Moderate Atypia. Is It Melanoma?

I am almost 22 and have been tanning in beds since I was in a preteen. (I won't be anymore) I got the results back from a biopsy and the mole was "moderate atypia." I have to go back in a couple weeks so my Dr can remove the skin around where they cut out my mole on my stomach. They said I would get stitches from this. Does this term "moderate atypia" mean I have cancer? What does it mean? Will I have a big scar from this next procedure where they remove more skin around it? Should I be worried?

Doctor Answers 11

Moderate atypia is not cancer, nor is it "benign"

Having a mole that shows "moderate atypia" means that if you do not have it removed, it could progress and "change" into a cancerous, (malignant), skin tumor. Takiing out a small amount of skin around the lesion is appriate to assure "total" removal of all the abnormal cells, but this is typically a small amount of  of additional skin.

Crestone Plastic Surgeon
5.0 out of 5 stars 3 reviews

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You are doing the right thing

Because it is not a cancer you only need a very thin margin of normal skin around it when it is removed. Yes there will be a scar, but it ought to be fairly small and fine, and become less conspicious with time, (as opposed to the mole which may likely have grown).

I agree that with your history of tanning - an annual visit to your dermatologist is more than just a good idea. It might literally save your life.

Christopher J. Peers, MD
South Bend Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

A moderately atypical mole is not melanoma, but should be removed.

Do not panic. "Moderate atypia" in a mole means that some of the cells have started to behave abnormally, and it is more than "mild" but not "severe". Melanoma is a mole that is "beyond severely abnormal", but you do not want to leave the remaining portion or border of a moderately atypical mole in your skin, because over time the remaining cells can continue to change, and it is very hard to follow visually. Best to have a small excision with stitches, get clear margins, and learn to watch future changing moles and bring them to your dermatologist's attention. It is also important, especially for someone with a history of tanning and changing moles, to get an annual head to toe skin cancer and mole check by a board-certified dermatologist (your annual physical with your internist does not count).

Jessica J. Krant, MD, MPH
New York Dermatologic Surgeon
4.5 out of 5 stars 41 reviews

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Moderate Atypia

No, Moderate Atypia doesn't mean that you have cancer. It means that your mole if not
removed has the potential to become malignant. Its good that you are having the       
surrounding skin removed to insure there is no chance of developing skin cancer in the



Edward E. Dickerson, IV, MD
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Moderately Atypical Nevi are controversial...

Your questions are very good ones.  In short, moderately atypical nevi (moles) are not cancerous.  When you get the lesion removed, the scar should be slightly larger than your biopsy scar.  Usually these are excised and closed in a linear fashion; so you should just have a fine line for a scar (with the length determined by  the size of the mole). 

Atypical nevi (moles) are very controversial lesions.  I would say the most dermatopathologists don't believe that they are "pre-cancerous" anymore.   The main thought is that having these lesions means that you are at a higher risk for developing a melanoma at another site.  Melanomas can develop from atypical nevi, but this is not how they usually come up.  Melanomas usually arise de novo (they come up from no preexisting lesion). 

Different dermatologists and dermatopatholgists manage atypical nevi in many fashions.  Personally, if I see mild atypia, I usually just watch the lesion.  If it is moderate, I usually talk to the dermatopathologist for his/her opinion on removal.  If it is severe atypia, it is getting cut off.  Other dermatologists watch these lesions, and other dermatologist cut out even the mildly atypical ones. 

Atypia means that the nevus cells have an atypical appearance themselves (cytologic atypia) or are arranged in an atypical pattern (architectural atypia).  It does not necessarily mean that these cells are cancerous.

Should you be worried?  Well you don't have to worry that you have cancer right now.  Use this as a warning to be very diligent with you sun protection from this point forward.  Also perform regular self-skin exams and get regular examinations from your dermatologist. 

Brent Spencer, MD
Frisco Dermatologic Surgeon
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Atypical moles are important

Great question- and you are right to be avoiding tanning beds from now on.  Atypical moles are neither cancer nor regular moles.  Controversy exists as to whether they are "pre-cancers" or simply a sign that someone is at higher risk for skin cancer.  Under the microscope, cancers are seen developing within these lesions, so I agree with your plan to have the mole completely removed so that you do not have to worry about it.  The size of the scar depends on many things and is an individual outcome which can not necessarily be predicted ahead of time.  Regarding the degree of atypia, "moderate" is right in the middle.  Severe means that the mole looks almost as bad as a skin cancer under the miscroscope, mild means it is barely atypical- almost like a regular mole.  Since yours is in between, it's a good idea to remove it, to avoid tanning and to have regular skin checks.

Victoria W. Serralta, MD
Arlington Dermatologic Surgeon
5.0 out of 5 stars 1 review

No one really knows

The world is grey - at one end of the spectrum are completely normal moles (Cindy Crawford, Clint Eastwood, Marilyn Monroe) and at the other end of the spectrum is melanoma, a very deadly cancer that often affects all ages.  Atypical or dysplastic moles are in that grey zone in the middle.  Some experts declare that these atypical moles are just funny and will always stay that way.  Other experts state that they are "premelanoma", and if left untreated will progress to melanoma. More evidence is showing that moderately and severely atypical moles can progress to melanoma so the consensus at this time is to conservatively remove moderately and severely atypical moles with small margins.  It is better off your body!

Jennifer T. Haley, MD, FAAD
Scottsdale Dermatologist
5.0 out of 5 stars 5 reviews

Removing atypical moles or revision of atypical mole biopsies

Atypia is a staging tool that is used to gauge the extent of abnormal cells in the skin biopsy. Although atypia is not considered cancer, it warrants immediate attention. 

Raffy Karamanoukian MD FACS
Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
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Moderate Atypia and skin cancer

When the pathologist who reads your biopsy they grade the moles on how atypical they are.  Moles can be slightly atypical, moderately atypical, or severely atypical.  Generally the dermatopathologist who examined the slides of your biopsy will recommend to the clinician (your dermatologist) what kind of removal is indicated.  If they think it is not too serious they will recommend a deep shave removal.  If the pathologist is more concerned about the cells in the mole they will recommend a surgical excision.  Please seek out a board certified dermatologist who is associated with an excellent laboratory for the best results.

Moderate dysplasia

Dysplastic nevi (moles) are NOT melanoma. They are a marker for an increase in melanoma risk. Most melanomas (75%) arise from normal skin, not from pre-existing moles. However, if a mole is changing or growing, or if it looks different from other moles, it may be biopsied to rule ouy melanoma. If such a biopsy comes back as a dysplastic nevus with moderate, focal severe, or severe dysplasia, it needs to be excisied (completely removed or cut out) to make sure it doesn't turn into a melanoma later on.

Gary Goldenberg, MD
New York Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.