Skin cancer is one of the few types of cancers that if often very easy to identify and monitor even in the early stages.1 Not all types of skin cancers are simple to detect and identify but, at the first signs of skin changes, a complete check-up by a dermatologist is very effective in early diagnosis and treatment. Skin cancers and melanomas that are detected early can be removed using simple surgical procedures.
Knowing the first signs of skin cancers, including melanomas, is the most effective early detection tool. This should include monthly self-exams that also document and record the size, location and general description of all moles on the body. The best way to record the information is with the use of a body map, a simple yet detailed written description that can be used to track changes in the skin as well as each individual mole.
The body map technique asks people completing a self examination to describe each mole that the encounter based on a set of criteria. These criteria form the mnemonic ABCD and are used by the National Cancer Institute, American Cancer Society and the American Academy of Dermatologists. The simplicity of the tracking system provides clear guidelines for everyone to use. The information can also be easily provided to medical professionals including family physicians and dermatologists.2
New options for tracking and identifying moles that may show signs of skin cancer include the use of digital imaging. Photographs can be taken and uploaded to a computer program or even a phone app that will transpose current photos on the last stored image, highlighting any changes in the mole itself. These new systems are very effective in highlighting even the smallest visible changes in the mole, freckle or irregular patch of skin.3
Regardless of the type of body map or mole monitoring system that you use, it is essential to look for four different areas of change. Any changes in these four categories of describing the mole should result in a complete skin examination by a dermatologist.
Understanding The ABCDs of Moles
Asymmetry is the A in the ABCD mnemonic. Asymmetry is a term that is used to describe the similarity in the different sides of the mole. A symmetrical mole is not atypical and is generally not considered to be at high risk of developing melanoma. A mole that is asymmetrical, which means it is not oval or circular in shape, is at greater risk for being cancerous. These moles are considered to be atypical, and are medically known as dysplastic
nevi.4
The greater the number of asymmetrical moles on the body the greater the risk is for having a condition known as atypical mole syndrome. This condition is usually found in families where it is also classified as familial atypical multiple mole-melanoma. Not all people with multiple atypical moles develop skin cancers but the rate of diagnosis rises from one in 3000 to one in 100 when dysplastic nevi are present.
The letter B stands for the borders of the mole. The borders are the edges where the mole connects with the surrounding skin. A normal mole has clean borders that are smooth and well defined. The border forms a circular or oval shape without any scallops, jagged edges or scallops. Moles that are atypical have a blurred or smudged look around the edges without any clearly defined borders. Moles that have a bright red ring or halo around the pigmented areas are also a sign of possible concern and should be immediately examined by your dermatologists.
Moles can be raised slightly off the skin or they can be flush with the surface of the skin. Raised moles do require slightly more attention but raised moles alone are not a sign of possible skin cancer unless they are accompanied by blurred borders and asymmetrical shapes.5
C is the color of the mole. There is no single color that designates the presence of melanoma, but a combination of colors in one mole or a mole that is differently colored than surrounding moles is a concern. Most moles will be tan to brown in color but very light moles, red moles, bluish colored moles or black moles are more likely to be problematic. Moles that appear to be on top of one another lighter color under dark or vice versa, are more likely to be a single mole with a melanoma.
The size of the mole is the diameter, which is the D in the ABCDs of moles. The diameter of a typical mole is about the same size of the blunt end of a pencil, which is about 5 millimeters in diameter. Moles smaller than these are less commonly melanoma, but they are not without concern if they show any of the other signs of melanoma. Very large moles or moles that grow in size need to be examined immediately.6
Knowing the ABCDs of moles and monitoring for any E or evolution in the categories is the key factor in the effectiveness of using a body map. Changes in any of the descriptions of the moles, which can develop rapidly or more slowly, need to be checked out by your dermatologist at the earliest possible opportunity.
References
1 Skin Cancer Symptoms. (n.d.). Retrieved from Mayo Clinic: www.mayoclinic.com/health/skin-cancer/DS00190/DSECTION=symptoms
2 Melanoma Monday Mole Map. (n.d.). Retrieved from American Academy Of Dermatology: www.melanomamonday.org/documents/08_96 Melanoma Monday Mole Map.pdf
3 How to Do a Self-Exam. (n.d.). Retrieved from Melanoma Center: www.melanomacenter.org/detection/howto.html
4 ABCD’s Of Melanoma. (n.d.). Retrieved from American Melanoma Foundation: www.melanomafoundation.org/prevention/abcd.htm
5 Pictures of Ordinary Moles and Dysplastic Nevi. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page8
6 Finding Melanoma Early: Warning Signs and Photos. (n.d.). Retrieved from Melanoma Education Foundation: www.skincheck.org/Page4.htm
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