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Do you harbor malignant melanoma?

By Stephen M. Schleicher, MD, Director, DermDOX Center for Dermatology

Although malignant melanoma accounts for only 3 percent of all cancers of the skin, it produces 65 percent of the deaths from skin cancer. In other words, malignant melanoma is the most uncommon but deadliest form of skin cancer. According to the American Academy of Dermatology, one American dies from skin cancer every sixty-two minutes.

Malignant melanoma may arise on normal skin or from a preexisting birthmark or mole. This skin cancer can afflict persons of all age groups, so anyone with a suspicious new growth or a change in color, size, or contour of an existing mole or birthmark should be examined by a dermatologist as soon as possible. Left unchecked, melanoma can spread to brain, lung, and lymph nodes with fatal results; detected early, the cure rate is very high.

        Everyone should be aware of the ABCDEs of melanoma recognition:

Asymmetry: One side of a mole does not look like the other side.

Border: Irregular or notched borders are a danger sign.

Color: Shades of red, white, or blue may be patriotic, but may also signify skin cancer.

Diameter: As a general rule, moles that are smaller than a pencil eraser are okay.

Elevation or Evolving: Increased height of an existing mole warrants evaluation, as does any change.

       One can also add the letter I, for itching, as this can be a sign that a mole is transforming into a skin cancer.

And keep in mind the ugly duckling rule as well. Moles on a given individual tend to look alike. The ugly duckling—the one that looks different from others—is more likely to be a melanoma, even if it doesn’t exhibit the classic ABCDE or I features.

Individuals at risk for melanoma should be examined by a dermatologist on a regular basis. Regular self-exams are prudent as well. Examine your body in front of a mirror and use a hand mirror to view your neck, scalp, back, and buttocks. The key to melanoma survival is early recognition, and both physicians and the public appear to be on the right track: the overall melanoma survival rate in the United States has climbed from under 60 percent in 1970 to over 90 percent in 2008.

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