Melanoma is an increasingly important public health problem in the United States and worldwide. The incidence of malignant melanoma continues to rise at an alarming rate in the US. Since prognosis in melanoma is directly proportional to the depth of the tumor, early detection is critical to save lives. Patients diagnosed with melanoma in its earliest phase have an almost 100% survival rate.
To make an early diagnosis of melanoma, the clinician needs to recognize the clinical features of early melanomas, and differentiate melanomas from common pigmented lesions and variants of clinically atypical melanocytic nevi (also known as dysplastic nevi) seen in association with melanomas.
Most early melanomas demonstrate the following clinical features:
- A – Asymmetry (if the mole cannot be folded like a book, and one half does not look like the other half)
- B – Border irregularity (most early melanomas are irregularly shaped with ill-defined borders)
- C – Color variegation (colors may range from shades of brown to areas of black, and less commonly, red, white and blue, except for amelanotic melanomas which lack colors)
- D – Diameter (most early melanomas when clinically identifiable are greater than 6mm in diameter)
Other factors that increase the risk for developing melanoma include personal or family history of melanoma, history of other non-melanoma skin cancers (such as basal cell carcinoma and squamous cell carcinoma), presence of dysplastic nevi, presence of many (>100) melanocytic nevi, intermittent sun exposure and sunburn history, history of tanning booth exposure (especially in childhood/adolescence), red/blond hair, light eyes, fair complexion and freckling, and history of long term use of immunosuppressive medications.
We recommend a full skin examination yearly for skin cancer screening, for every patient. If you have a new diagnosis or previous history of melanoma, dysplastic nevi (atypical moles) or many nevi (>100) or if you have higher risk factors for skin cancer (please see above list), you may be seen more frequently for routine skin cancer screening (e.g. every 3 or 6 months).