Dysplastic nevi is the medical term for moles that are atypical or abnormal. Dysplastic nevi can be present from birth or they may develop later in life, usually because of exposure to the sun and ultraviolet radiation. Often the presence of dysplastic nevi, especially if there are more than five on the body, is considered a risk factor to developing melanoma and skin cancers. However, not all people with atypical moles will be diagnosed with cancer and in fact the vast majority of people are not.1
Key Features Of Dysplastic Nevi
Just as a normal mole has typical features, a dysplastic nevus, a single atypical mole, will also have specific identifying features. They correspond to the first four letters of the alphabet which are ABCD.2
A is the indicator for asymmetry or irregular shape to the mole. Moles that do not have two equal sides or that have additional protrusions or shapes on one or the other side of the mole are considered to be atypical. This is important since tumors often start very small just under the surface of the mole which causes the change in shape on one part of the mole.
B is the mnemonic for borders, which is the defining edge between the dark pigment of the mole and the adjacent skin. A normal mole has a clearly defined border that is smooth and round or oval in shape. An atypical mole has a scalloped or notched border with irregular, jagged edges. There may also be blending, blurring of fuzzy areas between the mole and the skin with no clear distinction. This may vary around the mole with clear areas and fuzzy areas of the border.
C is the color of the mole. A uniform color from almost flesh colored to dark brown or even a brown-black color is very normal. Dysplastic nevi are different colors within the mole or a mole that is colored differently from other moles on the body. This can include yellows, blues, reds or orange colorations with the mole. Some moles may also be white to grey in color and these are more likely to indicate melanomas than the other colorations.3
D is the diameter of the mole, which should be smaller in size than the eraser of a pencil. Often diameter is a bit misleading since a small mole with the ABC differences as well as a noted change is just a likely to be a cause for concern as a mole that is larger than 5-7 millimeters.
In addition it is also important to consider E, which includes the evolution or change in the ABCDs of a mole. It is the change that is most important as atypical moles that are not evolving or changing typically require no treatment but careful monitoring.
Other Features To Consider
The Melanoma Education Foundation provides additional features or changes that people should be aware of if they have dysplastic nevi on their body. These are in addition to the ABCD and E indicators listed above.
Anyone that notes a change in the texture or feel of the mole, particularly a mole that is raised above the surface and becomes hard or firm to the touch, should be in contact with their dermatologist. Changing texture of the surface of the mole from smooth to rough is of concern and should be checked by a doctor. In addition any reddish border or halo around an atypical mole that appears suddenly or slowly is also a possible symptom of a change in the cellular structure of the tissue.
Moles that bleed, seep, or seem to be itchy or sensitive should be checked out by your doctor. Some moles may also begin to turn very dry and scaly and may appear suddenly in areas where there are currently moles or on areas of the body that don’t currently have moles. The appearance of large or small patches of freckles, even without atypical moles present may also be a warning sign of changes in skin tissue.4
Nodular Melanomas
While not all dysplastic nevi are melanomas, there is one type of change in a mole that can signal a very aggressively spreading type of melanoma. This known as nodular melanoma and the ABCD and E indicators will not be present in these rapidly developing cancers. Instead it is import to focus on the EFG properties.
E stands for elevated since these moles typically start as a bump under the skin that rapidly lifts above the skin’s surface. F is for firm, which is different than the soft, squishy surface feel of a normal or atypical mole that protrudes above the surface of the skin. The last letter, G, is of the rapid growth that is easy to see with these moles.5
These nodular and radial types of melanomas can start to spread within months to internal organs and other parts of the body. While they can start at the site of an existing mole on the body they can also pop up in areas without any existing moles, freckles or irregular skin patches. Any sudden bumps that are not a cause of an injury or infection should be examined by your doctor if they continue to grow or do not subside. When in doubt checking with your family doctor or dermatologist can be instrumental in early treatment and lowering the risk of reoccurrence of melanoma and skin cancers.
References
1 Skin Cancer Risk Factors. (n.d.). Retrieved from Mayo Clinic: www.mayoclinic.com/health/skin-cancer/DS00190/DSECTION=risk-factors
2 ABCD’s Of Melanoma. (n.d.). Retrieved from American Melanoma Foundation: www.melanomafoundation.org/prevention/abcd.htm
3 Pictures of Ordinary Moles and Dysplastic Nevi. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/moles-and-dysplastic-nevi/page8
4 Finding Melanoma Early: Warning Signs and Photos. (n.d.). Retrieved from Melanoma Education Foundation: www.skincheck.org/Page4.htm
5 EFG Properties of Nodular Melanomas. (n.d.). Retrieved from Melanoma Education Foundation: www.skincheck.org/Page4.htm#efg_properties
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