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Dysplasic mole increases future risk of melanoma

By Keith Roach, M.D.

DEAR DR. ROACH: I recently went to my dermatologist because I noticed a dark mole I hadn’t seen before. He did a biopsy, and it was called a “moderately dysplastic nevus.” He recommended removal, which was done right away. During the appointment he mentioned that I am now at greater risk for melanoma, even though I have no family history of melanoma and I do not have a great number of moles. I do get a yearly skin screening, as I am at risk to develop cancer due to my misspent youth basking in the sun despite my fair hair and skin. I have tried to find more information online, but it’s been challenging to find things I can understand. Can you shed more light on this topic? — T.M.H.

ANSWER: Sometimes, the name itself can tell you much about what you need to know. “Dysplasia” comes from the Greek roots literally meaning “bad growth.” A nevus is a mole, in medical-speak.

Dysplasia is on a precise scale, from mild to severe, then to cancer. A dysplastic mole is potentially precancerous. Anyone with a history of dysplasia is at higher risk for that happening again.

Dysplastic moles are almost always darkly pigmented, as yours was. The major cancer risk in people with a history of dysplastic moles is the cancer melanoma. The increase in risk for a person with a single dysplastic mole is about 50% greater than the risk of melanoma compared with a person who has never had a dysplastic mole. The more dysplastic moles, the greater the risk.

In addition to your regular skin exam by your dermatologist, you should make it a point to check yourself for any new or changing moles.

DEAR DR. ROACH: We’re almost into flu shot season, and, at about the same time, I’ll be at eight months since my second Moderna shot, which I understand is when I’ll be eligible for the third one. Here’s my question: Should I separate these two injections by a certain amount of time to avoid any problems? And if so, what is an adequate time frame? — B.F.

ANSWER: When the COVID-19 vaccines were first released, doctors recommended against getting them around the time of any other vaccine. That advice has changed, reflecting our increasing experience with this disease. Currently there are no restrictions on getting the COVID-19 vaccine in terms of timing of other vaccines. However, if you had more than the usual sore arm and some fatigue with the first doses, you may want to wait until you are recovered from the COVID-19 vaccine before getting the flu shot.

Last year’s flu season was milder than in recorded history, because of mask wearing and other measures to reduce spread of COVID-19. I anticipate this year will also be mild; as such, I would not delay the COVID-19 booster for fear of interaction with the flu shot. Get the COVID-19 vaccine first if you are worried about side effects, then get the flu shot once you are back to normal.

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