By Scott Thomas, DO and Benjamin Perry, DO
One of the most common reason that patients come to our office is the evaluation of pigmented spots or growths. As dermatologists, our primary concern in evaluating these pigmented spots is to make sure that they are not a melanoma.
Considered to be one of the most dangerous cancerous growths, melanomas originate from pigment producing melanocytes present in all people within the upper layers of the skin. It is this pigment production which gives people their skin color. These melanocytes are present in your eyes and in your mouth, and under nails, meaning that less commonly, melanomas can arise in these locations as well.
Some sources state that approximately 50% of the time melanoma will arise within an existing mole. This means that it is important to perform regular home self skin checks to not only monitor for any new pigmented spots but also to monitor existing moles for any new changes.
If melanoma is recognized and treated early, it is nearly always curable. However, if found late, melanoma can frequently spread to other parts of the body and may lead to a fatal outcome.
Despite medical advances in screening and prevention of various cancers, rates of melanoma have continued to increase worldwide. Further, deaths due to melanoma have also been increasing making early evaluation of new or changing moles and yearly routine screening that much more important. A higher risk of melanoma is found in patients with fair skin, light-colored eyes, a history of severe sunburn, prolonged periods living closer to the equator or at a higher elevation, having many moles or unusual moles, a family history of melanoma, personal history of childhood cancer, organ transplant recipients, HIV/AIDS, Parkinson’s disease, any prior history of indoor tanning or artificial sunlamp use, or a history of excessive outside ultraviolet (UV) light exposure.
An acronym referred to as the ABCDEs of melanoma was developed to help patients differentiate benign moles from melanoma.
- A is for asymmetry in shape, significant variability in shape of one half in comparison to the other is atypical.
- B is for border, check for moles with irregular, notched or scalloped borders.
- C is for color, significant color variability, uneven distribution or dark black appearance are all less common in benign moles.
- D is for diameter, approximately 66% of melanomas are greater than 6 mm in diameter.
- E is for evolution, new changes in a preexisting mole or new pigmented growths can be atypical, rapid changes are particularly concerning for melanoma.
One or more of the above atypical features warrants further evaluation by a medical professional. The majority of melanomas are brown or black however they can less commonly be skin-colored, pink, red, purple, blue or white. Any spot that is rapidly growing or personally concerning is worthwhile to have evaluated by a medical professional. We encourage self skin exams to help you learn the moles, freckles, and other skin spots that are normal for you so that you are more aware of any changes that occur.
Some precautions that can help reduce your risk of melanoma include: 1) Avoiding or limiting mid-day (10 am to 4 pm) sun exposure, 2) wearing sunscreen year-round (UVA/UVB), 3) wearing UV protective clothing, 4) avoid tanning beds.