receive from the healthcare professionals.  It might be worth looking into treatment for anxiety too.  That is not to diminish your concern about your skin, but it might be a worthwhile adjunct for you as treatment.  But hopefully some of the above will be helpful to you in dealing with skin changes.  It is possible to have moles and freckles on the arms, or pretty much anywhere else for that matter.  We do get new moles periodically that are harmless.  But it is always important to watch for change.

Find a dermatologist you trust, and then, when all is said and done, use sunblock and avoid too much sun exposure and live your life!

Good luck to you!

Will Doran
Posts: 207
Joined: Sep 2015

For heavens sake get them all checked. 

I had a Stage 1 Melanioma removed 10 years ago, and we thought all was well.  I have been diagnosed with Porstate Cancer and have had a Radical Prostatectomy.  I was Stage 4.  I am in remission from the Prostate Cancer for 2 ytears.  However, My melanoma has come back and I have had 12 Melanoma surgeries in the last year and 2 months.  My former dermatologist was telling me all was well.  My Oncologists suggested that I change doctors.  I did, and my new doctor (a former student of mine) has been very thorough and has caught all of these melanomas in a very early Stage 1 or Pre melanoma stage.  I have 2 or 3 biopsies done every three months and they all come back positive.  They are followed by follow up surgery and every time I end up with 2 - 3 inch incisions.  All of the pathology has come back clean. Nothing in the margins or surrounding tissue. Thanks to the work of my doctors.  I will have DNA testing done in November.  There is research that says Prostate Cancer patients are at greater risk for Melanoma (Journal of Clinical Oncology).  So better to be safe than sorry. 

For your own peace of mind, Don't mess around.  Get to a good dermatologist and get them all checked.  Better to be safe and have peace of mind that you are OK. 

Good Luck.

Peace and God Bless

Will

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