Melanoma, risks and signs

Many people come in to the office because they have a brown spot that they are concerned about.  Although, many of these brown spots, or pigmented lesions as we call them, are benign, some can be pre-cancerous or worse,  a melanoma.  Today we are going to talk about the risk factors and signs of melanoma.  Melanoma is a skin cancer that is definitely on the rise in the United States.  Although it accounts for a small percentage of all skin cancers, basal cell carcinoma and squamous cell carcinoma are much more common, melanoma accounts for most of the death due to skin cancer.

Melanoma can occur in any portion of the body.  Recent studies have shown that melanoma of the trunk and extremities is rising faster than melanoma of the head and neck regions.  The incidence of melanoma is 10 times higher in whites than blacks living in the same geographical region.  So what are the risk factors for melanoma?  The National Cancer Institute has listed the following as confirmed risk factors:   

                             more than 50 moles on a person’s body

                             having an atypical-dysplastic nevus

                             fair skin and light color hair

                             family history of melanoma

                             males greater than females

                             age greater than 50 years

                             having xeroderma pigmentosum

                             personal history of melanoma

                            UV exposure and sunburn

What are the signs you should look for in a pigmented lesion to cause concern?  Quite simply we say ABCD. A is for asymmetry, if you can draw a line through the spot and both haves look alike it is less worrisome. B is for border; if the border is smooth again a good sign.  If the edge is uneven or irregular, that is a cause for concern.  C is for color, multiple colors in a spot are bad. And lastly, D is for diameter.  A diameter less than 5 mm is good.  A simple way to determine that is, if the spot can be covered by the eraser of a pencil it is ok.  None of these are absolute but the combination of two or three certainly requires attention.  As always if you have a question about a spot, you should show it to your doctor.  Next time the treatment options of melanoma.