Liver stain, birthmark, or naivus - each of us has some. Some are present since birth, many others come in the course of life. Really dangerous are the least of them. Conversely, approximately one third of all cases of black skin cancer ( malignant melanoma ) arise on the basis of a normal liver spot.
The brighter the skin type and the more acquired liver spots a person has, the higher the risk of developing black skin cancer. Other significant risk factors are accumulated skin cancers in the family and severe sunburns, especially in childhood and adolescence.
We now assume the following scenario: A liver spot is bleeding. What now?
The bleeding of a liver spot is primarily to be considered harmless, especially in areas that are shaved frequently, it can easily cause injuries.
In rarer cases, it can lead to spontaneous bleeding of a liver spot or bleed the liver spot heaped, one should consult a doctor to clarify the possible presence of a malignant tumor.
Blood is always a warning signal to humans. But with a bleeding liver spot is not always the worst. The important thing is how the bleeding has come about and whether the mole has changed in the past.
It can happen that raised liver spots in areas such as the face, armpits, legs or genital area during shaving are injured and bleed. Partly the bleeding can be terrifyingly strong due to the good vascular supply.
Here, however, it is important to keep calm, to wait until the bleeding is satisfied and to provide the cut only with a plaster. As a rule, such injuries are harmless.
However, if the mole is in a location where it is regularly injured, consideration should be given to removal. This also applies to liver spots on BH lines or other areas with stressed skin, where bleeding can occur more frequently.
Now, however, a mole suddenly starts to bleed and an accidental injury can be ruled out. In such a situation you should definitely take a closer look at the liver spot. Is it a relatively new skin condition or has it always been there?
If it's an old mole, has it changed lately? Relevant changes are mainly size increase or darkening / blackening.
Another symptom that may indicate malignant degeneration of the liver spot is itching or pain.
Any sudden bleeding liver patch that is new or has changed or has been scratched due to itching is in need of clarification. A presentation at the dermatologist or dermatologist is recommended.
When you run your finger over a liver spot, you usually feel a slightly waxy surface, which stands out from the rest of the skin. When shaving the skin, it may therefore happen that the liver spot is easily scratched or cut. Especially used and blurred razor blades hold an increased risk of injury. Mostly, such an injury is due to carelessness, as the liver spot is overlooked when it is not at a very visible skin site.
In rarer cases, a birthmark or liver spot may also be prone to bleeding under mechanical stress such as shaving if it shows malignant changes. Melanomas, basaliomas or even spinal allomas, all of which are tumors of the skin, are not always clearly distinguishable from benign liver spots and are often very sensitive to shaving. They usually bleed faster than a benign liver spot, as they are traversed by more vessels than benign liver spots. However, a malignant change is less likely.
In case of an injured liver spot, it should be rinsed with clear water and, if necessary, covered with a plaster. However, it can also be left to heal in the air. There is no cause for concern. After a few days, the small wound heals very well on its own. If severe swelling, redness, pain or even fever occur, it may be an infection of the skin tissue. In this case, a doctor must be consulted as this may need to be treated with antibiotics.
Liver spots are not a major problem for many people. However, bothering with the raised skin spots and scratching them can lead to bleeding. Liver spots can also itch and therefore be scratched. Often also scratches tight footwear or tight clothing on the liver spot and scratching him so.
First of all, this need not be a cause for concern. The liver spot should be washed off with clear water. Any manipulation in the form of ointments, creams, bandages or the like should be avoided. The best way to show the mole spot a dermatologist promptly to rule out a malignant change.
The incidence of skin cancer in society is increasing due to various factors, such as sun exposure or even genetic predisposition. Often, many early stage skin cancers are treated and cured very well. Therefore, especially early detection measures such as skin cancer screening are particularly important.
Skin cancer, such as malignant melanoma or spinal anomalies, can sometimes resemble normal liver spots and does not always produce clear symptoms. However, one possible symptom is an increased tendency of skin cancer to superficial bleeding. Especially with light mechanical stress, such as touches with textiles, shearing movements of the skin or slight scratching, such skin changes may tend to bleed. In most cases, the bleeding is not a one-off event in this case, but occurs more frequently. Accompanying itching, pain or typical changes in the shape, color or surface of the liver spot may occur.
