From the Guidelines
The ABCD rule, which includes Asymmetry, Border irregularities, Color heterogeneity, and Dynamics (or evolution in colors, elevation or size), is the most effective guideline for identifying suspicious moles that may indicate melanoma, as supported by the most recent study 1. When examining moles, it's essential to look for these characteristics, as well as the "ugly duckling" sign, which refers to a mole that looks different from the others. The following characteristics should raise concern:
- Asymmetry: one half of the mole doesn't match the other
- Border irregularity: edges are ragged or blurred
- Color variation: multiple colors within one mole
- Dynamics: changes in size, shape, color, or symptoms like itching or bleeding Regular skin self-examinations, performed monthly, can help identify suspicious moles early on, and any concerns should be immediately discussed with a dermatologist or primary care physician, as early detection significantly improves treatment outcomes for skin cancer, as noted in 1. Dermoscopy by an experienced physician can also enhance diagnostic accuracy, and automated videodermoscopy systems can provide improved diagnostic accuracy for patients with multiple atypical naevi in follow-up, as mentioned in 1. It's crucial to prioritize early detection and seek medical attention promptly if concerning changes are noticed, as early intervention can be lifesaving, and this is supported by the guidelines outlined in 1.
From the Research
Guidelines for Suspicious Moles
There are no specific guidelines for suspicious moles mentioned in the provided studies. However, the studies discuss various treatment options for skin cancers and melanoma, including:
- Surgical excision 2, 3, 4
- Topical imiquimod cream 2, 3, 5, 4, 6
- Intralesional interleukin (IL)-2 4
- Topical retinoid combination therapy 4
- Radiation therapy 6
Characteristics of Suspicious Moles
The studies do not provide specific characteristics of suspicious moles. However, they discuss various types of skin cancers and melanoma, including:
- Basal-cell carcinoma 2
- Melanoma in situ 3
- Superficial basal cell carcinomas 5
- Bowen's disease (squamous cell carcinoma in situ) 5
- Lentigo maligna (an in situ precursor of melanoma) 5
- Cutaneous metastatic melanoma 4
- Microinvasive melanoma (invasive radial growth phase melanoma) 6
Treatment Options
The studies discuss various treatment options for skin cancers and melanoma, including:
- Surgical excision: considered the best treatment for low-risk basal-cell carcinoma 2 and primary melanomas 6
- Topical imiquimod cream: may be a useful treatment option for small low-risk superficial or nodular basal-cell carcinoma 2, melanoma in situ 3, and microinvasive melanoma 6
- Intralesional interleukin (IL)-2: combined with topical imiquimod and retinoid, may be a promising therapeutic option for managing cutaneous melanoma metastases 4