By Martha A. Simpson, D.O., M.B.A.
Assistant Professor of Family Medicine
Ohio University College of Osteopathic Medicine

KNOWING ALPHABET CAN HELP YOU SPOT DANGEROUS MOLES

Question: My husband has a lot of moles on his back. He frequently asks me to look at them for him. What am I looking for? He worries about his moles being bad, but I can’t get him to go to the doctor.

Answer: Moles are very common. The average Caucasian has about 20 moles on his or her body. Moles are less common in people with heavily pigmented skin, such as African Americans. Most moles are harmless, but it is important to watch moles and know which changes can signal possible danger.

Moles generally develop early in life and evolve over the life of the person. In childhood moles are flat, small brown lesions. Through adolescence and early adulthood, moles can grow in size and become slightly raised. During pregnancy moles can become darker and larger. After you reach the age of 70, your moles could start to fade and degenerate. This process may continue as you grow older.

Regardless of your stage of life, however, a normal mole has sharp borders or margins, a uniform color, a symmetrical shape, and a smooth outline or contour. In general a non-cancerous mole -- technically called a benign mole -- is also smaller than a pencil eraser and of a single color, usually pink to tan to dark brown.

When looking for an abnormal mole, it might be helpful to remember a mnemonic phrase that I’ve given to my medical students. It’s the first seven letters of the alphabet -- A-B-C-D-E-F-G. Each letter stands for an important clue that could indicate a cancerous mole. If you notice any of the following, ask your family doctor or dermatologist to take a look at the mole:
* Asymmetry (one side looks different than the other),
* Border irregularity,
* Color variation (two or three different colors in the same mole, such as black, brown, red, or white),
* Diameter over 6mm (pencil eraser),
* Elevation (raised above the skin surface),
* Feeling or change in sensation (e.g., itching or unusual sensation), and
* Growth (noticeable increase in size).

There is also the “ugly duckling sign.” This is a mole that stands out or looks very different from all the rest of the moles on your body.

Here are some additional things to look for that could signal that a mole is suspicious. A mole that ulcerates, or bleeds for over three weeks, moles that change in shape or color, and black lesions on non-sun exposed skin in Caucasian people.

The good news is that most moles are benign, but the best way to determine if you should be concerned about a mole is to visit your physician for a thorough skin exam. Some physicians will “map” patient’s moles and use this as a guide when doing follow up visits to see if moles have changed.

"Family Medicine" is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701. You can also email Dr. Simpson at simpsonm@ohio.edu Past columns are available online at http://www.FamilyMedicineNews.org.