A few dark moles on the back
Can you check my moles doctor? Why sure! The back is a high risk site as it gets more burnt, also may be less visible. It is good practice for a doctor to opportunistically inspect the backs of older white patients, especially those who are living alone.
Older white person’s back with seborrhoeic keratoses and moles
Several lesions to see. Some have the typical stuck on appearance and crusty feel of seborrhoeic keratoses, others are flat and dark. These are true moles, melanocytic naevi. Are they safe? Let’s use the dermoscope.
This shows reticular network (lines reticular) in a multifocal pattern, mildly irregular but not enough to worry about. The fact of the brown being a little darker nearer the middle is of minimal to zero concern. This mole is mildly atypical, but NOT dysplastic- the latter is a histopathology term. No worries- it is flat and has no colours other than brown.
Let’s scope the next mole.
Very bland, even medium/ light brown, apart from the darker blob. But if we study this, it is well defined and has some pale clods (milia like cysts). It is a tiny seborrhoeic keratosis growing on top of a mole, just as a barnacle may grow on top of a mussel shell. Harmless.
The other 2 dark moles are equally innocuous.
One colour, one pattern, flat- no concerns.
Examine enough older white people’s backs and every now and then you will see something nasty, but it’s important to study lots of harmless naevi to get a feel for the range of normality.