Skin Cancer Screening
What is a mole?
Benign Moles
Melanocytes are the cells in the skin responsible for producing pigment or color. Not uncommonly these cells cluster together or nest and produce a brown/black spot referred to as a mole. Depending on what level of the skin the melanocytes nest at determines whether a mole is flat or raised, dark or skin colored. These lesions appear in early childhood and reach a maximum number by young adulthood. By age 60 years most moles have involuted and are no longer apparent.
Atypical Moles
The term atypical is applied to moles which display any of he following features:
- Variegated color (tan, brown, dark brown) within the same mole
- Irregular or angulated borders
- Size greater than 5mm (pencil eraser)
When viewed under the microscope, atypical moles can be further categorized as slightly, moderately or severely atypical, based upon the degree of irregularity of the melanocytes. Atypical moles tend to run in families. There is a slightly increased risk of developing malignant melanoma (skin cancer) in patients with atypical moles. Routine mole checks by a dermatologist as well as the patient are essential.
Melanoma
Melanoma is a type of skin cancer arising from the melanocytes (pigment producing cells). In the United States the number of cases of melanoma diagnosed has tripled in the past 4 decades. 1 in 55 Americans will develop melanoma. Because melanoma is a highly visible tumor, its early detection is the key to a possible cure.
The ABCDE guidelines helps to suspect the diagnosis of melanoma in any pigmented lesion:
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A stands for Asymmetry, when one half of the mole doesn't match the other half.
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B stands for Border, when the border or edges of the mole are ragged, blurred or irregular.
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C stands for Color, when the color of the mole is not the same throughout or if it has shades of tan, brown, black, red, white or blue.
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D stands for Diameter, when the diameter of a mole is larger than 6mm, about the size of a pencil eraser.
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E stands for Evolving, when there are changes in size, shape, color and elevation. These are signs that generally point to danger.
- If a mole displays any of these signs, it should be checked promptly by a dermatologist.
Mole Checks
Patients should be taught to do regular self exams of their skin. By standing in front of a full length mirror patients should carefully exam their entire front surface. You need to lift up your arms and exam the undersurface of your arms as well as your genital region. You should part your hair and exam your entire scalp. This is most easily accomplished when the hair is wet. Next, using a hand mirror and a full length mirror you should attempt to examine your back and the back of your legs. Any changes in the color, size shape of your moles or the appearance of new moles should be brought too the attention of your dermatologist immediately.
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