If a birthmark or liver spot changes its shape, color or size, it is important to seek medical attention. Even with newly occurring pigmentation spots in adulthood and any bumps that appear to be "somehow funny", it is worth rather once more than once too little to go to the dermatologist's office.
Often a glance from the specialist is sufficient
In most cases, the dermatologist (specialist in skin diseases) give the all-clear. Thanks to his years of trained eye and experience, most suspicious skin patches can already be labeled with gaze diagnostics and classified as harmless. (If these pigment spots visually interfere with or cause other discomfort, they will talk to you about a removal or other treatment option).
Incident light microscope allows insight into the depth
If a suspicious skin condition is very small or can not be assessed immediately for other reasons, a so-called dermatoscope is used. This loupe-like device is also called incident light microscope and simply placed on the appropriate skin site for examination. With the help of a special oil and a special light, the doctor can now see and evaluate even deeper skin layers uncomplicated. Only if there remains a residual doubt then further steps are taken.
If a liver spot can not be reliably assessed even under the dermatoscope, it is usually advised to excise it and have the cell structure examined by specialists under the microscope. (Even this measure does not mean that you have cancer - you just want to be sure). For small findings such as a birthmark, this procedure can usually be done on the spot with local anesthesia.
Complete removal of the pigment spot is the means of choice
As a rule, a safety distance of 2 mm to the surrounding skin tissue is recommended. In large pigment changes or those that are not so easy to remove for aesthetic reasons, usually a separate surgery appointment is agreed - either in the practice itself or in a dermatological clinic. Partial or punch biopsies should be performed to exclude melanoma today only in exceptional cases (for example, in very large, rather unsuspicious-looking liver spot in the face). If there is an urgent suspicion of cancer, the risk of spreading the malignant cells would otherwise be too great.
As soon as the so-called histological result, which has been determined by specialists with the aid of a microscope, is known, one knows for certain whether a pigment change is benign or malignant.
Author: Dr. med. Monika Steiner