Atypical Moles and Melanoma from a Memphis Dermatologist

by George Woodbury Jr. M.D. (12/12/2022)

About one American loses his or her life needlessly to Melanoma every 54 minutes, a common type of Skin Cancer. That’s about 9300 needless American deaths due to melanoma each year.

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.

Who's at high risk of Melanoma and Skin Cancer? Those with red or blond hair, those who burn easily or who have had blistering sunburns, and those who work in or play in the sun: skiers, golfers, roofers, construction personnel, and military staff.

As a practicing Board-certified Dermatologist, in Cordova, Tennessee, a suburb of Memphis, near Germantown, Bartlett, and Arlington, let me share with you what Melanoma and Atypical Moles are, and how you can spot them.

The skin’s protective pigment is called melanin, and it’s made from melanin-producing cells, called melanocytes. 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. So one cell can potentially go berserk and eventually kill a human whose body is actually made up of trillions of cells!

Below is a Melanoma on a person's forehead:

Melanoma 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 a normal growth in the skin, like a common mole.

Below is another photo of a Melanoma:

The warning signs of moles that Dermatologists watch for – as originally described by Dr Rigel of New York University’s Department of Dermatology – are the A, B, C, D, 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.

Below is a Melanoma that arose within an Atypical Mole:

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 “dyplastic moles” or “dysplastic nevi,” 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 to 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 Dyplastic Mole or Atypical Mole can sometimes be suspected by a Dermatologist based upon inspecting the skin and finding a mole that’s unduly dark, or with a raised center.

For photos of melanoma and normal moles and atypical moles look like, go to the Skin Cancer Foundation website, SCF.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.

So the moral of the story is: “See Spot. See Spot Change. See a Dermatologist.” My own 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 to find a Dermatologist closer to you, go to the American Society of Dermatology website, AAD.org, then plug your zip code into the “Find a Dermatologist” tab.

George Woodbury Jr. M.D.

(12/12/2022)