Red spot on forehead in 65-year old

[Tatjana]

Dear Dr. Rockoff,

It is about my father who developed a spot on his forehead about 1-2 yrs ago, now 1cm in diameter.  It is pale red, not quite smooth to touch, but no extensive scaling either, it looks like the tiny capillaries are visible, although I cannot be sure that those indeed are the capillaries. It seems that the spot has gotten slightly bigger when I saw my father last.  He has been exposed to sun a lot, but always tanned well.  Please, take a look at the photo (for some reason, whenever I upload the photo it shows up blurry despite my efforts to resize, etc, so I hope the problem is in my comp. and that you will be able to see it clearly).  Of course I am worried about BCC or squamous cell carcinoma, but unlike very much advertised melanoma, I know very little about the appearance of these skin cancers, therefore I hope that you can help.  Many thanks for your advice.

http://i154.photobucket.com/albums/s242/BlueRose_011/red_mark-1.jpg

[Tatjana]

Thank you for your advice.  I will send my Dad immediately to the dermatologist.  One additional question I would like to ask you: Could dermoscopy help set the diagnosis in this case?

[Alan Rockoff, MD]

It may be a solar keratosis, a precancerous sunspot.  However, it may also be a basal cell carcinoma or a squamous cell carcinoma.  While these are not as serious as melanomas, they do need to be treated.  So what you need to do is have your father see a dermatologist, who can perform a biopsy and treat as needed.  Since this has been there for 1-2 years, I'd do this sooner rather than later.

Best.

Dr. Rockoff