Dysplastic Nevus - Precaution For Individuals With Dysplastic Nevi

Precaution For Individuals With Dysplastic Nevi

Although there are limited data to support its efficacy, skin self-examination is frequently recommended for preventing melanoma (by identifying atypical moles that can be removed) or for early detection of existing tumors. Examination by a dermatologist has been shown to be beneficial for early melanoma detection. Some dermatologists recommend that an individual with either histologic diagnosis of dysplastic nevus, or clinically apparent atypical moles should be examined by an experienced dermatologist with dermatoscopy once a year (or more frequently).

The acronym ABCDE has been useful for helping health care providers and laypersons remember the key characteristics of a melanoma (see "ABCDE" mnemonic below) moles Changes (in shape, size, color, itching or bleeding) should be brought to the attention of a dermatologist .

A popular method for remembering the signs and symptoms of melanoma is the mnemonic "ABCDE":

• Asymmetrical skin lesion.
• Border of the lesion is irregular.
• Color: melanomas usually have multiple colors.
• Diameter: moles greater than 6 mm are more likely to be melanomas than smaller moles.
• Evolution: The evolution (i.e. change) of a mole or lesion may be a hint that the lesion is becoming malignant.

The E is sometimes omitted, as in the ABCD guideline. A weakness in this system is the D. Many melanomas present themselves as lesions smaller than 6 mm in diameter. An astute physician will examine all abnormal moles, including ones less than 6 mm in diameter. Unfortunately for the average person, many seborrheic keratosis, some lentigo senilis, and even warts may have ABCD characteristics, and cannot be distinguished from a melanoma without a trained eye or dermatoscopy.

A recent and novel method of melanoma detection is the "Ugly Duckling Sign" It is simple, easy to teach, and highly effective in detecting melanoma. Simply, correlation of common characteristics of a person's skin lesion is made. Lesions which greatly deviate from the common characteristics are labeled as an "Ugly Duckling", and a dermatologist exam is required. The "Little Red Riding Hood" sign suggests that individuals with fair skin and light colored hair might prove more challenging. These fair skinned individuals often have lightly pigmented or amelanotic melanomas which will not present with easy to observe color changes and variation in colors. The borders of these amelanotic melanomas are often indistinct, making visual identification without a dermatoscope (dermatoscopy) very difficult. A dermatoscope must be used to detect "ugly ducklings" among those with light skin or blonde/red hair.

People with a personal or family history of skin cancer or of dysplastic nevus syndrome (multiple atypical moles) should see a dermatologist at least once a year to be sure they are not developing melanoma.