Since you're still very worried I would just go to your dermatologist and get the area punch biopsied. If it was a real melanoma it'd be very difficult to scratch off the entire tumor. There would be some residual tumor left behind. More than likely it was a benign keratosis.
It's unusual for a mole to grown that fast. Because of that reason alone I would biopsy that site even though the lesion looks like a benign mole. There's no drawback in doing a nice flat shave biopsy. If it's benign good, that means you don't have to worry about it anymore.
I agree with Dr. Ibrahimi. If you were in your late 80's or 90's I would probably suggest radiation therapy, however at your age you need a more definitive treatment. Alar reconstruction isn't that hard in the hands of someone who knows what they're doing. The hard part is finding the right surgeon.
Lindsay. Even if it's been there for 11 years, sometimes these BCC don't grow as rapidly. Also the chin is an area that is not as difficult to reconstruct compared to other sites. Go in with a positive attitude. It might not be as bad as you think. I've had tons of patients who come in thinking they were gonna lose and ear or nose just to have a pretty minor surgery.
A malignant acrospiroma or eccrine porocarcinoma is a rare tumor. The best way to initially remove the tumor is through Mohs surgery. Working with a Mohs surgeon and a head and neck surgeon (otolaryngologist) would be the most appropriate way to address this situation. A neck dissection will probably be required after the initial removal.
