The Dermatology Blog

By now most of you have heard about the US Iraq war veteran, Marine Corps Sgt. Carmelo Rodriguez, who died from melanoma at 29-years old. Read more…

Here is an excellent melanoma skin cancer website for patients as well as physicians. It provides good information about risk factors, moles and nevi, development of melanoma, diagnosis, staging, and treatment.

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Think that mole is too small to be a melanoma? Think again.

How far away is your dermatologist? Farther distances lead to thicker melanomas.

Is it normal for moles to change during pregnancy? No.

A common screening measure for determining if a mole is skin cancer is if the size is larger than 6 mm in diameter. This corresponds to the size of a pencil eraser.

However, new research has shown that at least in one study 55% of the melanomas were actually smaller than 6 mm in diameter. Although the commonly cited ABCDE (asymmetry, border, color, diameter, and evolving) guide to determining if a mole is suspicious is helpful, it is imperfect.

Unfortunately, melanoma is actually becoming more common; in fact, according to the National Cancer Institute:

In the United States … the percentage of people who develop melanoma has more than doubled in the past 30 years.

The good news is that melanoma is the only deadly cancer that can be diagnosed just by examining the skin. If you have a new, changing, or suspicious mole, even if it is smaller than a pencil eraser, then have it checked as soon as possible by your dermatologist.

Even a small melanoma is a melanoma.

How far away is your dermatologist?

A recent study from the University of North Carolina Chapel Hill published in the Archives of Dermatology showed that the farther a patient had to drive to get to a dermatologist, the thicker the melanoma at the time of diagnosis. They reviewed 615 cases of melanoma from patients in 42 counties in North Carolina and found that the thickness of the tumor (measured as the Breslow thickness) increased by 6% for every 10 miles traveled.

This is important because in melanoma, thicker cancers are more dangerous and more likely to have spread. Thin melanomas are usually cured by surgery alone; thick melanomas or metastatic melanomas are difficult to treat and can be life threatening.

Don’t let distance deter you. If you or a loved one has a new, suspicious, or changing mole, then hop in the car and have it checked. Even if you have to stop for gas on the way there.

It is a widely held belief that moles or nevi change during pregnancy. However, there is no convincing evidence to support this. There are many changes that happen to a woman’s skin when she is pregnant. She may develop melasma, brown splotches on her face, or linea nigra, brown pigmentation on her belly. She may also develop benign growths such as skin tags or angiomas.

It might be that some of these skin changes are misinterpreted as changes in the size or color of already existing moles. Also, since women’s skin stretches during pregnancy, moles might appear to be growing or spreading. This is not the same as a mole actually changing. According to an new review published in the December 2007 issue of the Journal of the American Academy of Dermatology:

The best data available … suggest that nevi do not typically change over the course of pregnancy; therefore a changing nevus during pregnancy should undergo biopsy, just as in a nonpregnant patient.

If you are pregnant, or are a physician who has a pregnant patient with a changing mole or nevus, then it should be evaluated by a dermatologist. Though uncommon, a new or changing nevus, can be a melanoma skin cancer.