Hi doctor, My son is 6 years old. He has one black mole on the left hand measuring about 5 mm in diameter with some elevated surface. It is from the last about one year and looking growing but can not sure about the growth. He has no complaint of itching and pain but when asked yesterday about this, today he is complaining of some itching and pain. I have one photograph of this for your review. Please advice.
Hi. I have seen the pictures. (attachment removed to protect patient identity). This is a mole in medical terms it is called melanocytic nevus. Majority of them are benign and go through growth cycle of inapparent to getting dark and with age slowly losing the color. But in some rare cases, they do have inflammation and can have itching or pain. In some patients there are numerous melanocytic nevi over the body in those there is a risk factor of melanoma. Moles which is present with itching and inflammation are not necessarily melanoma, but to be on a safer side they need to be removed and sent for histopathological examination to rule out any malignant changes in them. If your child has only one nevus and it is having inflammation but no sudden increase in growth it can be safely treated with anti-inflammatory cream. But if inflammation or increase in size or different color on different parts of the mole appears you should immediately remove it and send for pathological examination. You should share the histopathology report examination with me because some melanocytic nevi they do present histopathologically as malignant but actually are not so that has to be reviewed clinically. Histopathology report will be of malignant changes but only with clinical consultation and growth parameters, we decide whether it was melanoma or not. For the time being you can apply Hydrocortisone cream twice daily and Fusidate cream twice daily for five days. Give syrup Citizen one teaspoon once daily if there is itching. I advise not to irritate it or fiddle with it that will lead to more irritation. Kindly review after five days, if inflammation persists or there is an increase in size, it needs to be removed and sent for histological examination. By the time lockdown will also be over so you can always do that it will be a minor procedure and will be done under local anesthesia can be completed within half an hour. Genetic. Excision biopsy. Excision. No fiddling. Five days.