Frequently, two or more of these features are present in one tumor. In
addition, basal cell carcinoma sometimes resembles noncancerous skin
conditions such as psoriasis or eczema. Only a trained physician, such
as a specialist in diseases of the skin, can decide for sure. If you
observe any of the warning signs or some other worrisome change in your
skin, consult your physician immediately.
An open sore that bleeds, oozes, or crusts and remains open for a
few weeks only to heal up and then bleed again. A persistent, non
–healing sore is a very common sign of an early basal cell carcinoma.
A Reddish Patch or irritated area, frequently
occurring on the face, chest, shoulders, arms or legs. Sometimes the
patch crusts, and it may also itch or hurt. At other times, it persists
with no noticeable discomfort.
A Shiny Bump or nodule that is pearly or
translucent and is often pink, red or white. The bump can also be tan,
black or brown, especially in dark-haired people, and can be confused
with a mole.
A Pink Growth with a slightly elevated rolled
border and a crusted indentation in the center. As the growth slowly
enlarges, tiny blood vessels may develop on the surface.
A Scar-Like Area which is white, yellow or waxy,
and often has poorly defined borders. The skin itself appears shiny and
taut. This warning sign can indicate the presence of small roots, which
make the tumor larger than it appears on the surface.
Moles, brown spots and growths on the skin are usually harmless —
but not always. Anyone who has more than 100 moles is at greater risk
for melanoma. The first signs can appear in one or more atypical moles.
That's why it's so important to get to know your skin very well and to
recognize any changes in the moles on your body. Look for the ABCDEs of melanoma, and if you see one or more, make an appointment with a physician immediately.
Asymmetry
If you draw a line through this mole, the two halves will not match.
Border
The borders of an early melanoma tend to be uneven. The edges may be scalloped or notched.
Color
Having a variety of colors is another warning signal. A number of
different shades of brown, tan or black could appear. A melanoma may
also become red, blue or some other color.
Diameter
Melanomas usually are larger in diameter than the size of the eraser
on your pencil (1/4 inch or 6 mm), but they may sometimes be smaller
when first detected.
Evolving
Any change — in size, shape, color, elevation, or another trait, or
any new symptom such as bleeding, itching or crusting — points to
danger.
Prompt action is your best protection. The pictures below show atypical normal moles and melanomas.
A recently developed early detection tool can improve early diagnosis critical to the successful treatment of melanoma.
For many years, the early warning signs of melanoma have been
identified by the acronym "ABCDE" (A stands for Asymmetry, B stands for
Border, C for Color, D for Diameter and E for Evolving or changing was
recently added.). While the ABCDE rule helps detect many melanomas,
there are a group of melanomas that do not manifest the ABCDE features.
Recently, several melanoma specialists developed a new method of sight
detection for skin lesions which could be melanoma.
This new method
of sight detection for skin lesions is based on the concept that these
melanomas look different -- ie, "the ugly duckling" -- compared to
surrounding moles. Thus, during skin self examination, patients and
physicians should be looking for lesions that manifest the ABCDE's AND
for lesions that look different compared to surrounding moles.
As reported in December 2007 issue of The Melanoma Letter,
a publication of The Skin Cancer Foundation, an approach combining the
ABCDEs and the “Ugly Duckling” technique should improve the chances of
early detection of all types of melanoma. In the article "The “Ugly
Duckling” Sign: An Early Melanoma Recognition Tool For Clinicians and
the Public" by Dr. Alon Scope and Dr. Ashfaq A. Marghoob of Memorial
Sloan Kettering Cancer Center (New York, NY), the premise of the ugly
duckling sign is that the patient’s “normal” moles resemble each other,
like siblings.
The doctors suggest thinking of "the ugly duckling" mole, aka “the outlier”, as the lesion that, at a given moment in time, looks or feels different than the patient’s other moles, or that over time, changes differently
than the patient’s other moles. The “ugly duckling” methodology may be
especially useful in the detection of nodular melanoma, a dangerous
type of melanoma, which notoriously lacks the classic ABCDE signs.
These three different scenarios depict “ugly ducklings” moles that should prompt
suspicion. Squares A, B, and C each represent a body area such as the back.
In A, there is a dominant mole pattern with slight variation in
size. The "ugly duckling" is clearly darker and larger than all other
moles.
In B, there are two predominant patterns, one of larger moles and
the other of smaller, darker moles. The "ugly duckling" is small but
lacks pigmentation.
In C, there is only one lesion on the back. If this lesion is
changing, symptomatic, or deemed atypical, see a
doctor and have this "ugly duckling" examined.
The best way to identify an "ugly duckling" is to perform a self-examination of your skin monthly. Instructions on how to perform a skin self-examination are available from The Skin Cancer Foundation. If you spot an "ugly duckling", see a dermatologist without delay.
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