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March 18, 2011 / molehunter

Globular naevus with irregular border

This lesion caused concern as it was dark, irregular, and over 1cm diameter.

This naevus is mildly geometrically irregular with an iregular edge, but architecturally even and of essentially even colour. The slightly darker centre is of no concern, neither are a few dark but not strikingly abnormal globules situated clustered near enough the centre of the naevus. The irregular border and lack of perfect symmetry are not enough to cause alarm in view of the dermoscopically very regular medium brown colour and globular architecture.

Management- measure, advise, photograph if you are a bit paranoid or if there is a significant history,  review if changes. ALWAYS advise review if there is significant change. Dermoscopy can do many things, but it cannot predict the future.

NB as it has been said ‘recent change trumps everything.’ If there was a clear history of this mole emerging from nowhere over the last 6 months, especially in a previous melanoma patient, you would be very much more concerned. Having said that, this is a typical case where a somewhat worrying naevus looks much less worrying on dermoscopy. As long as there is no history of recent change.

NB A recent student said to me ‘if in doubt, why not just chop the mole out?” I replied, because it costs money and causes pain and scars. Besides, skilled dermoscopy can often remove that doubt.


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