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The response to the question below was authored by Marc Mitnick DPM

Freckle on foot.

by Cindy
(Washington)

Freckle on bottom of foot - biopsied found to be "weird".

In February 2008 I had a biopsy on a freckle on the bottom of my left foot that I discovered a year and a half ago. The PA removed, or "punched" 5mm in the biopsy which resulted in 4 stitches. Treatment for recovery was a band-aid. Recovery was very painful as I was not told to stay off it I chased my three children around and ended up hurting ankle/knee/back as a result of walking funny for a week. When the results came back they said the freckle was not cancerous but "weird". They would like to remove twice the area around the original site. I am most concerned with their response to my questions regarding recovery and experience removing skin on the bottom of a foot. Apparently they will need to do both internal and external stitches and said it should be fine with a band-aid. This area of my foot gets stretched with each step. The site is near the ball of my foot in my arch about in inch in from the inside of the foot. What is your recommendation for recovery and response to this PA's advice?

Hi Cindy,
You have to be very careful about excisions on the bottom of the foot. The number one concern is scarring and you are 100% correct that the "stretching" of the skin that you refer to could lead to scarring if not properly closed.
Depending on the actual location of the growth I sometimes keep my patients nonweightbearing for three weeks in order to prevent scarring.
At this point I would recommend the following:
1. Have another lab look at your biopsy slide because "weird" is not a diagnosis. I think you are entitled to a better explanation than that; it just tells me your PA did not research the actual diagnosis. Most of these types of biopsies come back as "dysplastic" which means noncancerous cells, but cells which are not normal either.
2. If you are going to need a wider excision this is not a job for a PA, I would recommend you see a podiatrist and if there is not one near you, I would recommend a plastic surgeon.
Good luck
Marc Mitnick DPM

Comments for Freckle on foot.

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Jan 29, 2016
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Dermatologist opinion
by: Anonymous

I am a dermatologist and have personally had a mole removed from the bottom of my foot so can sympathize. The pain can be excruciating and then it feels like you are walking on a lump for about 3 months. It will eventually heal though most of the time, so take pain medication, use ice and elevation aplenty. Prior to a larger excision on the foot, the pathology should always be reviewed by an expert dermatopathologist as moles on the hands and feet tend to look "weird" as part of their normal spectrum.

Oct 05, 2013
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Foot pain nightmare after a biopsy
by: Eve

I wish I had read your comments a week ago. I was not in any pain when i went to see a dermatologist for my face. The PA looked everywhere and found an unexplained black mole under my foot. A PA took a small piece and then i was called back to take out a bigger piece out. I was apprehensive at first but trust the dermatologist opinion that a bigger piece was needed and necessary to rule out anything bad. This time the dermatologist took out the piece as large as a nickel and much deeper than i could have imagined. I did receive written instructions for after care, but not exactly for my foot. I have shooting pain in the morning. It takes me a good 1/2 hour before i can put my foot down. It is almost as though the blood that did not flow as i was sleeping, was causing me pain as i tried to put my foot down. I am shock that i was not told to stay in bed for a few weeks. I have been going to work as normal, walking back and forth. I feel like i need crutches or a wheelchair. 4 days after i went back to the dermatologist, and he said everything looks good and referred me to a podiatrist due to my concerns. I'm going to see a podiatrist in a few days, i will see what they recommend. I hope that i will be normal in a few weeks. The tests came back negative and i hope i did not bring myself a lifelong of unnecessary pain for listening to doctors.

Does anyone know anyone who had this procedure where they actually found cancerous cells in that mole?

Oct 05, 2013
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Oct 05, 2010
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Weird
by: Anonymous

I am not a doctor;however, I have read a lot about reflexology. My suggestion to you would be for you to seek out a doctor in Chinese Medicine. In the mean time pick up a refexology book and find out what is going on in that area that is painful to you. The reflex points on the bottom of your feet indicate something else is going on with your body.

Jun 02, 2010
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Interesting
by: Anonymous

I am going through this exact thing right now, and I am concerned that I too will have to have more of the area removed.

I was also not given any instructions about how to treat the huge hole, which is now at the bottom of my foot caused by the biopsy. It sounds like my frekle and now hole is in the exact same place as yours. I have two preschoolers, and if they have to take more, I think it might be a little difficult. What is your follow up? Did you have more of the skin removed? If, so what did you do

Dec 01, 2009
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question for dr.
by: Anonymous

Hello,

Quick follow-up: a little over a month ago, my dermatologist did a punch biopsy on the sole of my left foot to check out a mole. I was limping around quite a bit for a couple of weeks (I'm severely flatfooted and the spot is about one inch from the center of my arch).

They took the stitches out about three weeks ago (it wasn't cancerous or anything--just a mole). I'm no longer limping but the area is still sore. The skin there is very slightly raised and very taught.

Is it normal to still be sore like this three weeks after getting the stitches out?

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San Diego, CA

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Colorado

Wonderful advice

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

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Florida

Dear Dr. Mitnick, Thank you so very much for taking your time to answer my question. You have greatly relieved my anxiety related to the continual tingly I feel in my feet. I will share your response with my podiatrist next week. God bless you for having this question and answer page on your website! Most gratefully,

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New Jersey

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a mom

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Bellevue, WA

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Jodi

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Freckle on foot.

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