In one of our previous, similar posts, ‘Normal Moles vs. Atypical Moles’, we discussed that titular subject. In today’s post, our focus will be on comparing atypical moles with melanoma.
What are Atypical Moles?
Many people know that melanoma is the deadliest form of skin cancer. But what are atypical moles? Are they cancerous?
Atypical moles (known in medical terms as dysplastic nevi) are similar to common moles in that melanoma usually does not develop in either. However, as we’ll expand on below, their presence is an indicator of an increased melanoma risk in general.
Atypical moles are usually larger than common moles, as well as differing in color (ranging from pink to dark-brown), shape (often irregular), and border with surrounding skin (often fuzzy).
While common moles are generally round or oval, atypicals may look more like a picture from a Rorschach inkblot test.
Turn and Face the Change
David Bowie’s hit song also provides us with some excellent skin care advice. Atypical moles are rarely removed because the procedure isn’t necessary. Nor would excision reduce the risk of converting them to melanoma by very much. However…
If you notice any change in an atypical mole (or in any mole, for that matter) during one of your highly-recommend monthly skin self-exams, it’s important to have it checked by a dermatologist as soon as possible. That means any change, including in size, color, texture, shape, or height. Also, if it turns hard/lumpy, or begins bleeding, itching or oozing.
Just the FAQ’s, Ma’am (or Sir), Just the FAQ’s
Here are a few other things you should know about atypical moles:
- The risk of melanoma increases 10-fold in people who have 5 or more atypical moles. Although it usually arises in clear skin rather than in an atypical mole. Atypical moles serve as markers for melanoma risk.
- The National Center for Biotechnology Information (NCBI) estimates that 2-8% of the current U.S. population has atypical moles
- No matter what an atypical mole looks like, judging it to be benign or malignant just on its’ appearance is an unreliable method of determining if melanoma is present. Even a trained dermatologist can’t make that determination just by viewing it. The only way to ensure a correct diagnosis is through a biopsy followed by a pathological examination
- As with any other moles or skin cancers, atypicals can appear anywhere on the skin. This includes under the hair (scalp) and areas of skin that rarely, if ever, see the light of day
- People with an abnormal number of moles, atypical or otherwise, should be even more careful about exposure to the sun’s harmful UV (ultraviolet) rays. Exposing moles to UV radiation, whether from the sun or tanning lamps, is dangerous.
Severely atypical moles, such as the one on the left, are even more challenging to distinguish from melanomas. The right image was a melanoma. As a result, dermatologists generally treat severely atypical moles the same way as melanomas.
Atypical Moles vs. Melanoma
Additional source articles: Ncbi.gov, Common Moles, Dysplastic Nevi and Risk of Melanoma
Potentially fatal melanoma is an ugly disease, both literally and figuratively. But it is important to know that it does have several ugly, benign “mimics” that may look similar, yet aren’t harmful.
One such mimic is called Spitz nevus, which sounds scary but is nothing more than an uncommon, seldom cancerous mole that develops primarily in children, adolescents and young adults.
Unfortunately, it can be so close in appearance to melanoma that even a highly-experienced dermatologist may not be able to distinguish whether the mole is cancerous without a biopsy and pathology report. And sometimes even that may not even be enough to confirm a malignancy.
As a result, most doctors and dermatologists won’t make assumptions or take any chances until melanoma is confirmed or ruled out.
Some physicians are not so diligent, however. So, if during your monthly skin self-exam you’ve discovered a new mole, or a previous one, that has changed its color, size, shape- or has bled or oozed, see a dermatologist as quickly as possible. It is vital that you don’t play around with your skin’s health.
At the Melanoma Education Foundation, we fully understand that very few people, if anyone at all, ever looks forward to an appointment with his or her doctor. But the indisputable fact of the matter is that, regarding skin cancer and especially melanoma, the speed of detection and treatment can and will in a very large part determine the difference between whether a patient lives or dies. That is not hyperbole, and it really is just that simple.
And, if an excised mole turns out to be nothing, the patient will gain both peace of mind and the removal of an unsightly skin growth. So, what is there to lose?
