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Melanoma

Melanoma is one of the most serious skin cancers and should be approached with elevated caution in suspected cases. While it is outside the scope of this website to speak on the numerous appearances, treatments, and prognosis of melanoma, simple screening methods may allow early detection and intervention.

A staple of any skin cancer prevention is the monthly self skin exam. Care must be taken to view every part of the body for new or changing lesions, or suspicious moles. For areas were examination may be difficult (back, posterior thighs), use of a mirror or help from a spouse may be needed. Any new, changing, or suspicious lesion MUST be brought to the attention of your personal physician or dermatologist. Even those with minor changes may represent a malignancy.

In specific regards to melanoma, recognizing suspicious lesions may be improved by employing the ABCDE's of melanoma:

A: Asymmetry

* If you draw a line through the lesion either vertically or horizontally, both sides should look roughly identical. If not, the lesion should be viewed as suspicious and brought to the immediate attention of your dermatologist.

B: Irregular Borders

* The borders of the lesion should be round, very smooth, and well-outlined. Suspicious features include jagged, scalloped, or spiky borders. Any suspicious border outline or changes in the border of a lesion should be viewed as suspicious and brought to the immediate attention of your dermatologist.

C: Color Variation

* The color of the lesion should be homogenous (even, similar) throughout. There should be no mixture of black, white, blue, or red present in the lesion. Any suspicious colors or color changes should be viewed as suspicious and brought to the immediate attention of your dermatologist.

D: Diameter

* Generally speaking, the diameter of the lesion should be smaller than a pencil eraser (approximately 5mm). If the diameter is larger than 5mm or the diameter of a lesion changes, this should be viewed as suspicious and brought to the immediate attention of your dermatologist.

E: Enlarging

* If a lesion is enlarging in any way, this should be viewed as suspicious and brought to the immediate attention of your dermatologist.

While these are general guidelines for recognition of suspicious lesions, anything suspicious is a reason to have the lesion specifically viewed by a dermatologist, even for reassurance. Other suspicious changes include bleeding or ulceration. Having a low threshold for identification of possible melanoma malignancies is key in the diagnosis and treatment of melanoma. Do not ever be afraid to return to your dermatologist for any spot that you feel is changing or does not belong.

Don Mehrabi MD, FAAD
Dermatologist, Certified by the American Board of Dermatology
Los Angeles, California

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