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    Old 08-04-2004, 09:15 PM   #1
    KarynLR
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    Questions for those with dysplastic moles...

    Hi all,

    About 3 years ago, I had a mole removed via excision surgery. It turned out to be dysplastic, but as I understand, these types of moles are more susceptible to cancer later in life, and was very glad we took the whole thing out. Yesterday, I had a full body screen, and had a couple moles removed with a shave biopsy. Dr. D said his "initial diagnosis" was dysplastic nevi. If this is the case, should the surrounding area be removed then? He didn't mention it, but it has me thinking. My brother who sees a different derm in the practice had a shave biopsy that was dysplastic, but I think had to have the surrounding area removed with excision surgery. What is common practice?

    Thanks,
    Karyn

     
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    Old 09-12-2004, 05:06 PM   #2
    Kitta
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    Re: Questions for those with dysplastic moles...

    Hey Karyn
    I too have dysplastic nevi moles, lots of them. All of mine have been flat and had to be cut out. Have you seen the doctor since this last post?
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    Old 09-12-2004, 05:43 PM   #3
    lisa1991
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    Re: Questions for those with dysplastic moles...

    Hi I have alot of moles. I have had malignant melanoma and basal cell cancer. I have my biopsies sent off to pathology and if it comes back mild they do not worry about. They have the patholigist report because insurance will not pay if they cut it out and it was not bad. Make sure it was sent to a pathology lab. I have had 22 moles biopsied and about 12 removed.


    Lisa

     
    Old 09-12-2004, 09:14 PM   #4
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    Re: Questions for those with dysplastic moles...

    Quote:
    Originally Posted by lisa1991
    Hi I have alot of moles. I have had malignant melanoma and basal cell cancer. I have my biopsies sent off to pathology and if it comes back mild they do not worry about. They have the patholigist report because insurance will not pay if they cut it out and it was not bad. Make sure it was sent to a pathology lab. I have had 22 moles biopsied and about 12 removed.


    Lisa
    That's pretty much what he said to me. That it could warrant removal, but it's so borderline the insurance company wouldn't cover it. Gotta love that insurance. Sometimes you wonder. They would like to pay for treatment of a melanoma in the future, but not a mole removal now. Hmmmmmm. Anyways, he isn't worried; we just check the bad spots every 2 months for changes. Has anyone got that special mole computer thing? They take close up pictures of your body so you can compare moles for change. I have quite a few moles we are "watching". When I asked him how you "watch" moles for change, he said, "That's a good question!" I am confused about what constitutes mole removal, especially with the ABCD's. If you have one mole that is A, B, C, or D, doesn't that warrant removal? I have also been taught that any mole that appears is bad--and I am getting a bunch of them on my foot--speckled dysplastic nevi. I just had major foot surgery, so my derm, who doesn't like mole removal on feet anyway, is very wary of removing them, but I don't want these to stay in if they become cancerous! I will see him tomorrow, and I have yet another nevus popping up on the foot, so I'll mention it to him. He did say to me last visit, "Don't worry, you'll get skin cancer sometime in your life." How nice; I feel so relieved (No, he acts like a smart aleck, but he's really a sweetheart. I love him!)

     
    Old 09-13-2004, 04:33 PM   #5
    Kitta
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    Re: Questions for those with dysplastic moles...

    Hey Karyn
    As a matter of fact, I just visited my Derm last week, for my 3 month checkup at which I had three more moles that looked like they are changing into the scrambled egg effect. I told here there was no way I could keep up noticing if a mole is changing since I have hundreds of them and new ones appearing every day. She gave me a brochure on "MOLE MAPPING". I haven't called them yet, but from the paper, it cost about $350 which includes photography, production of MoleMap CD, and shipping costs. I don't know if they do a checkup or just send the CD to your regular Derm for them to review. I'd have to drive several hours to get it done but I'm at such a panic stage I may end up doing it. I'd be glad to give you the numbers/contacts I have if your interested. Kitta...
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    Old 09-13-2004, 10:06 PM   #6
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    Re: Questions for those with dysplastic moles...

    Kitta,

    Who does the Mole Mapping? Does a dermatologist take the pictures? Where do you get it done? I do think it would be a good idea. Two comments: have you asked your derm if she thought this might be covered by insurance in the next several months or so? If that's the case, you might just keep doing 3 month checks with her until it happens. Also, my derm was telling me that if a doctor writes a prescription for an OTC or out of pocket thing like this, some companies cover part of the cost. Just something to look into! Those companies are strange... wouldn't the $350 cost be better than a bunch of unnecessary biopsies? I just had major foot surgery to correct damage from a podiatrist's surgery. My insurance company has shelled out close to $30,000 in hospital, doctor, and diagnostic testing bills, but would not cover the $75 orthotics that the podiatrist should have given me before he opened my foot--go figure!

    We decided to remove one or two of the moles on my foot. One is getting darker, and they keep popping up, which concerns me. My derm is not as worried, but we will wait until I am done with therapy in a month or so to remove them. He keeps telling me that he hates operating on the foot, and I don't know why. My foot is already horribly hacked up with a lovely scar; what do I care if there is more scarring? He might have my orthopaedic surgeon take it out; we will see. Would you go with the derm? I know he will get the pathology report etc, but it's in the area where my OS operated...

    Thanks for the response,

    Karyn

     
    Old 09-14-2004, 04:25 PM   #7
    Kitta
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    Re: Questions for those with dysplastic moles...

    Mole Mapping Info.
    I spent several hours on the phone today trying to see if this would be covered by insurance. I live in NC, so the closest facility is Duke University of Medicine, Durham, NC. This procedure takes 34 pictures which cover about 98% of the body surface with a high resolution digital camera. They then have to send to South Carolina to be processed. A copy of the CD is sent to yourself and your regular Derm. Patients must be referred by physicians. I tried to find out an insurance CPT code to ask my insurance if they would cover this, but no one could give me a code, so the insurance company is checking further for me tomorrow. But, the Derm at Duke did tell me that if I got the CD pics taken and a complete body check-up with their docs there, they would include and add in the CD process cost into the exam charge and possibly be covered that way. I may end up doing this once a year at Duke, and then the other 6 months at my regular derm. If anyone is interested to contact them: phone: 919-684-6159 patient appointments, 919-684-3748 account & billing info., 919-684-8803 fax.
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