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Mystery Moles

Patients Afraid to Consult an Expert Put Their Lives at Risk

Because sun exposure is so often associated with skin cancers, those areas of the body that do not receive regular exposure, like the feet and ankles, are often overlooked when people are checking their moles. Further, if a person notices an area of concern, s/he may not seek a medical opinion out of fear of what it could be. That is what happened to Julie when something that looked like a scab turned out to be much more than she thought.

“I noticed what looked like a scab from time to time just above my ankle but never thought much of it,” said Julie. “But the scab continued to come back in the same spot over the course of a year, which had me nervous to get it checked out of fear it may be something more serious.”

During one of Julie’s regular visit to see Michael Coyer, DPM, AACFAS, a California-based foot and ankle surgeon, he noticed the spot and was concerned with its appearance.

“When I noticed this small mass on her leg, I felt that it needed to be properly evaluated to rule out any potential cancer risks,” said Dr. Coyer, “I took a biopsy of the mass and sent it for testing, and the results came back confirming that it was a Basal Cell Carcinoma—a form of skin cancer.”

Skin cancers of the foot, like basal cell carcinomas, occur more commonly than one might think. Although they are most common in sun-exposed areas like the face, they also appear on the lower extremities. There are three distinct cancers that can appear on the foot: melanoma, basal cell carcinoma and squamous cell carcinoma.

“Many people think that because their feet are often covered by socks and shoes that they are not at risk for skin cancers like basal cell carcinoma and melanoma, but these risks are very real,” said Dr. Coyer. “People should always practice at-home screenings and keep a close eye on any spots that may be of concern.”  

Performing regular inspections can aid in early detection and treatment to ensure the best outcome. The ABCDs of melanoma —Asymmetry, Border, Color, Diameter—is a good at-home evaluation tool for examining concerning areas:

  • Asymmetry: Is one half a different shape from the other half?
  • Border: Is the border or edge ragged, notched or faded?
  • Color: Is the color a mix of colors rather than a single, solid color?
  • Diameter: Is the diameter larger than 5 mm (the size of a pencil eraser)?

Being aware of these simple questions allows people to be honest about changes to their body.

As for Julie, Dr. Coyer was able to entirely remove the cancerous mass, lessening the chance of future reoccurrence. Since the mass was removed and the cancer did not spread to a different part of the body, Julie did not need to go through any additional treatments.

“I was fortunate to receive exceptional treatment from Dr. Coyer who had my best interests in mind during the whole process,” said Julie. “After going through this, I always encourage people to see a doctor if they suspect something is wrong, especially since delaying treatment can be much, much worse.”