Atypical mole syndrome is not a disease in itself and does not conclusively indicate that an individual with the syndrome will develop melanoma or any form of skin cancer. However, individuals with atypical mole syndrome are considered to be at greater risk for melanoma and skin cancer simply because of the presence of atypical moles. For this reason frequent and routine self-examinations with regular appointments with a dermatologist are recommended for early detection and treatment of any possible skin cancers or melanomas.
Atypical mole syndrome is also known by a variety of other names which may not be medically the same condition but the terms are commonly interchanged. They include cutaneous malignant melanoma (CMM), B-K mole syndrome, dysplastic nevus syndrome (DNS) and familial atypical mole-malignant melanoma syndrome or FAMMM.
General Characteristics
The major signs and symptoms that lead to a diagnosis of atypical mole syndrome is the presence in large numbers of atypical moles on a person’s body. Individuals may normally have up to 40 moles, but those diagnosed with atypical mole syndrome may have up to 100 or more moles. Of these there will be normal moles as well as dysplastic nevi or atypical moles.1
In an article published in the New England Journal of Medicine it was reported that atypical mole syndrome exists in families and is an indicator to a predisposition of melanoma. It was further reported that the presence of atypical mole syndrome as an exclusive screening tool for melanoma is not statistically accurate. In other words the presence of atypical mole syndrome should be closely monitored but all people belonging to families with a history of atypical mole syndrome and melanomas should be monitored equally. Ruling out family members for screening and regular skin exams just because they do not exhibit atypical mole syndrome may be putting them at additional risk for missing early development of melanomas.2
The Genetic Link
Atypical mole syndrome is found within specific families and has a strong genetic component. This condition is more commonly known as Familial Atypical Mole-Malignant Syndrome or FAMMM. Not all individuals with FAMMM will develop melanomas but the risk is much higher for these individuals and within the specific family even if large numbers of atypical and regular moles are not present on each family member.
Children born to parents with atypical mole syndrome or FAMMM may have larger dysplastic nevi that are present at birth or develop rapidly after the child is born. It is important to keep in mind that there are steps that both adults and children, even with a genetic component to the condition, can take to reduce their likelihood of developing melanomas.
People with a genetic predisposition to melanoma need to be active in protecting their skin. This starts with wearing long sleeves and long pants whenever you are out in the sun for prolonged periods of time. For shorter periods of time use a very good quality high SPF sunscreen to reduce any exposure to ultraviolet radiation from the sun.3 According to the National Cancer Institute, to effectively prevent melanoma it is important to use as sunscreen with as SPF of at least 30 or higher. Tanning, even in tanning beds, needs to be avoided completely as this will greatly increase the risk of melanoma.4
The recommendations for prevention of melanoma for those individuals with atypical mole syndrome or FAMMM are no different than for individuals without the diagnosis. However the risk of failing to follow the guidelines consistently is much greater for people with the condition. Parents have to be proactive in teaching their children how to protect their skin and to avoid sun exposure even at a very early age.
Dermatologists And Examinations
Individuals that have been diagnosed with atypical mole syndrome should be regularly examined by a dermatologist. As skin specialists these doctors are experts at detecting even slight variations in the surface texture of the skin, the shape and size of an existing mole and even variations in coloring that can be indicators of melanoma.5
The dermatologist may recommend additional consultation with an oncologist, which is a doctor that has extensive experience in the diagnosis and treatment of cancer. Since atypical mole syndrome does pose a higher risk of melanomas, especially when atypical dysplastic nevi are present in large numbers, additional cancer screening may be recommended. This typically is determined based on other factors such as personal history with melanoma or cancer, current health condition and age of the patient.
The frequency of examinations by a dermatologist for individuals with atypical mole syndrome can range from every quarter to one or two times per year. Individual risk factors, the evolution or change in any dysplastic nevi and the family history of melanoma can all influence the frequency of examinations. Between dermatologist appointments these patients should also be completing monthly self-exams and reporting any changes noted in the moles on the body. The dermatologist can review how to complete a self exam and how to track changes to ensure accurate information is provided at the next exam.
Most people with atypical mole syndrome will not develop melanoma and will not require any specific treatment. Those that do may have options for treatment including a simple surgical removal completed in a doctor’s office through to much more inclusive therapies if the melanoma has spread to other organs and locations in the
body.6
References
1 WhatYou Need To Know About Moles and Dysplastic Nevi. (2002, September 16). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page2
2 Wachsmuth, R. (1998). The Atypical-Mole Syndrome and Predisposition to Melanoma. New England Journal of Medicine , 348-349.
3 Prevention of Melanoma. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page5
4 The Dangers of Indoor Tanning. (n.d.). Retrieved from American Academy of Dermatology: www.aad.org/skin-care-and-safety/skin-cancer-prevention/indoor-tanning/the-dangers-of-indoor-tanning
5 Early Detection Of Melanoma. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page6
6 Melanoma: Treatment and Drugs. (n.d.). Retrieved from Mayo Clinic: www.mayoclinic.com/health/melanoma/DS00439/DSECTION=treatments-and-drugs
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