This is a photograph of a Spitz Nevus:
Additional source articles: Healthline.com
Spitz Nevus: Mistaken Melanoma in Children
Most melanomas are initially discovered on the skin. However, in a small percentage (5%-10%) of people who’ve had a recent melanoma diagnosis, the disease has spread beyond their skin and into other organs or lymph nodes; with little-to-none of the initial blemish left visible.
Though the amount varies widely, to some extent we all have moles and skin growths. Occasionally, our immune system takes a disliking to one- and sets out to kill it. Once the body has set this ‘seek-and-destroy’ mission in motion the pigment, and thus the appearance and visibility of the targeted growth, slowly starts to dissipate. Sometimes, to the extent that a person can’t even tell that it was ever there at all.
If such a growth is benign (noncancerous) it’ll dissolve harmlessly. If it’s a malignant melanoma it is a real problem, and may be even more dangerous than the more traditional form of melanoma.
How can Regressive Melanoma be “More Dangerous” than Traditional Melanoma?
On the surface (so to speak) in and of itself regressive is not a deadlier version of melanoma. What makes it more dangerous though is that it’s much harder to see, and easier to misdiagnose, than a typical case. Melanoma is more often spotted by the patient than it is by his or her doctor. And the cure rate for melanoma is nearly 100% if it’s caught early enough. But regressive melanoma can metastasize (spread) without a patient even knowing it existed. Its remnants can be easily mistaken as nothing. And it’s totally natural for a medical layperson to assume that something “clearing up” is a good thing.
Our immune systems are a biological marvel; the lengths to which they go every day to protect us are truly extraordinary. Unfortunately, with regressive melanoma, their efforts to terminate cells that they believe to be harmful may be incomplete, allowing the disease to progress. In other words, they’re inadvertently helping melanoma conceal itself until it’s too late.
What can I do?
When performing your monthly skin self-exam, be sure to pay as much attention checking for moles and blemishes that appear to be fading unevenly, as you do to for those that are more visibly growing and changing. If either is found, schedule a dermatologist appointment quickly.
Here are two melanoma photos of both early and late-stage surface regression, presented respectively:
As can clearly be seen here, especially with the late-stage photo on the right, these blemishes appear to be healing. Healing marks of any kind tend to be disregarded.
That’s fine when it’s a simple, garden-variety bruise sustained from lightly bumping an arm against a countertop. But a fading skin growth, mole, or blemish should never be disregarded or ignored. They should be leant the same weight as any other suspicious change to the skin.
Melanomas with No Identified Primary Site
*Additional information sources: Melanoma Education Foundation (MEF) newsletter; Autumn 2015, Lloyd-derm.com
The appearance of melanomas can vary widely from one to another. They develop in many difference colors, sizes and other unique visual characteristics. For this reason, trying to discern whether a mole is cancerous just by looking at it isn’t a reliable method. Even dermatologists can’t always tell the difference based solely on appearance.
However, there is one distinctive warning sign that (nearly) always identifies a melanoma: change. it’s the most important reason why performing a regular monthly skin self-examination is so vital. It’s just as significant to check any pre-existing skin growths for change as it is to look for new ones.
What to Look for
This is a list of skin growth changes to help learn what it is you should be looking for:
– An increase in its diameter or elevation
– A change in its shape; especially if that shape has become irregular
– A change in its color or shade
– Persistent itching
– Any change in its surface, including:
- How it feels to your touch
- How it reacts to light (reflects)
- Development of one or more bumps- even if they’re small
- An ulceration (liquid-like appearance, such as found in an open sore)
- Bleeding spontaneously or upon minor trauma
Any of these changes that continue for 3 weeks or longer need to be checked out. Though any bleeding or ulcerations should be brought to the immediate attention of a dermatologist.
Please note that this list is a helpful guide, but it’s not all-inclusive. Any changes to skin growths that are not found here should not be ignored.
For more information about the two main types of melanoma, read our blog post Radial and Nodular Melanoma.CHANGE: The Most Important Melanoma Warning Sign
There is a lot to learn about melanoma. On the surface, it’s a fairly-straightforward subject; yet it’s also one that carries with it many important subtopics. This piece consists of selections from our previously published posts on the subject.
