What is a Mole, a Nevus, and a Melanoma? From a Memphis Dermatologist
by George Woodbury Jr. M.D. (03/12/2024)
About one American loses his or her life needlessly to Melanoma every 54 minutes. That’s about 9300 needless American deaths due to Malignant Melanoma each year. The most common locations of Melanoma on the body are the trunk and the legs - but it can occur on any area of the body - especially areas exposed to Ultraviolet light or UV light from the sun or from tanning salon bulbs.
Another shocking statistic: about half of people developing Melanoma are below the age of 52 years old. Melanoma is not just an affliction of the elderly. So you need to know about it now: advances in Dermatology have allowed us to learn what causes it, what can be done to prevent it, and what to do about it if it occurs.
Be aware that the average person develops between five and thirty-five collections of pigment-producing cells called a Melanocytic Nevus or Mole between the ages of five and thirty-five. The problem is that some Moles are precancerous – meaning that they’re at high risk of becoming malignant or harmful later. So, from my perspective as a Board-certified Memphis Dermatologist in Cordova, Tennessee, let me share with you what features to look for in a Mole, in a Nevus, and what to look for in a Melanoma, and how you can spot a high-risk lesion.
The skin’s protective pigment is called melanin, and it’s made from melanin-producing cells called melanocytes. These cells occur in both the Epidermis and the Dermis of the skin. Melanin acts to prevent damage to our body’s DNA from ultraviolet light from the sun. It’s ironic that the very cells that make this protective pigment, the melanocytes, can, at times, go haywire and start dividing out of control, becoming Melanoma, also called Malignant Melanoma. So, one cell can potentially go berserk and eventually kill a human whose body is actually made up of trillions of cells!
What is Melanoma?
Melanoma, sometimes also called Melanoma Cancer, can develop in the skin, in the back of the eye (the Retina), in the mouth or sinuses, and even in the spinal cord. It can grow out of normal skin or out of a pre-existing normal mole or arise from normal growth in the skin, like a common mole, also called a Nevus.
What are Melanoma Symptoms?
The warning signs of moles and Skin Cancer that Dermatologists watch for – as originally described by Dr Rigel of New York University’s Department of Dermatology – are the A, B, C, D, and E warning signs:
A stands for Asymmetry: one half of the mole does not match the other half.
B stands for an irregular Border: perhaps jagged like the coast of Maine rather than smooth, like the coast of Florida.
C stands for Color change: perhaps a mole that’s particularly dark or with different shades of brown, black, or gray, or with Color changes taking place.
D stands for a Diameter – or distance across – a mole that’s enlarging – particularly if that distance gets larger than the head of a number 2 pencil’s eraser.
E stands for Evolving or changing features.
So what’s the story on atypical moles, sometimes also called dysplastic nevi or dysplastic moles?
In the 1970s, a Dermatologist from the University of Pennsylvania – Dr. Wally Clark – first identified certain families within which people tended to have a number of dark moles and also people had a tendency to develop Melanoma. Dr. Clark described the features of what’s meant by a “Dysplastic Mole” or “Dysplastic Nevus,” these being moles that were dark in color, often with a raised center and a flat periphery.
Since the 1970s, these dark moles have been renamed “Atypical Moles,” and it’s been appreciated by Dermatologists that such moles are not rare but actually can affect up to 3-4% of us. Because there is an increased risk of Melanoma in families of people with Atypical Moles, there are a number of research studies underway currently to help identify the exact increased risk of an isolated Atypical Mole because we know that people with Atypical Moles can develop Melanoma both from their normal skin and from these dark moles.
Until more data becomes available, many Dermatologists – including myself – are generally recommending that Atypical Moles be completely removed – unless patients have so many of them that it’s more feasible to photograph the moles and monitor them for changes.
A Dysplastic Mole or Atypical Mole can sometimes be suspected by a Dermatologist based upon inspecting the skin and finding a mole that’s usually dark, or with a raised center.
For photos of melanoma and normal Moles and what Atypical Moles look like, go to the Skin Cancer Foundation website, https://www.skincancer.org.
The good news about the type of Skin Cancer that we call Melanoma is that early detection definitely saves lives: if caught early, Melanoma is close to 100% curable with an outpatient removal or “excision” under a shot of local anesthetic by a Dermatologic Surgeon.
So the moral of the story is: “See Spot. See Spot Change. See a Dermatologist.” My own Memphis Dermatology practice for over 30 years has been with Rheumatology and Dermatology (www.Rheumderm.com: 8143 Walnut Grove Road, Cordova TN 38018: 1-901-753-0168. Or you can find a “Dermatologist near Me,” “Dermatologists near Me,” or a “Best Dermatologist Near Me,” or if you’re looking for a “Mole Removal Near Me,” you could go to the American Academy of Dermatology website, AAD.org, then plugging your zip code into the “Find a Dermatologist” tab.
George Woodbury Jr. M.D.
Board-certified Dermatologist at Rheumatology and Dermatology Associates PC
8143 Walnut Grove Road
Cordova TN 38018
1-901-753-0168
(03/12/2024)
