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Q. I have a pink spot on the skin unnoticed for a longer period. What could it be?

Answered by
Dr. Vikas T. Talreja
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 14, 2020

Hello doctor,

I am a 22-year-old female. I have found a pink spot on my skin that resembles melanoma a little. I was wondering if I can send pictures for you to look at and let me know if it looks like that?

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#

Hi,

Welcome to icliniq.com.

I have gone through the picture and blood investigations that you sent. (attachment removed to protect patient identity).

This lesion is asymmetric and presents irregular borders and irregular distribution of the pigmentation presents border irregularity, color variation, and a nodular component of diameter ≥6 mm.

Before I make further diagnosis, I would like to know for the last few months is there any change in size and new lesion? Change in color? Change in shape? Is there inflammation? Bleeding or crusting? Sensory change? Lesion diameter ≥7 mm?

Meanwhile, I would like to classify this lesion as suspicious and would like to advise biopsy. For treatment, I would wait for the answers to the above questions and give you some iron and vitamin D supplements that are deficient in your body.


The Probable causes:

?Melanoma.

Investigations to be done:

Coagulation profile. Biopsy of the lesion.

Differential diagnosis:

Common melanocytic nevus. Atypical melanocytic nevus. Traumatized nevus. Pigmented actinic keratosis. Seborrheic keratosis.

Probable diagnosis:

Melanoma.

Treatment plan:

Iron and Vitamin D supplements. Injection Ferric Carboxymaltose 1000 mg in 100 ml NS over 30 minutes, Cholecalciferol sachet 60,0000 IU once a week for eight weeks, tablet Shelcal 500 mg twice daily. Biopsy of the lesion.

Thank you doctor,

Surprisingly I have not noticed it previously so I am not sure if there were any other changes previously and cannot answer the questions you have asked above. I have some very slight burning sensation but I have just begun to feel it as soon as I have noticed it so I am not sure if I am imagining it. I have started taking Vitamin D3 (10,000 IU cholecalciferol 250μg) and iron supplements as advised by my doctor.

Is there anything you could recommend me to do other than the biopsy? Would you recomend me to do it as soon as possible?

#

Hi,

Welcome back to icliniq.com.

May you review back with answers to the following questions.

When was the lesion (or a change in a pre-existing lesion) first noticed? Does the patient have a personal or family history of melanoma or other skin cancers? Does the patient have a history of excessive sun exposure and/or tanning bed use? Did the patient suffer severe sunburns during childhood or teenage years? Does the patient have a cancer-prone syndrome (eg, familial atypical mole-melanoma syndrome or xeroderma pigmentosum)? Is the patient immunosuppressed? Did the patient receive prolonged psoralen plus ultraviolet A (PUVA) therapy?

Meanwhile, I will advise you for the dermatologist opinion for dermoscopy examination of the lesion.

Thank you doctor,

I first noticed the lesion yesterday when I sent you the message. I do not have a family history of skin cancer. I have tanned for a few hours a month ago. I did not ever suffer severe sunburns. I do not think that I have cancer-prone syndrome and I am not immunosuppressed and have not received prolonged psoralen plus ultraviolet A (PUVA) therapy.

Also, at night I have put some of the cell food oxygen drops (I am not sure if you are familiar with it, I will attach a picture) on a cotton and covered the area with tape. I did this because I thought that maybe cancer does not thrive in a high oxygen environment and there were changes. I will attach an updated picture.

I truly appreciate your help.

#

Hi,

Welcome back to icliniq.com.

The oxygen therapy which you tried at home is neither under any regulatory approval nor amongst the treatment options available so I cannot advise you to do so.

However, in the best interest of the patient, the history looks to be benign nevi and I would advise you to observe it under close observation. When lockdown opens you can visit a dermatologist for dermoscopic examination and if then biopsy only will be needed.

Dermoscopy is a noninvasive, in vivo technique primarily used for the examination of pigmented skin lesions. However, it can also assist observers in assessing the lesions with little to no pigment. Dermatoscopy, epiluminescence microscopy, incident light microscopy, and skin-surface microscopy are synonyms.

Dermoscopy is performed with a handheld instrument called a dermatoscope. The procedure allows for the visualization of subsurface skin structures in the epidermis, at the dermo-epidermal junction, and in the upper dermis as these structures are usually not visible to the naked eye.

Cross-sectional studies, randomized trials, meta-analyses, and a 2018 Cochrane systematic review have indicated that dermoscopic examination has higher discriminatory power than naked-eye examination to detect skin cancer, including melanoma either in experimental or real-life clinical settings.

Let me know if there is any change in size, color, symmetry, number, and pigmentation of the lesions.


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