What is the Difference between a Mole and a Melanoma?

Moles can come in all different ways.  Some are brown, tan or even flesh covered.  Most are usually less than the size of a pencil eraser.  An ordinary mole can be present at birth and remain the same size, and color for many years. 

Melanomas are often larger than moles.  While common moles are less than 1/4^th an inch, a melanoma can be larger.  Common moles usually are the same color throughout, while melanomas have several colors or an irregular pattern.

Normal moles are usually round or oval with no border irregularity.  Melanomas do not have even borders and may be notched.  Melanomas are asymmetrical which means one half is different than the other half. 

Melanomas usually occur in people who have a higher number of moles, both irregular and larger.  If a family member has melanoma, there is higher risk for others in the family as well.

Lifestyle choices also contribute to potential melanoma development.  Frequent sun exposure, multiple sunburns at an early age, having fair skin, easily freckling, or having red or blonde hair can be a predisposition for risk of melanoma.

Be aware of any mole that changes, or a sore that doesn't heal.  Look closely at the borders of all moles and see if any of the pigment is spreading from the border into surrounding skin.  Be aware of any changes in sensation which may include itching, tenderness, or pain at a mole site.  Look for changes in the surface of a mole, if it oozes or bleeds.  Also look out for a mole that stands out differently than the other moles on your body. 

If anything looks or feels different come by the office and get a biopsy.  Pathology reports in about 7-10 days. 

Thanks for the questions.  Keep them coming. 

Justus Peters MD

Update on: A Walk in My Moccasins, Memoirs of a Deaf Physician

Greetings all,

I am very excited to finally finish this work in progress since i started over 10 years ago.  I hope it provides my readers with some insight to what life is like being deaf.  I've decided to go with Amazon's Createspace.com for publishing.  I have sent the final draft to the amazing Alexander Becker to do his magic.  For any aspiring writers check him out at http://www.alexanderbecker.net/

My next project is a long time dream of writing a novel.  I will also be starting a video log for this blog site.  If anyone has any questions, please do not hesitate to email me at runsinthewynd@gmail.com 

Happy Trails!

Justus Peters MD

Is it Food Allergies or Intolerances, and what to do about it?

Our immune system is continuously evolving to develop both immunity and allergies to new foods, drugs, chemicals, and the like.  But the recent guidelines released by the National Institute of Allergy and Infectious Diseases (NIAID) report that food allergies are increasing in prevalence. 

A clinical food allergy exists when a specific food causes an allergic reaction, namely hives, lip swelling, vomiting within 30 minutes of intake.  The most severe reaction is called anaphylaxis.   

Anaphylaxis is a potentially fatal reaction that causes swelling of skin and mucosal tissue like swollen lips, tongue and uvula.  It causes respiratory distress by constricting airways.  It causes decreased blood flow to end organs, like brain, muscle, bladder causing weakness, fainting, and incontinence. 

Almost always, anaphylaxis includes the skin with a rash that occurs within minutes to hours of eating a certain food.  These reactions should be taken to the ER as soon as possible. 

Milder reactions to food include flushing and itching of the skin.  These milder reactions can be treated with antihistamines like Benadryl. 

Children can outgrow allergies-- in fact about 80% of them outgrow allergies.  When adults develop food allergies, those tend to persist longer.

The NIAID recommends primarily prevention of offending foods to minimize allergies.  However, for expectant or breast feeding mothers, there is no reason to be eliminating foods.  They do recommend breast feeding in the first 4-6 months.  There is also no recommendation to avoid foods after that 4-6 month period. 

The best test for food allergy is the food challenge.  The food challenge is the best diagnostic test and should only be done under medical supervision where ability to treat anaphylaxis is near.

Food intolerances are simply reactions that are not severe enough to cause symptoms of flushing and itching or anaphylaxis. 

I hope this is helpful and please do not hesitate to email me at runsinthewynd@gmail.com, or blog at http://www.askjustusmd.blogspot.com/ 

Question: I am growing facial hair and can't have a baby. What gives?

I wish I could tell you what gives, but I think a couple things stick out.  One is that although the question holds a clue, I assume you are female, and two, that you have tried at least for a year to have a baby. 

Infertility is the failure to conceive after a year of trying.  A lot of things need to be looked at to determine why this may be happening.  The first thing to do is to make sure that the male spouse has sperm that work.

Sperm are supposed to do one thing and that is to swim in a straight line.  However, when observed under a microscope, doctors can see if there is possible insufficient sperm that cannot swim straight, but instead swim in circles or look like they seem to not care to swim at all.  The sperm count must be adequate as well.

The next step would be to have a doctor do a physical exam and make sure structurally all is well, and then order labs.  Hormone irregularities can cause a host of issues. 

Imaging the pelvis can tell us if you have any deeper structural issues.  One that comes to mind is possibly Polycystic Ovarian Syndrome (PCOS).  Diabetes will have to be ruled out, as well as uterine cancer, or endometrial hyperplasia.

Usually a doctor can diagnose this disease in the clinic, however, most PCOS show changes in menstruation, increased androgen hormones --hence the hair (hirsutism), or acne, obesity, and infertility.  1 in 5 women with PCOS have no symptoms at all. 

If a doctor suspects PCOS, labs will need to be done, a vaginal ultrasound to look at the ovaries will have to be done, and a treatment plan instituted.

If this is a problem you think you might have, call your doctor ASAP.  We would be glad to help in anyway. 

Remembering Resolutions and Keeping Them: A New Year’s Challenge

The first time I saw a New Year’s resolution list was when I was in Nursing School. A college educator and friend showed me his list and I became intrigued. New Year’s Resolutions are about starting over, and keeping a promise. New Years are synonymous with renewal of time, and thus a renewal of your soul and spirit. This enables many to think of challenging ourselves to be better. Some resolutions involve major change and some are small changes. But in order for your resolution to be successful, it is important have some good advice.
Keep it simple. The chance of failure increases when you set your sights too high. Making it a simple baby step with a specific detailed goal. A goal of weight loss of 10 lbs is more realistic than obtaining a model’s body.

Plan ahead. Thinking about how you will succeed in your resolution depends on good planning. There is a very good planning quote from Mark Twain, "the calamity that comes is never the one we had prepared ourselves for."

Utilize friends and family for support. In training, have a running buddy have your shoes, and you have their shoes. This way, you will have to meet up with the other in order to work out. Using family members for support is essential for motivation. They can help keep you on track and be your sounding board when you complain.

Understand that failure is not the end. If you have tried many times to complete your resolutions, just to fail by February, try to find out how and why. I know that it took Edison awhile to develop the light bulb, and Michael Jordan said, "you miss 100% of the shots you don’t take." Failure is just a stepping stone on your journey to success. Good luck with all your New Year’s resolutions!