ABCDE Education

The daylight hours are noticeably shorter, and the stores are advertising their back to school sales.  You have been careful about using your sunscreen, or you at least made an effort, but now there is a spot you don’t remember being there at the beginning at the summer. Is it dangerous?

THE ABCD & E'S

When trying to determine if a mole is suspicious, remember A, B, C, and D. 

1. Is the mole Asymmetric?  If one side of the mole looks different than the other side, it is suspicious. 
2. Is the Border sharp and smooth?  If the edges of the mole are jagged or poorly defined, you should be concerned. 
3. Is there more than one Color in the mole?  Benign moles tend to be uniform in color. 
4. Does the mole have a Diameter greater than 6mm (the thickness of a pencil eraser)?  Moles larger than this have an increased risk. 
5. Some physicians will add “E” for Evolution.  Normal moles generally don’t change over time.  Therefore, a new mole represents a change, and is suspicious.  In general, moles do not itch or bleed, so those symptoms, if present, should draw attention.

IS IT A MOLE?

Keep in mind that the features described above only apply if the spot in question is a mole, or nevus in medical terms.  Over time, people tend to develop benign growths that are not moles. 

Uniformly pigmented brown spots often represent lentigines, which are frequently referred to as “age spots,” “liver spots” or “freckles.”  Raised growths often develop in individuals over the age of 45.  These are called seborrheic keratoses, and are sometimes referred to as “barnacles.”  These often grow to over 6mm in diameter, and have multiple colors.  They are more common than dangerous moles. 

It can be difficult to distinguish seborrheic keratoses from dangerous moles without proper training, so a trained dermatologist should evaluate growths with these features.  Red spots, which represent tufts of small blood vessels called angioma, are also very common.

Sores that bleed easily with minor trauma, such as washing with a facecloth, or spots that repeatedly scab over, but never quite heal are worrisome for a superficial type of skin cancer called basal cell carcinoma.  These are often pink or violet, and small vessels can be seen running through many of them.

Hard, rough crusty spots may represent a form of sun damage called actinic keratoses.  These frequently have the texture of sandpaper.  If left untreated they can progress to a form of skin cancer called squamous cell carcinoma.

WHEN TO SEE THE DERMATOLOGIST

Dangerous growths tend to progress rather than come and go.  If you see a new spot, there is no need to panic.  However, if it persists and has any of the features mentioned above, it should be evaluated. 

Your physician will be happy to let you know if it is benign.  If it is potentially dangerous, it should be tested.  The overwhelming majority of skin cancers are completely treatable, particularly when caught early.

Author

Integrated Dermatology of Tidewater Integrated Dermatology of Tidewater, located in Norfolk, Virginia, provides comprehensive personalized dermatologic care to patients of all skin types, conditions, and ages. Medical director Jonathan Schreiber, MD, PhD and the entire professional medical team at Integrated Dermatology of Tidewater approach dermatologic exams from the medical root of an issue, and similarly, cosmetic issues from the science of a treatment, using science-based support and results with the treatment services offered to patients.