To view the original Melanoma Education Foundation (MEF) article on any of the topics below, simply click the link and you’ll be brought directly to it.
About Radial and Nodular Melanoma, the two primary forms of the worst skin cancer.
The reasons why exposing moles to sunlight is a very bad idea.
A discussion on the increased risk of melanoma to redheads.
For those with many moles, there is a tool that dermatologists can use to help keep tabs on patients’ skin health.
How to tell the difference between freckles and moles
Differentiating between normal and atypical moles.
A discussion of melanoma risk factors.
How to examine yourself for early signs of melanoma.
The differences and similarities between childhood melanoma and melanoma in adults.
Information on Acral Lentiginous Melanoma, which is more common in blacks, Hispanics and Asians than it is in whites.
The best form of the worst skin cancer.
Ocular Melanoma is a rare, deadly cancer that is not caused by UV (ultraviolet) ray exposure.
A quick visual quiz that tests your ability to tell benign moles from those that are cancerous.
What to do if a suspicious growth is found during a skin self-examination.
The excellent results from teachers who were surveyed regarding the effectiveness of the Melanoma Education Foundation’s (MEF) classroom melanoma lessons.A Melanoma Menu
Benign moles (or nevi) are so common that pretty much every human being on earth has them. In the language of medicine, “benign” means noncancerous. However, exposure to dangerous ultraviolet (UV) rays from our sun can create mutations on moles that cause nevi to turn from safely benign, to dangerously malignant (cancerous). UV rays even often promote a common mole’s formation to begin with.
In a report cited within an article posted by the Helen Diller Family Comprehensive Cancer Center, researchers in California have discovered a way to determine the direction moles take as they transform from skin lesions (“precursors”) to reaching their fully malignant, potentially fatal, forms.
This easy to remember chart shows the progression to melanoma upon UV exposure:
Normal mole (1 mutation) —> Atypical mole (several mutations) —> Melanoma (many mutations).
It was the data gathered by this group of scientists that confirmed the negative impact UV rays have on skin by initiating the growth of moles, as well as turning them cancerous. It also confirmed the existence of “intermediate lesions”, which are lesions whose benign or malignant status is not easily determined. The latter discovery will be greatly beneficial to dermatologists when choosing the treatment for their melanoma patients.
So, what does all of this mean to those of us who are non-medical laypersons? That has been neatly summarized by the words of Dr. Boris Bastian; the report’s senior author:
“A lot of melanomas have been sequenced at this point, and while it’s clear they carry UV-induced mutations, no one knew when they occurred…This study shows that they occur in benign moles, in the melanoma that arises from these moles, and in intermediate lesions. UV both initiates and causes the progression of melanoma, so exposing even benign moles to the sun is dangerous.”
Just because a mole is benign doesn’t mean it will stay that way. It’s very important to always take the appropriate skin protection precautions whenever we’re exposed to the sun.
Moles and Sun: A Dangerous Combination
*Additional information sources: University of California San Francisco, Helen Diller Family Comprehensive Cancer Center
If you have high skin cancer risk factors, or those who have over 50 moles, or too many moles to easily track yourself, mole mapping is a useful tool. Even better, the procedure is non-invasive and completely painless.
How Does Mole Mapping Work?
A dermatologist will take pictures and images of his or her patients that encompass the outer layer of skin. Once completed the records are archived. They’re then used later to check against future images and monitor any newly-developed moles; along with any changes to pre-existing ones.
This photograph depicts a patient undergoing mole mapping with her dermatologist:
It’s Not a Catchall
Research into mole mapping has revealed that it does increase the chances that dermatologists will discover early melanomas. (In one study, the odds increased by 17%).*
However, mole mapping should be used to augment, not replace, a person’s skin health care behaviors; as it has its limits. For instance, melanoma can develop on the scalp, which for most people is covered with hair that the cameras can’t see through. It can still miss cancerous moles, and there is always the possibility that a melanoma will develop and spread quickly during the time-gap between office visits.
