From the Guidelines
If you notice a suspicious mole on your skin, you should see a healthcare provider promptly for evaluation. Look for warning signs using the ABCDE rule: Asymmetry (uneven shape), Border irregularity (ragged or blurred edges), Color variation (multiple colors within one mole), Diameter larger than 6mm (pencil eraser size), and Evolution (changes in size, shape, color, or symptoms like bleeding or itching) 1. While waiting for your appointment, document any changes by taking photos of the mole next to a ruler for size reference. Don't try to remove the mole yourself or apply over-the-counter treatments. Your doctor will examine the mole and may perform a biopsy if concerned. Early detection of skin cancer, particularly melanoma, significantly improves treatment outcomes. Regular skin self-examinations are recommended, especially for those with risk factors like fair skin, history of sunburns, multiple moles, or family history of skin cancer. Some key points to consider when evaluating a suspicious mole include:
- Asymmetry: If the mole is not symmetrical, it could be a warning sign for cancer 1.
- Border: A mole with a notched, ragged, or irregular border may be cancerous 1.
- Color: Moles with multiple colors or an unusual color could be a sign of cancer 1.
- Diameter: Moles larger than 6mm in diameter are more likely to be cancerous 1.
- Evolution: Changes in the size, shape, or color of a mole over time could indicate cancer 1. Remember that most moles are benign, but prompt medical attention for suspicious changes is essential for peace of mind and early treatment if needed. It's also important to note that some populations are at higher risk for skin cancer, including fair-skinned men and women older than 65 years, patients with atypical moles, and those with more than 50 moles 1. By being aware of these risk factors and taking steps to monitor your skin, you can help reduce your risk of skin cancer and improve treatment outcomes if you do develop the disease.
From the Research
Suspicious Finding of a Skin Mole
- A suspicious finding of a skin mole can be a cause for concern, and various treatment options are available depending on the diagnosis.
- For non-melanoma skin cancers (NMSCs), such as basal cell carcinomas (BCCs) and cutaneous squamous cell carcinomas (SCCs), treatment options include surgical excision, Mohs micrographic surgery, and topical imiquimod therapy 2.
- Topical imiquimod therapy has been shown to be effective in treating certain types of skin cancer, including BCCs and SCCs, especially in elderly patients who are not candidates for surgical excision 2, 3.
- However, for melanoma in situ (MIS), the standard of care is surgical removal, and topical imiquimod therapy should be used with caution due to the risk of invasive components 4.
Treatment Options for Melanoma in Situ
- Surgical excision with 5 mm margins is the standard of care for MIS, but other treatment options, such as Mohs surgery and radiation therapy, may be considered in certain cases 4.
- Topical imiquimod therapy has been proposed as an alternative treatment for MIS, but its effectiveness is still being studied, and more research is needed to determine its role in the treatment of MIS 3, 4.
Treatment Options for Nodular Basal Cell Carcinoma
- For nodular basal cell carcinoma (nBCC), surgical excision is the standard of care, but superficial curettage followed by imiquimod cream has been shown to be a viable alternative treatment option 5.
- A recent study found that superficial curettage followed by imiquimod cream was substantially less effective than surgical excision at 5 years after treatment, but still provided a 77.8% probability of remaining free from treatment failure 5.
Other Treatment Options
- Electrochemotherapy (ECT) has been shown to be a safe and effective treatment option for certain types of skin cancer, including squamous cell carcinoma (SCC) 6.
- Combined surgical selective excision with ECT and collagen dermal template (CDT) has been shown to be a valid technique for the extended-deep dorsal hand tumor lesions reconstruction 6.