Melanoma: What and Where to look for during Self Exams

Since this is Melanoma Awareness Month, I felt it was important to republish an article I wrote last year that can help to identify the characteristics of melanoma so that you can detect it early and successfully treat it, if need be.  Unfortunately, the incidence of skin cancer is increasing rather than decreasing, which makes it imperative you know how to protect yourself and your loved ones and know when skin conditions warrant concern.

Have you heard about the ABCD criteria for melanomas? Treatment and cure of melanomas rely on early and accurate diagnosis. The ABCD mnemonic was created for individuals and primary care physicians to create awareness of the clinical features of melanomas.

• “A” stands for asymmetry.
• “B” stands for border irregularity.
• “C” stands for color variation in the same lesion.
• “D” stands for diameter greater than 6 mm.

Not all melanomas have all ABCD characteristics but may have a combination of some of the clinical features.  Benign growths can also demonstrate some of the ABCD criteria. Therefore, the ABCD criteria are only a screening tool for the clinical evaluation of skin lesion. Suspicious moles can be biopsied to establish the diagnosis.

Recently, the mnemonic changed to ABCDE in order to increase one’s ability for earlier diagnosis of melanomas. The “E” stands for evolving lesions characterized by change over time. Such lesions are characterized by change in symmetry, change in borders, shape, diameter, and symptoms over time.  Evolving lesions may lack significant asymmetry, fairly regular borders, mild color variation and smaller than 6 mm, but represent a non-healing, changing pigmented lesion.

As with other forms of cancer, self-examination plays a very important role in the early diagnosis of skin cancer.  The earlier the diagnosis, the easier it is to treat.  “Leave no stone unturned”, as they say, when doing a self-exam.  Be sure to look closely at all the following areas:

• Sides of your body with arms raised
• Complete front and back of your torso
• Forearms, underarms, and palms
• Legs (front and back), feet (soles and between toes)
• Scalp and back of neck
• Lower back and buttocks

Moles and suspicious lesions that fulfill the ABCD criteria can be biopsied to confirm a diagnosis, including identifying benign lesions, which require no further treatment.  I, along with the American Academy of Dermatology and the American Cancer Society, advocate the ABCD criteria for the early detection of melanomas and encourage you to perform a self-exam today. If you aren't comfortable doing a self-exam find a dermatologist to do a check for you!