could it be skin cancer??

[topcow]

my 9 yr old son was born with a light pink/fleshy colored birth mark on his scalp behind on ear. About 2 yrs ago it began to slowly change. But in the past eight months or so it has changes rapidly. It now is bigger, pinker, and has what look like lots of tiny skin tags growing on one half of it. I also recently found a spot on his big toenail. It appears to be dark brown and resmbles a mole except there is a tiny streak coming off the top of it. He has not hurt his nail, and hasnt gotten any splinters..besides, it is too far down on the nail to even be a splinter. could either of these be skin cancer?

[Dennis MD]

Hi.
You can observe the lesion on his toenail for changes.
A mole can transform into a malignant lesion.  As I've said earlier, when it changes in size, border and color, when it ulcerates and bleeds, there is a probability that it is becoming malignant.
Usually, a dermatologist will only remove superficial lesions. The location of your son's mole is in the head behind the ear.  A plastic surgeon is more trained in doing the excision in that location.
If it will give you peace of mind, push for an excision and have the specimen examined by a pathologist.

[topcow]

I was able to get my son seen by a dermatologist today but now i am even more confused. He barely even looked at the spot under his toenail and then said my son has hurt his toe and it will grow out with the nail. but the thing I was most concerned about was the birthmark. The doctor looked at it, rattled off the type of birthmark it is, says it has  about 15% chance of turning cancerous, but that it isnt now...how he knows that without a biopsy I have no idea...then he tells me that I could have it removed if I dont like the looks of it. But he said he wont do procedures on the scalp anymore "because those scalps just bleed and bleed" so I need to take him to a plastic surgon to have it removed. Can he really tell by looking at it for 1 minute and not doing a biopsy if it is cancerous or not?? He also told me it WILL NOT get bigger in diameter, just "grow upwards" but I tried telling him that it ALREADY HAS gotten much bigger in diameter. He just ignored me.

[Dennis MD]

Hi.
A definitive diagnosis of skin cancer can only be made by biopsy.
The lesion found on your son's big toenail could be subungual hemorrhage or pigmentation.
A mole that rapidly changes in character (change in size, irregular borders, ulcerations) warrants further examination.
It is best to have your son checked by a dermatologist for proper evaluation.
Good luck.