It is not always easy to tell if a mole is benign or malignant. Dermatologists often require a follow-up of the liver spot over a period of time to detect malignant changes. Not always is the appearance of the liver spot clearly assessable, therefore, in many cases, liver spots are removed even with an unclear diagnosis as a precaution.
But how can one even recognize whether a bleeding liver spot is dangerous or not? Suspicious are frequent bleeding that occurs even with the slightest mechanical irritation of the liver spot. For example, the mere donning of clothes, scouring sweaters, the morning shower, or a slight scratching may already suffice for the occurrence of bleeding. Furthermore, frequent itching or pain on the liver spot are suspicious for a malignant cause.
A good scheme for the evaluation of liver spots are the ABCDE rules. Based on this, one can estimate whether a liver spot could be malignant. Below is a brief guide to self-assessment of a liver spot according to the ABCDE rules:
Liver stains can sometimes itch slightly and thus provide an incentive to scratch them. In the course of this slight, superficial bleeding can occur. At first, this need not be a cause for alarm. The itching does not necessarily have to be associated with a malignant disease of the skin, as is often claimed. However, it can also be a symptom of skin cancer. Therefore, it is recommended as a prophylactic measure to itchy and bleeding liver spots once a dermatologist to show so that he can make an assessment. Often the mole is then observed at regular intervals to assess its course.
In other cases, a liver spot with an unclear status or suspected malignant disease is removed and examined histologically under the microscope. Additional suspicious changes in the appearance of the liver spot (see ABCDE rules) support the suspicion. A doctor's visit should not be delayed. Skin cancer is very treatable in early stages, whereas at an advanced stage and a spread of cancer often no good treatment options exist.
An objective scheme for assessing liver spots is the ABCD rule. It is used both for initial assessment and in the course of preventive examinations. Even as a layman, you can roughly comply with any uncertainties.
However, a doctor should always be consulted for suspicious bleeding. The more criteria are met, the more suspicious is the liver spot.
A - Asymmetry: Unremarkable liver spots are usually regular round or oval and symmetrical. Asymmetries are suspicious.
B - Limitation: The margin of the liver spot should be smooth and sharply defined; frayed margins or foothills are indicative of degeneration.
C - color or color: color is sometimes the most important criterion, as changes in the liver spot are most noticeable over time. Suspicious are black to bluish, gray or reddish spots or several shades next to each other. A liver spot should not be paler either.
D - Diameter: Any spot larger than 5mm in diameter should be observed, as well as spreading liver spots.
In the meantime an E such as sublimity or development has been added. Majesty, whether the spot is palpable, is also a criterion. As already mentioned, the development of the liver spot with any changes is also very important.
The liver spot is examined by the dermatologist with the so-called dermatoscope, a magnifying glass with light source. Thus, the criteria can be assessed very well.
If the stain is now found to be conspicuous by the ABCD rule, it will be excised as a whole and examined microscopically. Malignant changes are detected at the cellular level and ensure the diagnosis.
Especially in old age, other benign changes occur, such as the seborrheic wart, which may at first glance resemble a black skin cancer.
For benign liver spots no therapy is necessary. A distance is even partially taken over by the health insurance companies, if the spot sits in a disturbing or stressed place. However, cosmetic procedures are not paid.
If the microscopic examination of a suspicious liver spot confirms the presence of black skin cancer after removal, the progress of the disease must be clarified. These include the removal of associated lymph nodes and the search for daughter ulcers ( metastases ) by means of imaging.
In the early stage, the removal of melanoma as a therapy is usually sufficient and the prognosis is good. In advanced stages with metastasis, chemotherapy is required and the prognosis decreases depending on the location of the metastases.
In order to detect suspicious lesions at an early stage, it is advisable to attend the check-up periodically ( every two years ) from the age of 35 years. All liver spots on the body are evaluated according to the ABCD rule. Any changes that occur can thus be best detected and observed in a temporal context.
In general, avoiding sunburns by sunscreen or staying in the shade is also recommended to reduce the risk.