For those reasons, it’s also important to perform monthly skin self-examinations, so any oddities can be brought swiftly to the attention of a dermatologist.
Working in tandem, skin self-exams and mole mapping will provide an even greater chance of catching and stopping a melanoma before it’s too late.
How do I Locate Dermatologists Who Provide Mole Mapping?
If you or someone you know is interested in mole mapping and would like to find local offices that perform it, start by running an internet search for “mole mapping services, ZZ”. When you do, simply replace the “ZZ” with your state’s postal abbreviation. (For example, Wyoming = WY, Minnesota = MN, etc.)
* Additional information sources: News-medical.net/health/Mole-Mapping.aspx (Catherine Shaffer, M.Sc.)
The name of this week’s skin cancer blog post may sound a bit like the title of a Grade B movie. However, it’s actually a reference to a common confusion between the two titled skin conditions that we very often come across. Hopefully, this piece will help to alleviate any confusion.
To help illustrate the differences, we’re going to provide some of the most useful information to have regarding freckles and flat moles. We’ll begin with the most important fact. Unlike flat moles, true freckles lack any cellular structure, which makes it impossible for any of them to turn cancerous. So if that’s ever in any way been a worry to either you or someone you know, you can put it out of your mind.
With that said, here are some answers to a few more freckle FAQ’s. A mole can be flat, raised or partially-raised. They’re often secluded on our skin, and when not they’re part of an irregular grouping of other moles. By contrast freckles, which are simply clusters of melanin (our natural skin pigment), are without exception always flat.
Unlike some moles, freckles are never present at birth. They present later, after sun-exposure, to people who are predisposed to getting them. Moles are usually darker than freckles, with the latter susceptible to lightening in the winter and darkening during the summer months. To literally illustrate the difference, here are photos of both. The left picture depicts flat moles, and the right one, freckles:
We’d kindly ask you to keep one thing in mind. While freckles by themselves are totally harmless, having them usually means having a light complexion and/or sun-damaged skin. As such, extra care should be taken in the form of monthly self-examination of your skin, and meticulous sunscreen use whenever you’re outdoors.
Freckles versus Moles
*Additional source: Melanoma Education Foundation (MEF) Newsletter (Spring 2013)
When a person begins educating him or herself about melanoma, some of the first relevant information they’ll come across will be on moles. They’re very important, as 90% of all melanomas begin on the skin and pretty much everyone has them.
Although you’ve surely seen them countless times, you may not be aware that there are two types: normal moles, and atypical moles. (Officially, dysplastic nevi).
Atypical moles have a much greater chance to develop into melanoma than do normal moles. The odds are about 1 in 100 with the former; yet fewer than 1 in 3,000 with the latter. Those who have an atypical mole(s) carry a stronger risk of melanoma. Incidentally, the appearance of hair on any mole is medically irrelevant. It carries no weight with regard to an increased risk of skin cancer.
No one should ever try to tell the two apart without a biopsy; as even a dermatologist cannot be certain without one. However, they do have some distinguishing characteristics that (in general) helps to tell them apart.
For instance, normal moles maintain the same color (most often brown), are round, oval, and sometimes domed in shape. They have well-defined borders and are less than a quarter-inch wide.
These are two examples of normal moles, both raised and flat:
Atypical moles are wider than a quarter-inch and may be multi-colored (brown or pink). They have uneven borders and an irregular shape. Raised dysplastic nevi display a “fried egg” look.
These are two examples of atypical moles, both raised and flat:
Familial Atypical Mole Syndrome
One thing they both do have in common is that their surface areas are usually smooth or cauliflower in texture.
Familial Atypical Mole Syndrome is a disorder that is passed along through our genes. If any close relatives (immediate family but also including grandparents, uncles and aunts) have or have had melanoma and if a large number of atypical moles are present, there’s a high risk of developing the disease.
While monthly self-examination is important for every person of either gender, all races and skin tones, it’s even more vital to those with Familial Atypical Mole Syndrome.
Below is an example of Familial Atypical Mole Syndrome: