Mole, Wart and Similar Skin Lesions

Any abnormal growth in the skin is called “skin lesion”. These lesions can be “benign” “benign but at the risk of turning into malignant” or “malignant”; therefore, it is important to distinguish these from each other. Mostly it is possible to make a diagnosis based on the appearance of lesions; however, lesions removed surgically should definitely be pathologically analyzed because even the ones though to be benign based on the clinical diagnosis can be at a risk of being malignant, even if just a bit.

Even if benign skin lesions cannot be surgically removed, they do not spread. Diameters of moles, medically known as ‘nevus’, can grow in the course of time, and new ones may emerge as they grow old. In addition, there may be brownish skin lesions on a level with the skin, which emerge depending on the sunlight, hormonal effect or aging. Of course, they can be treated with medications of surgical procedures.

If not surgically removed, some skin lesions are likely to turn into malignant lesions. Brown or red lesions called “actinic keratosis”, which emerge with the effect of the sun’s rays, are the best examples in this regard. These lesions are likely to turn into squamous cell skin cancer.

In the course of time, lesions that have turned into malignant grow and spread to other parts of the body.

Distinguishing Moles from Malignant Melanomas

The moles in your body should be examined on a regular basis, in order to prevent melanoma formations. According to the latest studies, some kinds of moleas are more likely to turn into malignant. Congenital moles and moles different from normal ones, which are called “atypical” moles, are in this group. The table below can be useful in distinguishing moles. The findings that should be considered regarding a mole’s possibility to be malignant are as follows:

Removal of Skin Lesions

In the removal of skin lesions, it is a must to get help from a plastic surgeon. Since these are lesions that seem to be simple, many surgeons and even some dermatologists can take the risk of intervening in them. However, those who are experienced in this field are plastic surgeons. Plastic surgeons can remove these lesions from deeper boundaries, in such a way as to leave less scar and pose a lower risk. Removed lesions should definitely be sent for pathologic examination.

Brownish formations on the skin are usually moles that are medically known as “nevus”. They can be congenital and can also emerge in later periods of life. Moles can be swollen or on a level with the skin. They can grow gradually. They are usually removed for cosmetic purposes or because of the fact that they are likely to turn into malignant. Nevus can usually be distinguished from malignant melanoma. Melanomas may be brown, red, white, black, or multicolored. If the lesions are thought to be likely to turn into malignant, they should be removed with very wide boundaries around them. Sometimes, after removal of these lesions, skin transplant (grafts, flaps) may be required for the repair of the place, from where the lesion has been removed.

Patients with this type of lesions on their faces are usually worried about the potential scar that would be left by the surgical removal of their lesions. Therefore, skin lesions should be removed by plastic surgeons. Postoperative healing differs in different areas of the face. Surgical technique to be applied differs as well, depending on the area from where the lesion will be removed. The surgeon who will carry out the procedure needs to have a good command of all these techniques.


Wart is a skin tumor caused by various types of virus. Warts are small and hard lesions with distinctive boundaries, which are on a level with the skin, or are raised from the skin. They are medically known as “verruca vulgaris”. Since there are a wide variety of warts, they are classified according to their appearances or place where they are settled. Warts can be seen any part of the body (on the skin, in the mouth, throat, genitals etc.).

The group of viruses that cause the development of warts is called “human papillomavirus”—HPV. There are about 90 varieties in this group of viruses. Some of these cause wart formations on the skin, whereas some others cause such formations in the genital area.  Warts are contagious, and can be transmitted to other people by direct contact.

Warts can be seen at every age. Some of them can go away on their own, and some others may be long lasting.

The most common type of wart is seen on the skins of the hands and feet as well as on the nails. These are pale and raised lesions. They are not likely to become cancerous. They do not cause pain, and go away on their own. The treatment is intended to prevent the wart’s spread to other places of the body, and also prevent its transmission to other people. Their risk of recurrence after treatment is high. Unraised warts developing on the skin surface are mostly seen in children. Although they are mostly seen on the skin surface, they can also develop in other parts of the body. Since they are on a level with the skin or slightly raised from it, they are more difficult to identify. Such warts are mostly itchy or painful. They are likely to spread from person to person.

Warts developing on the soles may be mistaken for calluses. In general, they are lesions causing pricking pain that can be at a level that impedes walking or standing. Because spread may be very quick, they should be treated quickly. Warts on the sole are like an iceberg. The parts seen outside are smaller than the parts inside. Patients who have not severe pain may usually talk about feeling as if they have a stone in their shoe.

Genital warts are small, grayish lesions seen in the anus or the genital area in men and women. They can spread by direct skin-to-skin contact or sexual contact, and can also be seen in the mouth area. They can also spread to the baby during birth. These warts are quite contagious. Those who have a sexual intercourse with someone who has genital wart are at 60% risk of getting infection. Lesion is not necessarily seen in a person who has gotten infection. Even those without lesion increase the risk of genital cancers occurrence in women.

In the treatment of warts, some medical treatments that involve the use of salicylic acid, cantharidin, etc. can be used. The ones unresponsive to medical treatment or the ones requiring emergency treatment due to their settlement area (warts on the soles, genital warts) should be removed surgically. Since the recurrence rate of genital warts is too high, surgical treatment is preferred for reducing this risk. The removed warts are sent for pathologic assessment.

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Prof. Dr. Murat Emiroğlu
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