A nevus is commonly called a mole; moles can be noncancerous (benign) or cancerous (malignant), present at birth (congenital) or develop after birth (acquired). Some moles are raised and some are flat, and they can range in color from skin-colored to pink, tan, brown, black, or even blue. Regardless of these differences, all moles are made up of collections of the pigment-producing cells of the skin. It is very difficult to look at a mole and know if it is cancerous or not. Some signs of malignancy include large size (bigger than a pencil eraser), rapid growth or change, multiple colors in one mole, or unusual shape. You should show any mole that you are concerned about to your doctor.
Atypical moles (atypical nevi) or dysplastic moles (dysplastic nevi), are caused by collections of the color-producing (pigment-producing) cells of the skin (melanocytes) in which the cells grow in an abnormal way. Atypical moles may occur as new lesions or as a change in an existing mole. Lesions may be single or multiple. In atypical-nevus syndrome, hundreds of atypical moles may be seen. People with atypical moles may be at increased risk for developing skin cancer (melanoma), with the risk increasing with the number of atypical moles present.
Skin cancer is the most common cancer in the United States, and it is the sixth most common cause of cancer death in the United States. Melanoma is the least common of the skin cancers (the other types are squamous cell carcinoma and basal cell carcinoma), but it is the most serious. It can be life threatening if it spreads (metastasizes) to other parts of the body. The frequency of diagnosis of melanoma has been increasing in recent years, faster than any other cancer.Melanoma starts in the color-producing cells of the skin and may develop in an existing mole or may occur as a new mole. Early diagnosis and treatment can lead to a complete cure, while advanced forms are likely to have a poor outcome. Advanced melanoma can spread to lymph nodes as well as other areas in the body, typically the lungs, liver, and brain.
A birthmark (congenital melanocytic nevus, CMN) is a mole that is present at birth or shortly thereafter. A congenital melanocytic nevus is one common type of birthmark, caused by a cluster of color (pigment) cells in the skin and sometimes in deeper tissues.All birthmarks have a 2–5% lifetime risk of turning into a cancerous (malignant) mole, which is called melanoma. This risk is higher in children who have a giant (larger than 20 cm, or about 8 inches) congenital melanocytic nevus.Large moles on the head or spine may rarely have associated nervous system problems.
Supernumerary nipple is a medical term to describe the presence of one or more "extra" nipples that might be present on a person's body. These are equally common in both males and females, and they are always benign (not life-threatening or cancerous).
Vitiligo is a disease where the immune system turns against itself (autoimmune disease) where immune cells of the body attack the color-producing (pigment-producing) cells to cause white patches on the skin, which may contain hairs that are white in color. It may be seen with other autoimmune diseases, such as thyroid disease, alopecia areata, diabetes mellitus, Addison disease, and myasthenia gravis. The way that vitiligo progresses varies greatly; it may remain in the area where it started (localized) or it may become more widespread.
Many dermatology patients will undergo a skin biopsy at some point during their lives, especially if they have a new lesion that could potentially be a skin cancer. During a biopsy, a sample of body tissue is taken so that a type of doctor, known as a pathologist, can examine the individual cells in the tissue under a microscope in order to make a more definitive diagnosis.
Since both moles and melanoma come from melanocytes, how can you tell the difference between a normal mole and a melanoma?
Personal account by Kierna Terrisse The first time I noticed the mole on my fiancé Eric’s upper arm, we were living in New York City. It was only a mole, so we ignored it. Three years later we were celebrating our honeymoon when I noticed the mole appeared more distinct. It looked strange, but still, neither of us gave it much attention. At the time I didn’t realize something so simple and harmless looking could kill you. If I knew then what I know now, things might have turned out much differently.
It can be difficult to determine if a mole on your body is a warning sign for skin cancer. Some patients come into my office worried about red moles on their skin because they look suspicious. Red moles are often not true moles but instead are cherry hemangiomas. These round, bright red or purple spots are made up of blood vessels and are 1–4 mm in size. A person can have many cherry hemangiomas all over his or her body. These lesions are benign and do not necessarily need to be removed, though many patients have them removed for cosmetic reasons. If raised, they can become bothersome, and if they are scraped, bumped, or injured, they may bleed or become painful.
A patient recently came in because – even though it was midwinter and her legs hadn’t seen sunlight for months – a mole on her left calf seemed to be changing, getting darker, maybe larger, too. She knew these changes were a warning sign for skin cancer. I’m always happy when a patient takes a proactive stance like this. And I’m relieved that we’re all becoming more educated about and aware of how skin changes – particularly in moles – can be a signal to pay attention and see your doctor. Such changes, even subtle ones, can be a precursor to skin cancer.
There are two types of moles, typical and atypical. Both require monitoring, especially when there is a history of extreme sun exposure.
Melanoma cancers are classified most frequently by their depth into the skin and the deeper layers of the skin. The pathologist reads the biopsy and measures the depth of the melanoma cancer cells under the microscope. There are several melanoma stages, an early melanoma is typically quite superficial. The hope is that people will recognize the early signs of melanoma, see their doctor, and have the lesion removed – and that the pathology report will reveal a melanoma that has not deeply invaded the skin. A melanoma that has not invaded into the deeper skin is called a “melanoma in situ.”
Did you know approximately 20 out of every 100,000 light-skinned people will develop malignant melanoma? With odds like that you might not think it’s worth it to give much thought to this cancer. But malignant melanoma is real. I was one of those 20 in 100,000. My story isn’t unusual. In fact, you may find that my sun exposure sounds a lot like yours. I’m in my 30s and spend most of my days inside at work. It’s been years since I spent my summers life guarding at the pool. Plus, as an adult I always wore sunscreen whenever I knew I was going to be outside for any length of time. So what happened? Why did I get malignant melanoma? And more important, how did I manage to detect it early when it really wasn’t a prominent concern on my health radar?