Warning Signs of Melanoma


Melanoma is the most lethal of all the skin cancers. It is estimated that melanoma kills 10,130 people annually in the United States. Many of these deaths could be easily prevented with proper screening and catching the cancers in their infancy. These skin cancers are highly survivable if found early—before they are able to metastasize and affect internal organs. Being aware of the signs of melanoma is extremely important. Educating patients and their families about the warning signs of melanoma can extend life or possibly even prevent early death.

The ABCD&Es of melanoma are an effective method to educate our patients about the warning signs of melanoma.

A—Asymmetry. If a mole has one side that is larger than the other it is asymmetrical. An easy way to assess this is to draw an imaginary line through the center of the mole and compare the two sides. If one is larger than the other the mole is asymmetrical.


B—Border. Most benign moles have smooth borders that are even. Melanomas tend to have borders that are not smooth but instead uneven, possibly with scallops or notches.


C—Color. Benign moles are usually all one color often a shade of brown. When there are two or more colors present, the mole is a warning sign of melanoma. Secondary colors are frequently black, tan, red, white, or blue, as well as some deeper shades of brown.


D—Diameter. Normally benign moles will be smaller than 6 mm in diameter (the size of a pencil eraser), but melanomas frequently grow larger than this. While some moles that are benign can be this size or larger, most are not. The size of the lesion can be another warning sign.


E—Evolving. A typical benign mole will look the same over time with only minor changes occurring. Changes such as size, shape, color, elevation, or any other changing trait can be a warning sign of melanoma. In addition, symptoms such as burning, bleeding, itching, or crusting can indicate the need for further evaluation or possibly even biopsy.


Skin Cancer Foundation (2016). Melanoma. Retrieved September 28, 2016: http://www.skincancer.org/skin-cancer-information/melanoma

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About Author

Darrel Arthurs, ARNP, DCNP

Darrel Arthurs’ passion for dermatology developed while he was serving in active duty in the U.S. Navy. Since then he has accumulated over 11 years' experience in medical and surgical dermatology. Currently he works independently in a small city in northeastern Oklahoma. Arthurs is on the NADNP Board of Directors.

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