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Mole or Melanoma: When to Worry?

Author: Dr. Nandhini J - Dermatologists and Skin Care
Last reviewed at: 07.Sep.2018  



Melanoma is a grave disease that mostly arises from an innocent-looking mole. If a mole is present on the body, here is how you can know if it is just a mole or melanoma. This article sketches the various aspects of the mole, from its morphology to the preventive measures.
Image: Mole or Melanoma: When to Worry?


A mole or nevus is a black or brown spot present in the skin. It is usually round, has a uniform color with smooth edges, and often measures less than 6 mm in diameter. They are often acquired during childhood or adolescence. Most of them will never cause a problem. If new moles arise with age or there is a change in it, there is always a risk of it turning into a melanoma.

Where Does It Appear?

It can occur anywhere in the body, irrespective of if the area is exposed to the sun or not.

Do Moles Have Different Appearances?

Yes, moles have a variety of shapes, and a recurring pattern in a patient constitute 'signature' lesions.

Common mole signatures include:

  • brown or pink type,
  • fried-egg,
  • eclipse,
  • inverse pattern,
  • targetoid or cockade,
  • shrapnel or ladybug pattern,
  • perifollicular hypo or hyperpigmentation pattern,
  • cheetah phenotype, etc.

What Is ABCDE of Melanoma?

  • A - Asymmetry - one-half of the mole is different from the other.
  • B - Border - irregular borders.
  • C - Color - has a variety of shades.
  • D - Diameter - larger than 6 mm.
  • E - Evolving - changing in size, shape, color, and border with time.

When to Worry?

All the symmetric changes occurring in a mole, such as an increase in size with age, a uniform darkening after sun-exposure or after a chronic trauma, etc., are not signs of malignancy. However, if there is bleeding, ulceration or an increase in number after 50 years of age, then it is a red flag for malignancy.

Who Should Be Tested?

Patients with the following increased risk factors should be screened annually or bi-annually.

  1. Moles with an irregular shape and which increase in number.
  2. Familial atypical multiple mole melanoma syndrome.
  3. A large congenital nevus.
  4. Persons with fair skin, and blond or red hair.
  5. A family history of melanoma.
  6. A previous history of melanoma or other skin cancer.
  7. Low immunity (immunosuppressants, HIV, etc.).
  8. Advanced age.
  9. Male sex.
  10. Exposure to sunrays and UV (ultraviolet) rays.
  11. Xeroderma pigmentosum.

What Does Having a Risk Factor Indicate?

Not all the persons who have multiple risk factors will end up having the disease. It is also possible that melanoma may arise in a person with few or no risk factors. It is significant to know that anyone can get melanoma.

Can Melanoma Be Found at an Early Stage?

Yes, it can be detected at an early stage. If it is done, the success rate of the treatment is very high (99 to 100 %).

How to Do a Skin Self-Examination?

Your eyes and a full-length mirror are all that is required.

  1. Thoroughly examine all the areas of the body including the scalp, palms, back of your thighs, etc., every month.
  2. Check for the appearance of new moles, as well as the size, shape, color, and texture of the existing ones.
  3. Clicking pictures of the involved area will be an added tool for comparison of the progress if any.
  4. Never inspect using a magnifying lens as it may intensify the ruggedness of the borders. The more magnified a mole is, the more attenuated and uneven edges it appears to have, which causes a lot of anxiety.

When to Approach a Physician?

In patients with a family history or a history of melanoma, if you find any mole which does not fit into the signature lesion category, a mole having an irregular border to a naked eye, is sore or bleeds, it is always better to get examined by a dermatologist using a dermatoscope.

What Are the Tests to Be Done?

  • Serial dermatoscopy.
  • Digital epiluminescence microscopy (DELM).
  • Biopsy.
  • Chest X-ray.
  • Reflex transmission imaging (RTI).
  • CT scan.
  • MRI scan.
  • PET scan.

Should I Get All the Moles Removed?

No, the doctors will not always remove all the moles, as most of them are harmless. By removing few or all of them, the risk of melanoma development does not decrease, and it is also possible for a melanoma to develop de novo (from the beginning).

What Are the Preventive Measures?

Certain risk factors like age, gender, family history, etc., cannot be prevented. However, the following precautions can be taken.

  • Limit exposure to UV rays including tanning beds and solar lamps.
  • Use sunscreen creams with high SPF (sun protection factor).
  • Always seek shade.
  • Keep an eye on abnormal moles.
  • Avoid weakening the immune system (with drug abuse, multiple sex partners, etc.).

For more information consult a melanoma specialist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist/melanoma



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