I have been consulting with more and more patients expecting long standing moles to be removed by laser or cautery for cosmetic reasons. Removing pigmented moles without histology should only ever be performed for non-pigmented and non-cancerous skin lesions after a thorough clinical assessment and examination under a magnifying lens. Whilst many pigmented moles (melanocytic naevi) may appear very superficial, the “roots” of these lesions lie deeper in the skin (subdermal).
Although Malignant melanoma is a rarer form of skin cancer, congenital moles may be at slightly higher risk for melanoma. Even if these appear benign on examination, these pigmented moles should always be formally excised and sent for histology. If these are incompletely removed this carries the risk of “recurrent naevus syndrome” where the pigment returns within the scar, often within 6 months. These can look rather worrying, but also create a diagnostic dilemma for the pathologist if no original histology was sent. A recent tragic case occurred when a young man had a mole “burnt” off in a Beaty clinic, and died 18 months later from metastatic melanoma.
