Diagnosis

The majority of liver spots are harmless new formations.Nevertheless, changes in liver spots, such as a change in shape, size or color, as well as the appearance of bleeding, itching, painful, weeping or new liver spots should be brought to the attention of the affected person and presented to a dermatologist (dermatologist). With the help of various examination techniques, the dermatologist can differentiate between harmless liver spots and malignant liver spots that can lead to the development of malignant melanoma (black skin cancer) and thus initiate early treatment if necessary. However, inconspicuous liver spots should also be checked by a dermatologist at regular intervals, for example, as part of skin cancer screening.

As a rule, the examination by the dermatologist begins with an examination of all liver spots with the help of a special magnifying glass, the dermoscope. This enables the dermatologist to view the liver spots under magnification and illumination. The dermatologist proceeds according to the so-called ABCDE scheme: Liver spots that suddenly bleed, itch, hurt or wet are considered suspicious.

The more criteria of this ABCDE scheme apply, the more likely it is that the mole under examination is malignant. Complete certainty as to whether the mole is benign or malignant can only be provided by a fine tissue examination of the mole by a pathologist. For this purpose, tissue samples of the suspicious mole must be obtained, which can finally be viewed under a microscope.

This allows healthy cells to be differentiated from abnormal cells. Tissue samples are often taken during a biopsy, during which parts of the suspicious mole are taken. Often, however, the suspicious mole is also simply removed in its entirety.

Stands for asymmetry (an uneven liver spot is suspicious)
Stands for border (an irregular or frayed border of the mole is suspicious)
CStands for coloration (a multicolored mole or a color change, for example a sudden black color of the mole is suspicious)
It stands for diameter (increasing in size or moles larger than 6 millimeters are suspicious)
Stands for grandeur (a mole protruding from the skin level is suspicious). The development of the mole also falls under point E.

Liver spots do not normally need to be treated, as they are usually harmless neoplasms. Bleeding, itching or painful moles that show changes in shape, size and color should always be treated, as they can increase the risk of developing a malignant cancer, malignant melanoma.

The timing of the therapy is particularly important. The earlier the suspected mole is treated, the better the prognosis. The treatment of suspicious liver spots consists of surgical removal.

Surgical removal of the suspicious mole is performed as a whole and with a safety margin of about two centimeters from healthy tissue. In addition, the affected skin area must be operated on sufficiently deep, i.e. all skin layers down to the muscles in the affected area must be completely resected. This ensures that no degenerated cells are left behind at the affected skin area, thus reducing the risk of recurrence of precancerous lesions at the same site.

The removal of the suspected mole can be performed under local anesthesia. This means that no general anesthesia is required for this procedure, but only an anesthetic (pain-relieving medication) has to be injected into the affected skin area. The removed mole is then sent to a pathologist, who examines the mole under a microscope and can classify it as benign or malignant.

Depending on the results of the pathologist’s examination, further examinations follow. But not only liver spots that show suspicious changes such as itching, pain, weeping, color changes or bleeding are removed surgically. Also liver spots, which due to their shape, color, size or localization lead to a cosmetic impairment of the affected person, can be removed surgically.